Northern Light Mercy Hospital
144 State Street, Portland, ME 04101 · 136 Priced Procedures · 86% Patient Recommendation
Typical commercial prices here are 17% below the fair benchmark (0.83×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.83× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Northern Light Mercy Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.84× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 1.00× 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 60% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 86% patient recommendation (73/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (38.6% 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 1.00×) jump +19% above the median procedure ratio (Q50 0.84×)
- Consolidated metro market (HHI 6,792) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
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 Mercy 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.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| C-section delivery (full package) CPT Code: 59510 | $4,033 | 1.4× |
| Vaginal delivery (full package) CPT Code: 59400 | $3,644 | 1.4× |
| Trauma team activation HCPCS Code: G0390 | $1,318 | 0.9× |
| Cataract surgery with lens implant CPT Code: 66984 | $1,012 | 0.4× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $873 | 0.1× |
| Bunion correction surgery CPT Code: 28296 | $797 | 0.2× |
| Inguinal hernia repair CPT Code: 49505 | $759 | 0.2× |
| Breast lump removal CPT Code: 19120 | $761 | 0.2× |
| Injection procedure for pain management HCPCS Code: G0260 | $683 | 0.8× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $651 | 0.6× |
| Colonoscopy with biopsy CPT Code: 45380 | $673 | 0.5× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $581 | 0.6× |
| Upper endoscopy with biopsy CPT Code: 43239 | $578 | 0.6× |
| Total hip replacement CPT Code: 27130 | $538 | 0.0× |
| Total knee replacement CPT Code: 27447 | $450 | 0.0× |
| Rabies immune globulin HCPCS Code: 90375 | $335 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $341 | 0.8× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $349 | 0.7× |
| MRI, lower back (no contrast) CPT Code: 72148 | $234 | 0.7× |
| MRI, brain (no contrast) CPT Code: 70551 | $236 | 0.7× |
| MRI, knee or other leg joint CPT Code: 73721 | $238 | 0.6× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $257 | 0.1× |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $236 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $202 | 0.7× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $226 | unverified |
Audit a Bill or Quote at Northern Light Mercy Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $4,430
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (38.6% of gross = $4,430).
Self-Pay Cash Rate ($2,986) Beats Your Bill
Northern Light Mercy Hospital's published 45 CFR § 180 self-pay cash rate is $2,986 (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 (38.6% 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 (796 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 Mercy 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.