Nursing facility discharge management 30 min/less than 99315 at Lincoln Health
35 Miles St, Damariscotta, ME · MaineHealth · · NPI 1912094806
$136.40
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.
$136.40
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.
$68.20 with Cigna vs $164.70 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 |
|---|---|---|---|
| Cigna | Commercial | $68.20 | ↓ -50% |
| Aetna | MHACO Government | $79.44 | ↓ -42% |
| United Healthcare | Medicare Advantage | $86.40 | ↓ -37% |
| Anthem | Medicare Advantage | $86.40 | ↓ -37% |
| Wellcare | Medicare Advantage | $89.86 | ↓ -34% |
| Humana | Medicare Advantage | $91.36 | ↓ -33% |
| Aetna | Medicare Advantage | $91.36 | ↓ -33% |
| Aetna | HMO/PPO | $93.76 | ↓ -31% |
| Anthem | HMO/POS/PPO Pathway Enhanced | $122.69 | ↓ -10% |
| Multiplan | Commercial | $146.91 | ↑ +8% |
| United Healthcare | Commercial | $154.64 | ↑ +13% |
| Harvard Pilgrim Healthcare | Commercial | $156.11 | ↑ +14% |
| Harvard Pilgrim Healthcare | Maine's Choice | $156.11 | ↑ +14% |
| Aetna | MHACO Commercial | $162.16 | ↑ +19% |
| Community Health Options | Commercial | $164.70 | ↑ +21% |
Visitor-reported prices
Comments
Nursing facility discharge management 30 min/less than 99315 at other Maine hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Stephens Memorial Hospital | Norway | $204.10 | $79.44 – $164.70 |
| Waldo County General Hospital | Belfast | $179.50 | $79.44 – $164.70 |
| Franklin Memorial Hospital | Farmington | not published | $79.44 – $164.70 |
| Pen Bay Medical Center | Rockport | not published | $78.59 – $164.70 |
| Spring Harbor Hospital | Westbrook | not published | $77.81 – $164.71 |
| Mid Coast Hospital | Brunswick | not published | $77.81 – $164.70 |