How many shoppable procedure prices are published for Calais Community Hospital?

Calais Community Hospital in Calais, ME currently has 103 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Calais Community Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Calais Community Hospital's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-09-29

Calais Community Hospital

24 Hospital Lane, Calais, ME 04619 · 103 Priced Procedures · 72% Patient Recommendation

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.93×vs. Fair Market Price

Typical commercial prices here are 7% below the fair benchmark (0.93×) after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 43% of the Time

File Completeness100

Price Logic64

Peer Alignment64

Clean Billing85

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Calais Community Hospital prices routine shoppable procedures near 1.0× Medicare (p50 0.92×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 1.16×, +26% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#15 of 27 in ME · 51st State Percentile#856 of 3,385 in U.S. · 25th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 7% below peer Fair BaseRate (0.93×)
Self-pay cash beats commercial insurance on 43% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (68/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (40.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (1.1×) & laboratory (1.1×) services average 1.80× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.16×) jump +26% above the median procedure ratio (Q50 0.92×)
Unnegotiated chargemaster list prices average 7.8× Medicare (20¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.0× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.80× Divergence

1.8× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+26% Upper Tail

Q25 0.57× · Q50 0.92× · Q75 1.16×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.1× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.1× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.0× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

43% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 68/100Fair

Procedure Prices at Calais Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 103 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$51,587	$51,587	$19,432	2.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$14,751	$3,462	$3,372	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$13,977	$3,279	$6,109	0.5×
Inguinal hernia repair CPT Code: `49505`	$11,612	$2,726	$3,629	0.8×
Colonoscopy with biopsy CPT Code: `45380`	$772	$772	$1,256	unverified
Rabies immune globulin HCPCS Code: `90375`	$3,149	$739	$322	2.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$626	$626	$981	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$2,411	$515	$987	0.5×
MRI, knee or other leg joint CPT Code: `73721`	$1,910	$448	$369	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,042	$421	$448	0.9×
Blood transfusion CPT Code: `36430`	$1,812	$425	$498	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,749	$356	$303	1.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,676	$331	$511	0.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,273	$300	$583	0.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,247	$262	$258	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$1,182	$239	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,182	$239	$343	0.7×
Psychiatric evaluation (first visit) CPT Code: `90791`	$225	$225	$185	unverified
CT scan, head (no contrast) CPT Code: `70450`	$840	$179	$160	1.1×
CT scan, pelvis CPT Code: `72192`	$868	$180	$163	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$880	$181	$167	1.1×
CT scan, sinuses CPT Code: `70486`	$879	$179	$166	1.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$880	$180	$168	1.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$880	$180	$169	1.1×
CT scan, head (with contrast) CPT Code: `70460`	$937	$196	$242	0.8×
Sleep study (overnight, in lab) CPT Code: `95810`	$844	$198	$1,021	0.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$576	$135	$272	0.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$535	$108	$134	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$106	$106	$201	0.5×
Typhoid vaccine HCPCS Code: `90675`	$1,004	$236	$347	0.7×
Pneumococcal vaccine HCPCS Code: `90732`	$758	$178	$140	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$605	$142	$203	0.7×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$81	$81	$3	27.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$87	$87	$6	14.5×
Blood test, magnesium CPT Code: `83735`	$96	$96	$7	13.7×
Blood test, lipase CPT Code: `83690`	$78	$78	$7	11.1×
Blood test, liver function panel CPT Code: `80076`	$97	$97	$9	10.8×
Blood test, calcium CPT Code: `82310`	$61	$61	$5	12.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$61	$61	$5	12.2×
Blood test, amylase CPT Code: `82150`	$74	$74	$7	10.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	$83	$83	$8	10.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$103	$103	$10	10.3×
X-ray, shoulder CPT Code: `73030`	$338	$79	$92	0.9×
X-ray, foot CPT Code: `73630`	$338	$79	$92	0.9×
X-ray, hand CPT Code: `73130`	$338	$79	$93	0.8×
X-ray, ankle CPT Code: `73610`	$338	$79	$93	0.8×
X-ray, hip CPT Code: `73502`	$314	$74	$93	0.8×
Drug screening test HCPCS Code: `G0480`	$91	$91	$116	unverified
Blood test, sodium CPT Code: `84295`	$57	$57	$5	11.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$341	$80	$111	0.7×
Blood test, potassium CPT Code: `84132`	$54	$54	$5	10.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$46	$46	$5	9.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$145	$34	$20	1.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$160	$37	$25	1.5×
Colorectal cancer screening HCPCS Code: `G0010`	$54	$54	$49	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$252	$59	$56	1.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$48	$48	$49	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$296	$69	$86	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$242	$57	$93	0.6×
X-ray, lower back CPT Code: `72110`	$304	$64	$112	0.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$353	$70	$126	0.6×
Ultrasound, pelvis CPT Code: `76856`	$368	$71	$130	0.5×
Ultrasound, thyroid and neck CPT Code: `76536`	$349	$70	$132	0.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$107	$25	$11	2.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$105	$25	$14	1.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$107	$25	$14	1.8×
Blood test, vitamin D CPT Code: `82306`	$155	$36	$31	1.2×
X-ray, chest (two views) CPT Code: `71046`	$223	$48	$93	0.5×
Screening mammogram (both breasts) CPT Code: `77067`	$203	$55	$123	0.4×
X-ray, pelvis CPT Code: `72170`	$215	$48	$110	0.4×
X-ray, chest (single view) CPT Code: `71045`	$181	$39	$92	0.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$293	$61	$148	0.4×
Blood test, basic metabolic panel CPT Code: `80048`	$86	$20	$9	2.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$142	$33	$86	0.4×
New patient office visit (30-44 min) CPT Code: `99203`	$179	$42	$110	0.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$179	$42	$123	0.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$46	$11	$4	2.8×
Culture, bacterial CPT Code: `87070`	$87	$21	$9	2.3×
Culture, blood CPT Code: `87040`	$100	$23	$11	2.1×
Blood test, glucose (blood sugar) CPT Code: `82947`	$29	$7	$4	1.8×
Blood test, vitamin B12 CPT Code: `82607`	$108	$26	$16	1.6×
Blood test, thyroid (TSH) CPT Code: `84443`	$121	$29	$18	1.6×
Blood test, PSA (prostate screen) CPT Code: `84153`	$121	$28	$19	1.5×
Hepatitis C antibody test CPT Code: `86803`	$88	$21	$15	1.4×
Electrical stimulation therapy HCPCS Code: `G0283`	$64	$15	$14	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$150	$35	$35	1.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$157	$37	$38	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$140	$33	$34	1.0×
Speech therapy (group session) CPT Code: `92508`	$110	$26	$27	1.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$161	$38	$40	0.9×
Physical therapy (gait training) CPT Code: `97116`	$132	$31	$33	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$150	$35	$38	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$150	$35	$38	0.9×
Orthotic fitting and training CPT Code: `97760`	$175	$41	$51	0.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$108	$25	$64	0.4×
Office visit, established patient (20-29 min) CPT Code: `99213`	$177	$29	$87	0.3×
Hepatitis B vaccine HCPCS Code: `90744`	$37	$37	$37	unverified
Blood test, hemoglobin CPT Code: `85018`	$19	$4	$3	1.3×
Blood antibody screen CPT Code: `86850`	$46	$11	$46	0.2×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$23	$23	$17,936	0.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$24	$24	$25	unverified
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$24	$24	$39	unverified
Flu vaccine injection HCPCS Code: `G0008`	$20	$20	$48	unverified

