Penobscot Valley Hospital
7 Transalpine Road, Po Box 368, Lincoln, ME 04457 · 107 Priced Procedures · 77% Patient Recommendation
Typical commercial prices here are +26% above the fair benchmark (1.26×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Penobscot Valley Hospital prices routine shoppable procedures at 2.5× Medicare (median 1.18× Fair BaseRate) while upper-quartile commercial rates jump +52% to 1.79× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.50× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 45% of shoppable procedures (98/100 Cash Honesty)
- CMS clinical safety score (71/100 safety score) with 77% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (47.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.26× 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.
- Commercial insurance median sits at 1.18× Fair BaseRate (2.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.79×) jump +52% above the median procedure ratio (Q50 1.18×)
- Consolidated metro market (HHI 5,180) 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 Penobscot Valley Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 107 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Total hip replacement CPT Code: 27130 | $3,250 | 0.2× |
| C-section delivery (full package) CPT Code: 59510 | $2,594 | 0.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,046 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,888 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,574 | unverified |
| Hepatitis B immune globulin HCPCS Code: 90371 | $1,531 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $1,429 | 4.4× |
| MRI, brain (no contrast) CPT Code: 70551 | $1,334 | 3.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,337 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,297 | 3.8× |
| MRI, knee or other leg joint CPT Code: 73721 | $1,294 | 3.5× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,300 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,145 | 0.2× |
| Total knee replacement CPT Code: 27447 | $1,149 | 0.1× |
| CT scan, pelvis CPT Code: 72192 | $978 | 6.0× |
| CT scan, chest (no contrast) CPT Code: 71250 | $969 | 5.8× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $968 | 5.8× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $989 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $925 | 1.6× |
| CT scan, sinuses CPT Code: 70486 | $866 | 5.2× |
| Bunion correction surgery CPT Code: 28296 | $818 | 0.2× |
| CT scan, head (no contrast) CPT Code: 70450 | $734 | 4.6× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $673 | 0.2× |
| Inguinal hernia repair CPT Code: 49505 | $674 | 0.2× |
| Breast lump removal CPT Code: 19120 | $638 | 0.2× |
Audit a Bill or Quote at Penobscot Valley Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,913
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (47.1% of gross = $1,913).
Self-Pay Cash Rate ($3,250) Beats Your Bill
Penobscot Valley Hospital's published 45 CFR § 180 self-pay cash rate is $3,250 (vs. $3,250 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($13,413).
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (47.1% 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
Source: CMS Hospital Care Compare (31 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 Penobscot Valley 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.