Northern Light Maine Coast Hospital
50 Union Street, Ellsworth, ME 04605 · 136 Priced Procedures · 58% Patient Recommendation
Typical commercial prices here are 17% below the fair benchmark (0.83×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.83× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Northern Light Maine Coast Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.86× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.99× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 17% below peer Fair BaseRate (0.83×)
- Self-pay cash beats commercial insurance on 55% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (62/100 safety score) with 58% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (28.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.83× 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 (1.1×) services average 1.25× higher multiples than routine shoppable care (0.8×)
- Upper-quartile procedures (Q75 0.99×) jump +15% above the median procedure ratio (Q50 0.86×)
- Unnegotiated chargemaster list prices average 6.9× Medicare (17¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Northern Light Maine Coast Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 136 published procedures.
Audit a Bill or Quote at Northern Light Maine Coast Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,230
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (28.1% of gross = $3,230).
Self-Pay Cash Rate ($2,871) Beats Your Bill
Northern Light Maine Coast Hospital's published 45 CFR § 180 self-pay cash rate is $2,871 (vs. $4,033 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $2,975 Fair BaseRate ($2,473 Medicare)
Your bill ($11,483) is $8,508 above the denoised Fair BaseRate ($2,975) and 4.6× the $2,473 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (28.1% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (389 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Northern Light Maine Coast Hospital.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.