Pr discharge day management hospital ip/obs > 30 min on encounter date 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

$225.10

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.

$225.10

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.

$111.61 with Aetna vs $231.82 with Community Health Options — 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 $111.61 ↓ -50%
Cigna Commercial $112.55 ↓ -50%
United Healthcare Medicare Advantage $121.54 ↓ -46%
Anthem Medicare Advantage $121.54 ↓ -46%
Wellcare Medicare Advantage $126.41 ↓ -44%
Aetna Medicare Advantage $128.35 ↓ -43%
Humana Medicare Advantage $128.35 ↓ -43%
Aetna HMO/PPO $136.70 ↓ -39%
Anthem HMO/POS/PPO Pathway Enhanced $202.26 ↓ -10%
Multiplan Commercial $205.66 ↓ -9%
United Healthcare Commercial $216.48 ↓ -4%
Harvard Pilgrim Healthcare Commercial $218.44 ↓ -3%
Harvard Pilgrim Healthcare Maine's Choice $218.44 ↓ -3%
Aetna MHACO Commercial $226.60 ↑ +1%
Community Health Options Commercial $231.82 ↑ +3%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Pr discharge day management hospital ip/obs > 30 min on encounter date at other Maine hospitals

Hospital City Cash price Negotiated range
Franklin Memorial Hospital Farmington $246.80 $111.61 – $231.82
Stephens Memorial Hospital Norway $338.05 $111.61 – $231.82
Pen Bay Medical Center Rockport $363.10 $110.37 – $231.82
Spring Harbor Hospital Westbrook $344.10 $82.40 – $230.46
Waldo County General Hospital Belfast $280.80 $111.61 – $231.82
Mid Coast Hospital Brunswick $279.45 $109.28 – $231.82

All Maine hospitals for this procedure →