How many shoppable procedure prices are published for Houlton Regional Hospital?

Houlton Regional Hospital in Houlton, ME currently has 101 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Houlton Regional Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Houlton Regional Hospital's median negotiated commercial rate is 0.7× the regionally adjusted fair BaseRate benchmark.

What is Houlton Regional Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Houlton Regional Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 3/25/2026

Houlton Regional Hospital

20 Hartford Street, Houlton, ME 04730 · 101 Priced Procedures · 61% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.72×vs. Fair Market Price

Typical commercial prices here are 28% below the fair benchmark (0.72×) after accounting for local nurse/doctor wages and patient complexity.

72/100 · Corroborated

72/100Self-Pay Cash Beats Insurance 18% of the Time

File Completeness85

Price Logic73

Peer Alignment74

Clean Billing83

Real Cash Discount41

Regional Value Leader

4-Star CMS clinical quality rating paired with 0.72× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Houlton Regional Hospital prices routine shoppable procedures near 0.8× Medicare (p50 0.70×) while skewing captive emergency, lab, and upper-quartile codes to 2.5× Medicare (p75 0.90×, +29% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#1 of 27 in ME · 1st State Percentile#147 of 3,385 in U.S. · 4th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 28% below peer Fair BaseRate (0.72×)
Self-pay cash beats commercial insurance on 18% of shoppable procedures (41/100 Cash Honesty)
CMS clinical safety score (69/100 safety score) with 61% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (42.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.72× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.2×) & laboratory (0.6×) services average 3.13× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 0.90×) jump +29% above the median procedure ratio (Q50 0.70×)
Unnegotiated chargemaster list prices average 5.8× Medicare (23¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.8× Medicare

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

Back-Door Captive & ER3.13× Divergence

2.5× Medicare

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

Quantile Tail Spread+29% Upper Tail

Q25 0.45× · Q50 0.70× · Q75 0.90×

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

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.6× MedicareGood

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

0.5× MedicareGood

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

18% Cash Edge · 41/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 69/100Fair

