Closed tx humerus fx with manip 23605 at Lincoln Health
35 Miles St, Damariscotta, ME · MaineHealth · · NPI 1912094806
$951.90
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.
$951.90
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.
$343.63 with Humana vs $875.25 with Aetna — 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 |
|---|---|---|---|
| Humana | Medicare Advantage | $343.63 | ↓ -64% |
| Aetna | Medicare Advantage | $343.63 | ↓ -64% |
| United Healthcare | Medicare Advantage | $343.63 | ↓ -64% |
| Anthem | Medicare Advantage | $353.94 | ↓ -63% |
| Wellcare | Medicare Advantage | $357.38 | ↓ -62% |
| Aetna | MHACO Government | $416.60 | ↓ -56% |
| Aetna | HMO/PPO | $556.27 | ↓ -42% |
| Harvard Pilgrim Healthcare | Maine's Choice | $765.94 | ↓ -20% |
| Multiplan | Commercial | $776.06 | ↓ -18% |
| United Healthcare | Commercial | $816.90 | ↓ -14% |
| Anthem | HMO/POS/PPO Pathway Enhanced | $818.12 | ↓ -14% |
| Cigna | Commercial | $821.10 | ↓ -14% |
| Community Health Options | Commercial | $833.13 | ↓ -12% |
| Harvard Pilgrim Healthcare | Commercial | $851.04 | ↓ -11% |
| Aetna | MHACO Commercial | $875.25 | ↓ -8% |
Visitor-reported prices
Comments
Closed tx humerus fx with manip 23605 at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Memorial Hospital | Farmington | $3,878.20 | $416.60 – $939.28 |
| Stephens Memorial Hospital | Norway | $564.60 | $113.24 – $275.83 |
| Pen Bay Medical Center | Rockport | $1,248.45 | $319.43 – $486.66 |
| Waldo County General Hospital | Belfast | $1,024.40 | $411.50 – $904.87 |
| Spring Harbor Hospital | Westbrook | not published | $423.18 – $939.28 |
| Mid Coast Hospital | Brunswick | not published | $416.60 – $939.28 |