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Lower Extremity and Humerus Procedures (without CC/MCC)

Maine rates for MS-DRG 494

Lower Extremity and Humerus Procedures Except Hip, Foot, Femur without CC/MCC

Rates data updated July 2026.

How much does Lower Extremity and Humerus Procedures (without CC/MCC) cost?

$38,019

Typical facility fee. In Maine, July 2026.

Insurers have agreed to pay about $38,019 for this service. Most negotiated rates run $30,903 to $39,811.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $38,019 · 10th to 90th $25,704 to $46,774
$20.0K$50.0Kfacility $38,019

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$39,810.72
Typical High
$46,773.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26,302.68
Median
$30,902.95
Typical High
$60,255.96
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$28,840.32
Median
$28,840.32
Typical High
$28,840.32
United
Setting
Facility
Modifier
Global
Typical Low
$25,703.96
Median
$25,703.96
Typical High
$25,703.96

Where Maine sits

The same service costs 3.0 times more in Colorado than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maine $38,019 · 12th of 51
CO $48,978NM $16,218

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.