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 |
|---|---|---|---|---|
| Attach bladder/urethra simple 51840 CPT 51840 | not published | not published | $671.03 – $1,416.60 | 8 |
| Attach ocular implant CPT 65140 | not published | not published | $890.92 – $1,858.53 | 8 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | not published | not published | $71.30 – $145.05 | 8 |
| Atxn10 gene detc abnor allel CPT 81183 | not published | not published | $137.00 – $287.07 | 7 |
| Atxn1 gene detc abnor allele CPT 81178 | not published | not published | $137.00 – $287.07 | 7 |
| Atxn2 gene detc abnor allele CPT 81179 | not published | not published | $137.00 – $287.07 | 7 |
| Atxn3 gene detc abnor allele CPT 81180 | not published | not published | $137.00 – $287.07 | 7 |
| Atxn7 gene detc abnor allele CPT 81181 | not published | not published | $137.00 – $287.07 | 7 |
| Atxn8os gen detc abnor allel CPT 81182 | not published | not published | $137.00 – $287.07 | 7 |
| Aud brainstem implt programg CPT 92640 | not published | not published | $92.08 – $208.16 | 9 |
| Audiometry air + bone CPT 92553 | $191.65 | $191.65 | $40.58 – $180.53 | 9 |
| Audit/dast 15-30 min CPT 99408 | not published | not published | $31.19 – $65.54 | 8 |
| Audit/dast over 30 min CPT 99409 | not published | not published | $62.37 – $127.42 | 8 |
| Auditory function + 15 min CPT 92621 | not published | not published | $18.27 – $41.76 | 9 |
| Auditory function 60 min CPT 92620 | not published | not published | $77.91 – $169.62 | 9 |
| Aud rehab postling hear loss CPT 92633 | not published | not published | $147.12 – $147.12 | 1 |
| Aud rehab pre-ling hear loss CPT 92630 | not published | not published | $147.12 – $147.12 | 1 |
| Augmentation cheek bone CPT 21270 | not published | not published | $718.98 – $1,969.16 | 9 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $647.84 – $4,977.19 | 9 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $743.16 – $7,705.09 | 9 |
| Augmentation of facial bones CPT 21208 | not published | not published | $713.21 – $3,145.51 | 9 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | not published | not published | $208.27 – $5,538.06 | 9 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | not published | not published | $488.26 – $10,813.34 | 9 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $1,010.53 – $2,179.80 | 8 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $1,577.81 – $3,387.65 | 8 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $318.77 – $1,761.53 | 7 |
| Autologous blood op salvage CPT 86891 | not published | not published | $166.81 – $223.85 | 3 |
| Autologous blood process CPT 86890 | not published | not published | $118.09 – $145.72 | 3 |
| Autolog prp diab wound ulcer HCPCS G0465 | not published | not published | $24.99 – $994.54 | 3 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $1,473.81 – $8,987.48 | 3 |
| Automated diff wbc count CPT 85004 | not published | not published | $6.47 – $13.56 | 7 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $45.03 – $89.48 | 8 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $43.58 – $87.44 | 8 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $43.58 – $88.78 | 8 |
| Autopsy (necropsy) complete CPT 88020 | not published | not published | $688.90 – $733.38 | 3 |
| Autopsy (necropsy) complete CPT 88025 | not published | not published | $678.44 – $755.23 | 3 |
| Autopsy (necropsy) complete CPT 88027 | not published | not published | $723.42 – $822.40 | 3 |
| Autopsy (necropsy) complete CPT 88028 | not published | not published | $399.58 – $425.67 | 3 |
| Autopsy (necropsy) complete CPT 88029 | not published | not published | $399.58 – $425.67 | 3 |
| Autopsy (necropsy) gross CPT 88000 | not published | not published | $407.33 – $444.36 | 3 |
| Autopsy (necropsy) gross CPT 88005 | not published | not published | $474.78 – $510.65 | 3 |
| Autopsy (necropsy) gross CPT 88007 | not published | not published | $497.26 – $555.46 | 3 |
| Autopsy (necropsy) gross CPT 88012 | not published | not published | $399.58 – $425.67 | 3 |
| Autopsy (necropsy) gross CPT 88014 | not published | not published | $373.26 – $399.58 | 3 |
| Autopsy (necropsy) gross CPT 88016 | not published | not published | $510.65 – $544.27 | 3 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $8,184.00 | $8,184.00 | $90.96 – $7,692.96 | 9 |
| Av fistula revision CPT 36833 | not published | not published | $756.29 – $1,609.11 | 8 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $683.85 – $1,452.53 | 8 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $646.01 – $1,373.89 | 8 |
| Av fusion direct any site CPT 36821 | not published | not published | $619.49 – $1,315.62 | 8 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $678.15 – $1,455.24 | 8 |
