Emergency Department Visit with High Level of Medical Decision Making Cost in Maine
What this costs without insurance: real self-pay cash prices and insurance-negotiated rates at 27 Maine hospitals. CPT 99285. Sourced directly from each facility's CMS-mandated transparency file. Dataset: Q4 2026.
📊 Median $513
📉 Low $30.00
📈 High $1,015
🏥 27 hospitals
🏛️ 24 with insurance contracts
🇺🇸 Medicare $164
Hospital comparison — Maine
Sorted by cash price (lowest first). Showing top 27 of 27 hospitals.
Billed more than $513 for this? That gap is evidence.
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| Hospital | Cash | Aetna | UHC | Centene | Cigna | Humana | MultiPlan | Medicare | TRICARE |
|---|---|---|---|---|---|---|---|---|---|
| NORTHERN MAINE MEDICAL CENTER FORT KENT |
$30.00 | $365 | $365 | $365 | $644 | $365 | $631 | — | $586 |
| SEBASTICOOK VALLEY HOSPITAL PITTSFIELD |
$77.86 | $162 | $165 | $165 | $277 | — | — | — | — |
| MOUNT DESERT ISLAND HOSPITAL BAR HARBOR |
$93.60 | — | — | — | — | — | — | — | — |
| NORTHERN LIGHT A R GOULD HOSPITAL ACADEMY ST. PRESQUE ISLE |
$190 | $150 | $165 | $165 | $277 | — | — | — | — |
| EASTERN MAINE MEDICAL CENTER STATE ST BANGOR |
$190 | $150 | $165 | $165 | $277 | — | — | — | — |
| NORTHERN LIGHT MERCY HOSPITAL PORTLAND |
$235 | $150 | $168 | $168 | $277 | — | — | — | — |
| DOWN EAST COMMUNITY HOSPITAL MACHIAS |
$246 | $274 | $282 | $144 | $296 | $144 | — | — | — |
| NORTHERN LIGHT BLUE HILL MEMORIAL HOSPITAL WATER ST. BLUE HILL |
$352 | $162 | $165 | $165 | $277 | — | — | — | — |
| MAINEHEALTH LINCOLN HOSPITAL DAMARISCOTTA |
$389 | $172 | $186 | $193 | $195 | $198 | $315 | — | — |
| HOULTON REGIONAL HOSPITAL HARTFORD STREET HOULTON |
$429 | $429 | — | — | — | — | — | — | — |
| MID COAST HOSPITAL BRUNSWICK |
$454 | $168 | $164 | $189 | $227 | $189 | $320 | — | — |
| NORTHERN LIGHT CA DEAN HOSPITAL PRITHAM AVE GREENVILLE |
$475 | $165 | $165 | $165 | $277 | — | — | — | — |
| MILLINOCKET REGIONAL HOSPITAL MILLINOCKET |
$487 | $481 | — | $184 | $501 | $186 | — | $184 | — |
| MAINE MEDICAL CENTER PORTLAND |
$513 | $168 | $164 | $189 | $257 | $189 | $320 | — | — |
| WALDO COUNTY GENERAL HOSPITAL BELFAST |
$559 | $172 | $198 | $206 | $279 | $198 | $315 | — | — |
| CENTRAL MAINE MEDICAL CENTER LEWISTON |
$587 | $588 | $588 | $588 | — | $588 | — | $588 | $588 |
| PENOBSCOT VALLEY HOSPITAL LINCOLN |
$639 | $188 | $184 | $162 | $751 | $184 | — | $160 | — |
| NORTHERN LIGHT MAINE COAST HOSPITAL ELLSWORTH |
$647 | $162 | $162 | $162 | $277 | — | — | — | — |
| NORTHERN LIGHT MAYO HOSPITAL DOVER FOXCROFT |
$670 | $162 | $162 | $165 | $277 | — | — | — | — |
| MAINEHEALTH FRANKLIN HOSPITAL FARMINGTON |
$670 | $172 | $198 | $198 | $335 | — | $315 | — | — |
| CALAIS COMMUNITY HOSPITAL CALAIS |
$755 | $865 | $208 | $443 | $846 | $443 | — | — | — |
| MAINEHEALTH MAINE MEDICAL CENTER BIDDEFORD BIDDEFORD |
$779 | $168 | $164 | $189 | $389 | $189 | $320 | — | — |
| REDINGTON-FAIRVIEW GENERAL HOSPITAL FAIRVIEW AVE SKOWHEGAN |
$837 | $1,116 | $1,116 | — | — | $1,116 | — | — | — |
| PEN BAY MEDICAL CENTER ROCKPORT |
$922 | $168 | $189 | $169 | $461 | $189 | $320 | — | — |
| RUMFORD HOSPITAL RUMFORD |
$922 | — | — | — | — | — | — | — | — |
| BRIDGTON HOSPITAL BRIDGTON |
$986 | — | — | — | — | — | — | — | — |
| STEPHENS MEMORIAL HOSPITAL NORWAY |
$1,015 | $172 | $198 | $206 | $508 | $198 | $315 | — | — |
What these prices are. Each figure is the facility’s own published self-pay (cash) price for CPT 99285, filed under the federal price transparency rule (45 CFR Part 180). Hospital facility charges may not include separate physician, anesthesia, or pathology fees. National median for this code: $1,180 across all reporting facilities. Dataset: Q4 2026. Always confirm the final price with the facility before booking.
Billed more than $513 for this?
That is the median of what the 27 Maine hospitals above publish for Emergency department visit with high level of medical decision making — their own figures, filed under federal law. A bill well above them is evidence you can put in writing.
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Medicare reimbursement benchmark
For CPT 99285 in Maine, Medicare reimburses about $164 on the 2026 Physician Fee Schedule (non-facility, state average across localities). Hospital cash prices for the same code in Maine range from $30.00 to $1,015 — that means hospital cash prices are typically 3.1x what Medicare pays. If a self-pay quote you receive is more than 2-3x the Medicare rate, ask the hospital for the cash-discount price in writing.
Frequently asked questions
- How much does emergency department visit with high level of medical decision making cost in Maine?
- Cash prices for emergency department visit with high level of medical decision making (CPT 99285) in Maine range from $30.00 to $1,015, with a median of $513. Prices vary widely by hospital.
- Where can I find the cheapest emergency department visit with high level of medical decision making in Maine?
- The cheapest Maine hospital published cash price for this procedure is $30.00. Use the table above sorted by cash price to find the lowest-priced facility near you.
- Are these the prices I'll pay?
- These are the rates hospitals publish. Final price depends on your insurance, deductible, and the specific services billed. Always confirm with the facility and your insurer before any procedure.
- Why do prices vary so much between hospitals?
- Hospitals set cash prices independently, and insurance contracts negotiate different rates per payer. Two facilities a few miles apart can charge 5-10x different prices for the same procedure.
- Where does this data come from?
- Federal law (45 CFR § 180) requires hospitals to publish their pricing in a machine-readable file. We aggregate these files and republish in a consumer-friendly format.
Emergency department visit with high level of medical decision making in nearby states
Other procedures in Maine
Methodology. Cash prices and insurance-negotiated rates published by each Maine facility under federal price transparency rules (45 CFR § 180). CPT code 99285 (Doctor Visits). Data refreshed regularly; verify with the facility before any procedure.