Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Maine Pricing in Context
In Maine, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $50.23 — 1% below the national benchmark of $50.77. 20 providers across the state submitted claims for this procedure in 2023, performing 991 total services. Individual payments in ME ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Maine is $260.16, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Maine sits below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Medicine procedures, the estimated commercial insurance price in Maine lands near $138.68, with self-pay cash prices typically around $118.82. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost in Maine?
The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Maine is $50.23, which is 1% below the national average of $50.77. Providers in ME typically bill $260.16 for this procedure.
What does Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost with insurance in Maine?
With commercial insurance in Maine, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $138.68. Without insurance, the estimated cash price is $118.82. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Maine?
20 providers in Maine billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 991 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cheaper in Maine than the national average?
Yes — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 1% below the national average in Maine. The state average Medicare payment is $50.23 compared to $50.77 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.