Medicare & Medicaid in Maine (ME)
2026 healthcare costs, coverage, and spending data for Maine.
$10,677
Spending/Capita
2,376,122
Medicare Enrollees
3,201,497
Medicaid Enrollees
3.4%
Uninsured Rate
Medicare Premiums in Maine
Part B Premium
$185/mo
Part D Premium (Avg)
$77/mo
Medigap Premium (Avg)
$206/mo
Medicaid Expansion: Yes - Maine expanded Medicaid under the ACA
Procedure Costs in Maine
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $179,905 | $143,924 | $35,981 |
| Kidney Transplant | $145,836 | $116,669 | $29,167 |
| Heart Valve Replacement | $86,752 | $69,401 | $17,350 |
| Coronary Artery Bypass Graft (CABG) | $70,106 | $56,085 | $14,021 |
| Spinal Fusion | $62,437 | $49,950 | $12,487 |
| Defibrillator Implantation (ICD) | $49,480 | $39,584 | $9,896 |
| Laminectomy | $33,063 | $26,451 | $6,613 |
| Pacemaker Implantation | $30,728 | $24,582 | $6,146 |
| Total Knee Replacement | $28,402 | $22,721 | $5,680 |
| Total Hip Replacement | $27,469 | $21,975 | $5,494 |
| Lumbar Disc Surgery | $25,763 | $20,611 | $5,153 |
| Carotid Endarterectomy | $23,667 | $18,933 | $4,733 |
| Hip Fracture Repair | $21,772 | $17,417 | $4,354 |
| Colectomy | $21,621 | $17,297 | $4,324 |
| Mastectomy | $20,247 | $16,198 | $4,049 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $9,981 | $7,985 | $1,996 |
| TURP (Prostate) | $8,938 | $7,151 | $1,788 |
| Lithotripsy (Kidney Stones) | $7,008 | $5,606 | $1,402 |
| Septoplasty | $6,534 | $5,227 | $1,307 |
| Tonsillectomy | $5,922 | $4,737 | $1,184 |
| Endoscopic Sinus Surgery | $5,568 | $4,454 | $1,114 |
| Nasal Polyp Removal | $5,541 | $4,433 | $1,108 |
| Dialysis Access Surgery | $5,136 | $4,109 | $1,027 |
| Pilonidal Cyst Surgery | $4,971 | $3,977 | $994 |
| Bunionectomy | $4,644 | $3,715 | $929 |
| Hemorrhoid Surgery | $4,064 | $3,251 | $813 |
| Cataract Surgery (Outpatient) | $3,782 | $3,025 | $756 |
| Bronchoscopy | $3,420 | $2,736 | $684 |
| Adenoidectomy | $3,288 | $2,630 | $658 |
| Carpal Tunnel Release | $3,224 | $2,580 | $645 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $4,300 | $3,440 | $860 |
| Nuclear Stress Test | $2,446 | $1,957 | $489 |
| MRI Brain | $1,767 | $1,414 | $353 |
| MRI Hip | $1,425 | $1,140 | $285 |
| CT Scan Abdomen/Pelvis | $1,421 | $1,137 | $284 |
| MRI Knee | $1,375 | $1,100 | $275 |
| CT Angiography | $1,275 | $1,020 | $255 |
| MRI Spine (Cervical) | $1,209 | $967 | $242 |
| MRI Spine (Lumbar) | $1,198 | $959 | $240 |
| CT Scan Chest | $1,084 | $868 | $217 |
| MRI Shoulder | $1,009 | $807 | $202 |
| Bone Scan | $784 | $627 | $157 |
| CT Colonography (Virtual) | $755 | $604 | $151 |
| Echocardiogram | $680 | $544 | $136 |
| CT Scan Head | $629 | $503 | $126 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $382 | $306 | $76 |
| Allergy Testing | $358 | $287 | $72 |
| Psychiatry Visit | $266 | $213 | $53 |
| Mammogram (Screening) | $241 | $241 | $0 |
| Annual Wellness Visit | $222 | $222 | $0 |
| Office Visit (New Patient) | $200 | $160 | $40 |
| Bone Density Test (DEXA Scan) | $198 | $159 | $40 |
| Mental Health Counseling | $185 | $148 | $37 |
| Office Visit (Established Patient) | $180 | $144 | $36 |
| Shingles Vaccination | $167 | $167 | $0 |
| Wound Care Visit | $162 | $130 | $32 |
| Speech Therapy Session | $155 | $124 | $31 |
| Skin Cancer Screening | $137 | $109 | $27 |
| Physical Therapy Session | $137 | $109 | $27 |
| EKG (Electrocardiogram) | $132 | $105 | $26 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Thyroid Panel (TSH) | $42 | $34 | $8 |
| Comprehensive Metabolic Panel | $42 | $33 | $8 |
| Blood Culture | $41 | $33 | $8 |
| Troponin Level | $41 | $33 | $8 |
| Blood Type and Crossmatch | $41 | $32 | $8 |
| BNP (Heart Failure Marker) | $40 | $32 | $8 |
| Vitamin D Level | $39 | $31 | $8 |
| Urine Drug Screen | $37 | $29 | $7 |
| Glucose Tolerance Test | $36 | $29 | $7 |
| Hemoglobin A1C | $35 | $28 | $7 |
| Iron Studies (Ferritin) | $34 | $27 | $7 |
| Liver Function Panel | $33 | $26 | $7 |
| Lipid Panel | $32 | $26 | $6 |
| C-Reactive Protein (CRP) | $31 | $24 | $6 |
| PSA (Prostate-Specific Antigen) | $31 | $24 | $6 |
Compare Maine With Other States
Frequently Asked Questions
How much does Medicare spend per person in Maine?
In 2026, the average Medicare spending per beneficiary in Maine is $10,677.
How many people are enrolled in Medicare in Maine?
Maine has approximately 2,376,122 Medicare beneficiaries.
Did Maine expand Medicaid?
Yes, Maine expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Maine?
The uninsured rate in Maine is 3.4%.
What is the average Medigap premium in Maine?
The average Medigap (Medicare Supplement) premium in Maine is $206 per month.