Ghs clsd tx frac distal tibia w/manipulation at Lincoln Health

35 Miles St, Damariscotta, ME · MaineHealth · · NPI 1912094806

Source: hospital's published price file ↗ · Published Sep 9, 2025 · Ingested Aug 12, 2026

$933.90

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.

Full explanation →

What you pay up front if you don't use insurance.

$933.90

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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$478.84 with Aetna vs $1,080.63 with Harvard Pilgrim Healthcare — same scan, same building. Share

Negotiated rates by payer
?

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 $478.84 ↓ -49%
United Healthcare Medicare Advantage $529.18 ↓ -43%
Anthem Medicare Advantage $529.18 ↓ -43%
Wellcare Medicare Advantage $550.35 ↓ -41%
Humana Medicare Advantage $550.67 ↓ -41%
Aetna Medicare Advantage $550.67 ↓ -41%
Aetna HMO/PPO $639.40 ↓ -32%
Multiplan Commercial $888.52 ↓ -5%
United Healthcare Commercial $935.28 ↑ +0%
Anthem HMO/POS/PPO Pathway Enhanced $986.49 ↑ +6%
Cigna Commercial $994.46 ↑ +6%
Aetna MHACO Commercial $995.02 ↑ +7%
Community Health Options Commercial $1,039.06 ↑ +11%
Harvard Pilgrim Healthcare Maine's Choice $1,080.63 ↑ +16%
Harvard Pilgrim Healthcare Commercial $1,080.63 ↑ +16%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Ghs clsd tx frac distal tibia w/manipulation at other Maine hospitals

Hospital City Cash price Negotiated range
Franklin Memorial Hospital Farmington $4,931.10 $478.84 – $1,080.63
Stephens Memorial Hospital Norway $654.75 $135.58 – $330.27
Pen Bay Medical Center Rockport $2,884.30 $478.84 – $1,080.63
Waldo County General Hospital Belfast $1,056.60 $424.44 – $994.46
Spring Harbor Hospital Westbrook not published $483.79 – $1,080.63
Mid Coast Hospital Brunswick not published $478.84 – $1,080.63

All Maine hospitals for this procedure →