CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Houlton Regional Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$97
about 1.0× the $95 Medicare rate · typically $59–$157
modeled estimate · not a bill or quote
What this hospital charges insurers
$105
About the fair price
about $8 over the fair price · 1.1× Medicare
Medicare pays $95 Fair price $97 This hospital $105 Cash price $160 Hospital's list price $168

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

On the higher side — 6 of 8 other ME hospitals charge less.

Cheapest $63 Priciest $125

Black dot = this hospital, among the 9 ME hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $97 (about 1.0× the $95 Medicare rate). Houlton Regional Hospital charges insurers about $105, or about $160 in cash — about the fair price. Located in Houlton, 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✓ Cigna HumanaKaiser 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 $116 - $180 122%
Blue Cross Blue Shieldmajor $74 - $160 78%
Aetnamajor $75 - $106 79%
Cignamajor $111 - $173 117%
WellCare $75 - $105 79%
+ 2 smaller / regional plans $62 - $167
Government programs also on file: Military & VA.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 20 Hartford Street, Houlton, ME 04730
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals