healthcosts.net
Waldo County General Hospital
118 Northport Ave, Belfast, ME · MaineHealth · · NPI 1841397932
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,784.45 | $2,784.45 | $65.61 – $2,622.95 | 9 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,515.80 | $2,515.80 | $59.86 – $2,369.88 | 9 |
| Abdominal CT scan (without contrast) CPT 74150 | $2,019.15 | $2,019.15 | $55.94 – $1,902.04 | 9 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,273.10 | $3,273.10 | $103.23 – $3,083.26 | 9 |
| Abdominal MRI (with contrast) CPT 74182 | $3,061.10 | $3,061.10 | $81.45 – $2,883.56 | 9 |
| Abdominal MRI (without contrast) CPT 74181 | $2,696.70 | $2,696.70 | $68.84 – $2,540.29 | 9 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,159.45 | $1,159.45 | $37.96 – $1,092.20 | 9 |
| Abdominal Ultrasound (limited) CPT 76705 | $751.80 | $751.80 | $27.87 – $708.20 | 9 |
| Allergy Skin Testing CPT 95004 | not published | not published | $3.70 – $7.46 | 8 |
| Ankle X-ray CPT 73610 | $403.55 | $403.55 | $8.29 – $380.14 | 9 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | not published | not published | $84.23 – $224.22 | 8 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | not published | not published | $91.30 – $238.36 | 8 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | not published | not published | $92.21 – $248.63 | 8 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | not published | not published | $111.84 – $286.53 | 8 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $575.86 – $1,239.70 | 8 |
| Blood Clotting (PT/INR) Test CPT 85610 | $74.30 | $74.30 | $3.47 – $47.25 | 9 |
| Blood Clotting (PTT) Test CPT 85730 | $170.05 | $170.05 | $6.01 – $160.19 | 9 |
| Blood Count (CBC) Test CPT 85025 | $76.95 | $76.95 | $6.29 – $48.00 | 9 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $51.25 | $51.25 | $5.24 – $32.25 | 9 |
| Blood Culture Test CPT 87040 | $274.05 | $274.05 | $10.32 – $258.16 | 9 |
| Bone Density Scan (DEXA) CPT 77080 | $377.95 | $377.95 | $9.32 – $356.03 | 9 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $3,190.70 | $3,190.70 | $69.53 – $3,005.64 | 9 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $2,650.80 | $2,650.80 | $56.28 – $2,497.05 | 9 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,109.55 | $2,109.55 | $56.59 – $1,987.20 | 9 |
| Brain MRI (with and without contrast) CPT 70553 | $3,088.05 | $3,088.05 | $107.81 – $2,908.94 | 9 |
| Brain MRI (with contrast) CPT 70552 | $2,725.05 | $2,725.05 | $84.11 – $2,567.00 | 9 |
| Brain MRI (without contrast) CPT 70551 | $2,360.60 | $2,360.60 | $69.85 – $2,223.69 | 9 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $3,048.95 | $3,048.95 | $149.16 – $950.85 | 9 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $2,515.34 – $5,482.73 | 8 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,725.10 | $3,725.10 | $102.83 – $3,509.04 | 9 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $3,630.70 | $3,630.70 | $85.49 – $3,420.12 | 9 |
| CT Angiogram of the Head CPT 70496 | $3,038.15 | $3,038.15 | $82.45 – $2,861.94 | 9 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $6,057.45 | $6,057.45 | $94.25 – $5,706.12 | 9 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $4,781.90 | $4,781.90 | $85.80 – $4,504.55 | 9 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $3,659.00 | $3,659.00 | $82.10 – $3,446.78 | 9 |
| Cardiac Stress Test CPT 93015 | not published | not published | $67.80 – $148.44 | 8 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,333.55 | $1,333.55 | $37.36 – $1,256.20 | 9 |
| Carpal Tunnel Release Surgery CPT 64721 | not published | not published | $420.72 – $914.34 | 9 |
| Cataract Surgery CPT 66984 | not published | not published | $519.50 – $1,093.29 | 8 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,101.65 | $3,101.65 | $58.63 – $2,921.75 | 9 |
| Chest CT scan (with contrast) CPT 71260 | $2,352.50 | $2,352.50 | $54.90 – $2,216.06 | 9 |
| Chest CT scan (without contrast) CPT 71250 | $1,899.05 | $1,899.05 | $50.88 – $1,788.91 | 9 |
| Chest X-ray CPT 71046 | $471.05 | $471.05 | $10.33 – $443.73 | 9 |
| Chest X-ray (single view) CPT 71045 | $332.00 | $332.00 | $8.64 – $312.74 | 9 |
| Cholesterol (Lipid) Test CPT 80061 | $137.90 | $137.90 | $10.85 – $37.50 | 9 |
| Circumcision (newborn) CPT 54150 | $294.75 | $294.75 | $93.20 – $267.73 | 9 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $88.28 – $654.68 | 9 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $192.08 – $834.57 | 9 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $243.22 – $873.75 | 9 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,610.20 | $1,610.20 | $77.18 – $461.94 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $77.70 | $77.70 | $7.87 – $50.25 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $503.35 | $503.35 | $46.73 – $474.16 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $418.40 | $418.40 | $37.96 – $394.13 | 9 |
| EKG (Electrocardiogram) CPT 93000 | not published | not published | $13.83 – $29.15 | 8 |
| ER Visit (level 1, minor) CPT 99281 | $199.80 | $199.80 | $11.41 – $31.03 | 9 |
| ER Visit (level 2) CPT 99282 | $248.35 | $248.35 | $40.96 – $84.72 | 9 |
| ER Visit (level 3) CPT 99283 | $472.40 | $472.40 | $70.30 – $143.01 | 9 |
| ER Visit (level 4) CPT 99284 | $917.80 | $917.80 | $118.62 – $244.01 | 9 |
| ER Visit (level 5, high severity) CPT 99285 | $1,391.50 | $1,391.50 | $172.42 – $353.81 | 9 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,336.35 | $2,336.35 | $67.32 – $2,200.84 | 9 |
| Established Patient Office Visit (level 1) CPT 99211 | $45.85 | $45.85 | $8.64 – $40.69 | 9 |
| Established Patient Office Visit (level 2) CPT 99212 | $160.60 | $160.60 | $21.71 – $50.92 | 9 |
| Established Patient Office Visit (level 3) CPT 99213 | $194.40 | $194.40 | $26.01 – $60.99 | 9 |
| Established Patient Office Visit (level 4) CPT 99214 | $303.75 | $303.75 | $26.01 – $60.99 | 9 |
| Established Patient Office Visit (level 5) CPT 99215 | $381.95 | $381.95 | $23.32 – $54.68 | 9 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $53.63 – $359.14 | 9 |
| Foot X-ray CPT 73630 | $403.55 | $403.55 | $7.98 – $380.14 | 9 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $630.02 – $1,359.67 | 8 |
| Hand X-ray CPT 73130 | $400.85 | $400.85 | $8.29 – $377.60 | 9 |
| Head CT scan (with and without contrast) CPT 70470 | $2,409.20 | $2,409.20 | $59.86 – $2,269.47 | 9 |
| Head CT scan (with contrast) CPT 70460 | $2,073.15 | $2,073.15 | $53.23 – $1,952.91 | 9 |
| Head CT scan (without contrast) CPT 70450 | $1,715.45 | $1,715.45 | $39.97 – $1,615.95 | 9 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $500.27 – $1,080.41 | 8 |
| Hip X-ray CPT 73502 | $495.40 | $495.40 | $10.65 – $466.67 | 9 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $781.50 | $781.50 | $34.61 – $177.00 | 9 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $598.53 – $1,291.88 | 8 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $521.96 – $1,127.87 | 8 |
| Knee MRI (with and without contrast) CPT 73723 | $3,657.70 | $3,657.70 | $101.19 – $3,445.55 | 9 |
| Knee MRI (with contrast) CPT 73722 | $2,915.35 | $2,915.35 | $76.56 – $2,746.26 | 9 |
| Knee MRI (without contrast) CPT 73721 | $2,352.50 | $2,352.50 | $63.88 – $2,216.06 | 9 |
| Knee X-ray CPT 73564 | $514.30 | $514.30 | $10.95 – $484.47 | 9 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,344.30 | $1,344.30 | $32.43 – $1,266.33 | 9 |
| Liver Function Test CPT 80076 | $159.35 | $159.35 | $8.17 – $150.11 | 9 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,812.75 | $2,812.75 | $59.86 – $2,649.61 | 9 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,254.00 | $2,254.00 | $57.28 – $2,123.27 | 9 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,853.10 | $1,853.10 | $46.73 – $1,745.62 | 9 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,382.30 | $3,382.30 | $107.81 – $3,186.13 | 9 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,775.00 | $2,775.00 | $84.11 – $2,614.05 | 9 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,440.30 | $2,440.30 | $69.85 – $2,298.76 | 9 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $514.30 | $514.30 | $10.65 – $484.47 | 9 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,505.90 – $3,255.47 | 8 |
| Lung Function Test (Spirometry) CPT 94010 | $224.05 | $224.05 | $7.98 – $211.06 | 9 |
| Metabolic Blood Panel (Basic) CPT 80048 | $136.35 | $136.35 | $8.46 – $128.44 | 9 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $159.35 | $159.35 | $10.56 – $150.11 | 9 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $3,109.70 | $3,109.70 | $59.55 – $2,929.34 | 9 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,113.65 | $2,113.65 | $57.28 – $1,991.06 | 9 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,755.90 | $1,755.90 | $46.73 – $1,654.06 | 9 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $2,669.70 | $2,669.70 | $107.81 – $2,514.86 | 9 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $2,775.00 | $2,775.00 | $84.43 – $2,614.05 | 9 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $2,301.25 | $2,301.25 | $69.85 – $2,167.78 | 9 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $5,211.25 | $5,211.25 | $84.80 – $4,909.00 | 9 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $2,931.50 | $2,931.50 | $70.54 – $2,761.47 | 9 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,282.40 | $2,282.40 | $56.59 – $2,150.02 | 9 |
