66/100
#773 nationally
Southern Maine Health Care
1 Medical Center Drive, Biddeford, ME 04005
Charges moderately above what care is paid for
For every $1 of care Medicare actually paid for here, Southern Maine Health Care billed $4.01 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 4.0x
- volume-weighted across all its priced work
- Procedures priced
- 31
- inpatient and outpatient combined
- Rank in ME
- #9
- lower markup ranks higher
- CMS quality stars
- Not rated
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 62% of U.S. hospitals.
Better than 68% of U.S. hospitals.
Better than 64% of U.S. hospitals.
Better than 83% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
64 | $47,709 | $14,106 | -27% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
64 | $13,512 | $2,476 | -30% |
|
Level 1 Nerve Procedures
APC 5431 · Hospital outpatient visit |
62 | $10,532 | $1,791 | -7% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
54 | $48,070 | $12,348 | -23% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
49 | $37,411 | $10,262 | -14% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
43 | $6,681 | $1,523 | -34% |
|
Level 3 Musculoskeletal Procedures
APC 5113 · Hospital outpatient visit |
36 | $18,643 | $2,907 | -9% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
34 | $26,043 | $4,748 | -5% |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
29 | $49,679 | $12,604 | -10% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
29 | $33,849 | $6,168 | -15% |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
$15,097 | $1,787 | +17% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
$36,082 | $5,421 | about average |
|
Respiratory Infection (with complications)
MS-DRG 178 · Inpatient stay |
$37,263 | $7,890 | about average |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
$44,278 | $12,658 | -5% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
$26,043 | $4,748 | -5% |
|
Level 1 Nerve Procedures
APC 5431 · Hospital outpatient visit |
$10,532 | $1,791 | -7% |
|
Level 3 Musculoskeletal Procedures
APC 5113 · Hospital outpatient visit |
$18,643 | $2,907 | -9% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
$18,747 | $3,276 | -9% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
$10,737 | $2,883 | -57% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
$11,580 | $2,855 | -39% |
|
Level 2 Musculoskeletal Procedures
APC 5112 · Hospital outpatient visit |
$6,898 | $1,510 | -39% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
$6,681 | $1,523 | -34% |
|
Kidney Failure (with complications)
MS-DRG 683 · Inpatient stay |
$22,484 | $7,193 | -32% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$8,053 | $1,704 | -31% |
|
Fluid and Electrolyte Disorder (without major complications)
MS-DRG 641 · Inpatient stay |
$21,018 | $6,469 | -31% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
$13,512 | $2,476 | -30% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.