CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Central Maine Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$18,674

about 1.3× the $14,044 Medicare rate · typically $15,124–$22,836

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,125

Below the fair price — a good deal

about $3,549 under the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $18,674 This hospital $15,125 Cash price $15,718

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

One of the lower prices — 6 of 7 other ME hospitals charge more for the same procedure.

Cheapest $14,143 Priciest $25,062

Black dot = this hospital, among the 8 ME hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $18,674 (about 1.3× the $14,044 Medicare rate). Central Maine Medical Center charges insurers about $15,125, or about $15,718 in cash — below the fair price — a good deal. Located in Lewiston, ME.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$15,125 - $15,718	108%
Blue Cross Blue Shieldmajor	$15,125 - $34,855	108%
Aetnamajor	$15,125	108%
Humanamajor	$15,125	108%
WellCare	$15,125	108%
+ 1 smaller / regional plan	$38,133

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,718), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Central Maine Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Central Maine Medical Center

Compare: Hip or knee replacement (inpatient stay) at other ME hospitals

Mainehealth Mid Coast Hospital · Brunswick $14,143
Mainehealth Maine Medical Center · Portland $16,659
Cary Medical Center · Caribou $17,447
Mainehealth Pen Bay Hospital · Rockport $19,483
Rumford Hospital · Rumford $22,740
Bridgton Hospital · Bridgton $22,740
St Mary's Regional Medical Center · Lewiston $25,062

Insurance negotiated median for the same procedure, sorted lowest first.