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Tonsillectomy (child under 12) at Mid Coast Hospital
123 Medical Center Drive, Brunswick, ME · MaineHealth · · NPI 1932164795
not published by hospital
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
not published by hospital
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$260.52 with Aetna vs $557.83 with Community Health Options — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Aetna | MHACO Government | $260.52 | — |
| Anthem | Medicare Advantage | $262.17 | — |
| United Healthcare | Medicare Advantage | $262.17 | — |
| Aetna | Medicare Advantage | $267.41 | — |
| Humana | Medicare Advantage | $301.50 | — |
| Wellcare | Medicare Advantage | $301.50 | — |
| Aetna | HMO/PPO | $347.86 | — |
| Anthem | HMO/POS/PPO/Pathway Enhanced | $347.98 | — |
| Multiplan | Commercial | $509.01 | — |
| Harvard Pilgrim Healthcare | Commercial | $524.90 | — |
| Harvard Pilgrim Healthcare | Maines Choice | $524.90 | — |
| United Healthcare | Commercial | $535.80 | — |
| Aetna | MHACO Commercial | $545.37 | — |
| Community Health Options | Commercial | $557.83 | — |
Visitor-reported prices
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Tonsillectomy (child under 12) at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Memorial Hospital | Farmington | not published | $260.52 – $557.83 |
| Stephens Memorial Hospital | Norway | not published | $260.52 – $557.83 |
| Lincoln Health | Damariscotta | not published | $260.52 – $557.83 |
| Pen Bay Medical Center | Rockport | not published | $260.52 – $557.83 |
| Spring Harbor Hospital | Westbrook | not published | $262.17 – $553.76 |
| Waldo County General Hospital | Belfast | not published | $260.52 – $557.83 |