Showing top 25 high-impact procedures of 103 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 40.4%

Audit a Bill or Quote at Calais Community Hospital (Zero PHI Required)

CMS CCN: 201305

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $51,587

Insurer Median $51,587

1. Amount on Your Bill or Quote ($) Pre-filled with Calais Community Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $27,809 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $27,809

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (40.4% of gross = $27,809).

Step 2 · Cash vs. Insurance Arbitrage Save $17,196 Paying Cash

Self-Pay Cash Rate ($51,587) Beats Your Bill

Calais Community Hospital's published 45 CFR § 180 self-pay cash rate is $51,587 (vs. $51,587 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$49,351 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($68,783) is $49,351 above the denoised Fair BaseRate ($19,432) and 4.9× the $14,044 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 862728785

Filing Period: 202104

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (40.4% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite68/100

Would Recommend72%

Rated 9 or 10 (HCAHPS)64%

Median ER Wait160 min

Left ER Before Seen3%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Source: CMS Hospital Care Compare (37 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Calais Community Hospital.

Price Index: 1.99× regional baseline

Quality: 54/100 CMS composite

Median Household Income$52,237U.S. Census ACS

Local Uninsured Share9.8%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 82/100 · Corroborated CMS CCN 201305 EIN 862728785

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 201305) ↗ Verify IRS Form 990 (EIN 862728785) ↗ CMS HCRIS Cost Reports ↗

Published MRF File862728785_calais-community-hospital_standardcharges.json

Publication / Vintage2026-09-29 · 28.04 MB

Validated Rate Rows1,628 (CMS v3.0.0)

File Integrity Digest8989f3af846840a44499…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

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