| Avul nail plate addl CPT 11732 | $68.80 | $68.80 | $16.85 – $60.66 | 9 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $226.75 | $226.75 | $52.31 – $210.19 | 9 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $458,230.78 – $967,690.13 | 6 |
| Axillary crutch extension HCPCS L0978 | not published | not published | $184.21 – $488.70 | 3 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $669.75 – $1,445.75 | 8 |
| Azacitidine injection HCPCS J9025 | $2,718.56 | $2,718.56 | $0.35 – $2,555.45 | 9 |
| Azathioprine 50 mg tablet HCPCS J7500 | not published | not published | $1.83 – $14.33 | 8 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $130.15 – $725.53 | 4 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $107.08 | $107.08 | $1.83 – $79.69 | 9 |
| Azithromycin dihydrate, oral HCPCS Q0144 | not published | not published | $24.76 – $26.44 | 3 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $480.73 | $480.73 | $2.13 – $274.25 | 9 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $177.58 – $343.65 | 8 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $37.44 – $80.51 | 8 |
| Baclofen eval charges CPT 97750 | $167.35 | $167.35 | $32.99 – $105.50 | 9 |
| Bacterial meningitis antigen CPT 86403 | $113.40 | $113.40 | $11.54 – $106.82 | 9 |
| Bacterial vaginosis pcr CPT 87801 | $257.80 | $257.80 | $70.20 – $242.85 | 9 |
| Bactericidal level serum CPT 87197 | not published | not published | $15.02 – $31.18 | 7 |
| #bac vag cand-c. albicans naa CPT 87481 | $251.05 | $251.05 | $35.09 – $236.49 | 9 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | not published | not published | $7.36 – $17.31 | 3 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $188.95 | $188.95 | $33.15 – $177.99 | 9 |
| Balloon dilate urtrl strix CPT 50706 | not published | not published | $173.69 – $1,583.68 | 9 |
| Banding pulmonary artery CPT 33690 | not published | not published | $1,132.35 – $2,427.21 | 8 |
| Barium Enema (Colon X-ray, barium and air) CPT 74280 | $1,374.00 | $1,374.00 | $59.20 – $1,294.31 | 9 |
| Barium Enema (Colon X-ray, barium only) CPT 74270 | $1,178.30 | $1,178.30 | $48.74 – $1,109.96 | 9 |
| Barium Swallow (Esophagus X-ray) CPT 74220 | $799.00 | $799.00 | $28.52 – $752.66 | 9 |
| Barrier film 1.0ml wipe HCPCS A5120 | not published | not published | $0.30 – $0.67 | 2 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | not published | not published | $2.69 – $7.10 | 3 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | not published | not published | $10.97 – $28.90 | 3 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | not published | not published | $6.91 – $18.17 | 3 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | not published | not published | $5.47 – $14.40 | 3 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | not published | not published | $9.74 – $25.65 | 3 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | $603.30 | $603.30 | $175.23 – $372.80 | 9 |
| Bartonella dna pcr-sendout CPT 87471 | not published | not published | $35.09 – $73.19 | 7 |
| Bartonella dna quant CPT 87472 | not published | not published | $42.84 – $89.48 | 7 |
| Basic vestibular evaluation CPT 92540 | $985.30 | $985.30 | $53.54 – $928.15 | 9 |
| Basiliximab HCPCS J0480 | not published | not published | $4,397.19 – $9,207.22 | 8 |
| Battery chrgr 12 volt utah/e HCPCS L7366 | not published | not published | $649.85 – $1,723.89 | 3 |
| Battery chrgr six volt otto HCPCS L7362 | not published | not published | $263.81 – $699.81 | 3 |
| Battery elec/combo vad, rep HCPCS Q0496 | not published | not published | $1,405.35 – $3,701.57 | 3 |
| Battery pneum vad replacemnt HCPCS Q0503 | not published | not published | $1,218.96 – $3,210.63 | 3 |
| B cells total count CPT 86355 | $199.40 | $199.40 | $25.08 – $187.83 | 9 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | not published | not published | $2.87 – $5.93 | 8 |
| Bcg vaccine intravesical CPT 90586 | not published | not published | $146.59 – $296.42 | 8 |
| Bcg vaccine percut CPT 90585 | not published | not published | $182.95 – $219.44 | 3 |
| Bckdhb gene CPT 81205 | not published | not published | $94.99 – $199.05 | 7 |
| Bebtelovimab injection HCPCS M0222 | not published | not published | $336.77 – $734.45 | 7 |
| Becaplermin 0.01% gel 15 gm HCPCS S0157 | not published | not published | $26.44 – $46.23 | 2 |
| Bedside drainage bag HCPCS A4357 | not published | not published | $9.17 – $24.16 | 3 |
| Behavior counsel obesity 15min medicare g0447 HCPCS G0447 | not published | not published | $22.40 – $61.00 | 8 |
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.