Procedure Prices at Houlton Regional Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 101 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Gallbladder removal (laparoscopic) CPT Code: `47562`	$4,042	$4,042	$6,109	0.7×
Total hip replacement CPT Code: `27130`	$3,059	$3,059	$13,413	0.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,707	$2,707	$1,021	2.7×
Blood transfusion CPT Code: `36430`	$1,163	$1,163	$498	2.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,049	$1,049	$583	1.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$775	$775	$272	unverified
Rabies immune globulin HCPCS Code: `90375`	$659	$659	$322	2.0×
Breast lump removal CPT Code: `19120`	$2,268	$614	$3,875	0.2×
Psychotherapy session (45 minutes) CPT Code: `90834`	$534	$534	$166	3.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$534	$534	$181	3.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$534	$534	$185	2.9×
Colonoscopy with biopsy CPT Code: `45380`	$1,297	$519	$1,256	0.4×
Inguinal hernia repair CPT Code: `49505`	$2,229	$543	$3,629	0.1×
Upper endoscopy with biopsy CPT Code: `43239`	$893	$452	$987	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,192	$409	$981	0.4×
Speech therapy (language evaluation) CPT Code: `92507`	$329	$329	$86	3.8×
Hepatitis B immune globulin HCPCS Code: `90371`	$323	$323	$151	2.1×
Breathing treatment (nebulizer) CPT Code: `94640`	$295	$295	$201	1.5×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,956	$316	$448	0.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,511	$335	$511	0.7×
Speech therapy (group session) CPT Code: `92508`	$199	$199	$27	7.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$214	$214	$64	3.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,153	$183	$258	0.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,506	$194	$303	0.6×
MRI, brain (no contrast) CPT Code: `70551`	$1,141	$207	$343	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$1,141	$203	$338	0.6×
MRI, knee or other leg joint CPT Code: `73721`	$1,121	$216	$369	0.6×
Physical therapy (manual therapy) CPT Code: `97140`	$136	$136	$34	4.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$321	$159	$148	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$131	$131	$35	3.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$142	$142	$40	3.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$133	$133	$38	3.5×
Physical therapy (functional capacity test) CPT Code: `97750`	$132	$132	$38	3.5×
Occupational therapy (self-care training) CPT Code: `97535`	$130	$130	$38	3.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$138	$138	$86	1.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$224	$149	$123	1.2×
Physical therapy (gait training) CPT Code: `97116`	$110	$110	$33	3.3×
Orthotic fitting and training CPT Code: `97760`	$116	$116	$51	2.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$705	$121	$134	0.9×
CT scan, pelvis CPT Code: `72192`	$747	$140	$163	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	$755	$140	$167	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$737	$138	$169	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$737	$137	$168	0.8×
CT scan, sinuses CPT Code: `70486`	$715	$135	$166	0.8×
CT scan, head (with contrast) CPT Code: `70460`	$1,141	$157	$242	0.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$490	$114	$132	0.9×
Ultrasound, pelvis CPT Code: `76856`	$511	$111	$130	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$82	$82	$14	5.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$160	$105	$87	1.2×
New patient office visit (30-44 min) CPT Code: `99203`	$195	$129	$110	1.2×
Prosthetic fitting and training CPT Code: `97761`	$101	$101	$45	2.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$665	$91	$126	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$710	$113	$160	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$314	$85	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$849	$849	$347	2.4×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$375	$375	$203	1.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$224	$224	$19	11.8×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$238	$238	$111	2.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$183	$183	$18	10.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$176	$176	$20	8.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$146	$146	$14	10.4×
Pneumococcal vaccine HCPCS Code: `90732`	$150	$150	$140	1.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$123	$123	$49	2.5×
Blood test, complete blood count (CBC) CPT Code: `85025`	$85	$85	$8	10.6×
Blood test, magnesium CPT Code: `83735`	$73	$73	$7	10.4×
Blood test, basic metabolic panel CPT Code: `80048`	$92	$92	$9	10.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$108	$108	$14	7.7×
Blood test, potassium CPT Code: `84132`	$52	$52	$5	10.4×
Blood test, amylase CPT Code: `82150`	$71	$71	$7	10.1×
Blood test, lipase CPT Code: `83690`	$71	$71	$7	10.1×
Blood test, liver function panel CPT Code: `80076`	$89	$89	$9	9.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$93	$93	$10	9.3×
Blood test, vitamin B12 CPT Code: `82607`	$114	$114	$16	7.1×
Blood antibody screen CPT Code: `86850`	$106	$106	$46	2.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$91	$91	$56	1.6×
Blood test, calcium CPT Code: `82310`	$56	$56	$5	11.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$56	$56	$5	11.2×
Blood test, sodium CPT Code: `84295`	$52	$52	$5	10.4×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$47	$47	$5	9.4×
Hepatitis C antibody test CPT Code: `86803`	$62	$62	$15	4.1×
Blood test, vitamin D CPT Code: `82306`	$66	$66	$31	2.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$57	$57	$39	1.5×
Blood test, hemoglobin CPT Code: `85018`	$26	$26	$3	8.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$43	$10	$4	2.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$43	$10	$4	2.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$66	$15	$6	2.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$115	$26	$11	2.4×
X-ray, hip CPT Code: `73502`	$230	$51	$93	0.5×
X-ray, lower back CPT Code: `72110`	$389	$56	$112	0.5×
Culture, bacterial CPT Code: `87070`	$86	$21	$9	2.3×
Culture, blood CPT Code: `87040`	$88	$25	$11	2.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$33	$33	$25	1.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$332	$42	$93	0.5×
X-ray, hand CPT Code: `73130`	$447	$40	$93	0.4×
X-ray, ankle CPT Code: `73610`	$251	$39	$93	0.4×
X-ray, shoulder CPT Code: `73030`	$286	$38	$92	0.4×
X-ray, foot CPT Code: `73630`	$423	$36	$92	0.4×
X-ray, chest (two views) CPT Code: `71046`	$171	$35	$93	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$34	$8	$3	2.7×
X-ray, chest (single view) CPT Code: `71045`	$146	$27	$92	0.3×
X-ray, pelvis CPT Code: `72170`	$169	$29	$110	0.3×

Showing top 25 high-impact procedures of 101 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 42.4%

Audit a Bill or Quote at Houlton Regional Hospital (Zero PHI Required)

CMS CCN: 201308

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash $4,042

Insurer Median $4,042

1. Amount on Your Bill or Quote ($) Pre-filled with Houlton Regional 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: $1,806 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,806

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (42.4% of gross = $1,806).

Step 2 · Cash vs. Insurance Arbitrage Save $213 Paying Cash

Self-Pay Cash Rate ($4,042) Beats Your Bill

Houlton Regional Hospital's published 45 CFR § 180 self-pay cash rate is $4,042 (vs. $4,042 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $6,109 Fair BaseRate

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($6,109).

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: 237134386

Filing Period: 197301

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 (42.4% 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

CMS Overall4/5 Stars (4/5)

Safety Composite69/100

Would Recommend61%

Rated 9 or 10 (HCAHPS)72%

Median ER Wait192 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Houlton Regional Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-05·administrative_or_closure
Closure Notice
Recorded
2025-01-15·cap_corrective_action
CAP Request
Recorded
2024-10-07·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (106 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.56× regional baseline

Quality: 65/100 CMS composite

Median Household Income$54,254U.S. Census ACS

Local Uninsured Share8.0%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 72/100 · Corroborated CMS CCN 201308 EIN 237134386

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 201308) ↗ Verify IRS Form 990 (EIN 237134386) ↗ CMS HCRIS Cost Reports ↗

Published MRF File237134386_houlton-regional-hospital_standardcharges.csv

Publication / Vintage3/25/2026 · 29.71 MB

Validated Rate Rows1,090 (CMS v3.0.0)

File Integrity Digestee259c5e439df5be7e2e…

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.

Submit MRF Update Correction Policy