| New Patient Office Visit (level 2) CPT 99202 | $307.70 | $307.70 | $24.93 – $58.45 | 9 |
| New Patient Office Visit (level 3) CPT 99203 | $441.30 | $441.30 | $26.01 – $60.99 | 9 |
| New Patient Office Visit (level 4) CPT 99204 | $680.20 | $680.20 | $65.06 – $152.56 | 9 |
| New Patient Office Visit (level 5) CPT 99205 | $857.05 | $857.05 | $58.57 – $137.34 | 9 |
| Nuclear Stress Test (Heart) CPT 78452 | $3,228.40 | $3,228.40 | $74.86 – $151.14 | 9 |
| PSA (Prostate) Test CPT 84153 | $152.55 | $152.55 | $18.39 – $143.70 | 9 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,604.95 | $2,604.95 | $57.28 – $2,453.86 | 9 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,055.55 | $2,055.55 | $54.58 – $1,936.33 | 9 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,732.95 | $1,732.95 | $51.22 – $1,632.44 | 9 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,390.40 | $3,390.40 | $103.23 – $3,193.76 | 9 |
| Pelvic MRI (with contrast) CPT 72196 | $2,630.60 | $2,630.60 | $81.75 – $2,478.03 | 9 |
| Pelvic MRI (without contrast) CPT 72195 | $2,460.50 | $2,460.50 | $68.84 – $2,317.79 | 9 |
| Pelvic Ultrasound (complete) CPT 76856 | $800.35 | $800.35 | $32.57 – $65.75 | 9 |
| Pelvic Ultrasound (limited) CPT 76857 | $435.95 | $435.95 | $18.42 – $43.15 | 9 |
| Postpartum Care Only CPT 59430 | not published | not published | $171.05 – $513.33 | 9 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $558.75 | $558.75 | $47.00 – $526.34 | 9 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $426.00 | $426.00 | $46.70 – $98.00 | 9 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $413.20 – $1,092.19 | 9 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $758.73 – $1,998.07 | 9 |
| Rapid Strep Test CPT 87880 | $96.15 | $96.15 | $13.39 – $39.00 | 9 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $88.51 – $655.32 | 8 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $88.28 – $654.68 | 8 |
| Screening Mammogram CPT 77067 | $383.30 | $383.30 | $35.92 – $361.07 | 9 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,027.33 – $2,200.81 | 8 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,559.15 | $3,559.15 | $101.50 – $3,352.72 | 9 |
| Shoulder MRI (with contrast) CPT 73222 | $2,959.85 | $2,959.85 | $76.56 – $2,788.18 | 9 |
| Shoulder MRI (without contrast) CPT 73221 | $2,361.95 | $2,361.95 | $64.19 – $2,224.96 | 9 |
| Shoulder X-ray CPT 73030 | $425.20 | $425.20 | $8.95 – $400.54 | 9 |
| Sinus CT scan (with and without contrast) CPT 70488 | $2,598.20 | $2,598.20 | $59.86 – $2,447.50 | 9 |
| Sinus CT scan (with contrast) CPT 70487 | $1,893.70 | $1,893.70 | $53.23 – $1,783.87 | 9 |
| Sinus CT scan (without contrast) CPT 70486 | $1,544.10 | $1,544.10 | $40.29 – $1,454.54 | 9 |
| Skin Biopsy CPT 11102 | $214.60 | $214.60 | $36.59 – $186.30 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $3,829.05 | $3,829.05 | $115.88 – $3,606.97 | 9 |
| Thyroid (TSH) Test CPT 84443 | $191.65 | $191.65 | $13.61 – $118.50 | 9 |
| Thyroid Ultrasound CPT 76536 | $727.50 | $727.50 | $21.13 – $49.55 | 9 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $248.12 – $530.04 | 8 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $260.52 – $557.83 | 8 |
| Total Hip Replacement CPT 27130 | not published | not published | $1,230.66 – $2,638.68 | 8 |
| Total Knee Replacement CPT 27447 | not published | not published | $1,229.50 – $2,635.28 | 8 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $360.61 – $760.50 | 8 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $3,186.60 | $3,186.60 | $107.81 – $3,001.78 | 9 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,775.00 | $2,775.00 | $84.11 – $2,614.05 | 9 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,438.90 | $2,438.90 | $69.85 – $2,297.44 | 9 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $117.19 – $554.44 | 9 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $132.30 – $724.70 | 9 |
| Urinalysis (with microscopy) CPT 81001 | $35.05 | $35.05 | $2.57 – $6.64 | 9 |
| Urinalysis (without microscopy) CPT 81003 | $21.55 | $21.55 | $1.82 – $15.75 | 9 |
| Urine Culture Test CPT 87086 | $206.55 | $206.55 | $8.07 – $194.57 | 9 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $2,282.40 – $4,935.74 | 8 |
| Vasectomy CPT 55250 | not published | not published | $220.27 – $648.25 | 9 |
| Vitamin D Test CPT 82306 | $206.45 | $206.45 | $23.98 – $138.00 | 9 |
| Wrist X-ray CPT 73110 | $406.20 | $406.20 | $8.29 – $382.64 | 9 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.