Pneumonia, with complications in Maine
MS-DRG 194: Simple pneumonia and pleurisy with cc
$25,324typical hospital bill
$7,458typical amount paid
$6,534–$8,693range paid across 8 hospitals
Maine hospitals billed Medicare a typical $25,324 for this stay in 2024, about 3.4 times what was actually paid. Medicare's payment depends mostly on the hospital's location and teaching role; the bill depends on the hospital's own price list, so bills vary far more than payments.
Billed (list price)Actually paid (Medicare + patient)
| Hospital | City | Medicare stays | Billed | Paid | |
|---|---|---|---|---|---|
| Northern Light Eastern Maine Medical Center | Bangor | 22 | $26,892 | $6,534 | |
| Mainehealth Mid Coast Hospital | Brunswick | 18 | $24,360 | $6,537 | |
| St Joseph Hospital | Bangor | 19 | $19,743 | $7,269 | |
| Central Maine Medical Center | Lewiston | 13 | $20,845 | $7,341 | |
| Cary Medical Center | Caribou | 18 | $14,128 | $7,575 | |
| Maine General Medical Center | Augusta | 30 | $27,457 | $8,265 | |
| Southern Maine Health Care | Biddeford | 11 | $26,288 | $8,662 | |
| Mainehealth Maine Medical Center | Portland | 22 | $28,201 | $8,693 |
Medicare: CMS, 2024 (hospitals with 11 or more Medicare stays). Cash and insurer prices: hospitals' own price files, where read; insurer figures are commercial plans only, median and 10th–90th percentile across plans.