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 |
|---|---|---|---|---|
| Shorten radius & ulna CPT 25392 | not published | not published | $974.67 – $2,096.44 | 8 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $83.75 | $83.75 | $13.61 – $78.89 | 9 |
| Shoulder abduction joint pai HCPCS L6640 | not published | not published | $265.56 – $704.49 | 3 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $423.80 | $423.80 | $8.95 – $399.22 | 9 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,027.33 – $2,200.81 | 8 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $391.40 | $391.40 | $8.60 – $368.70 | 9 |
| Shoulder flexion-abduction j HCPCS L6645 | not published | not published | $302.66 – $802.87 | 3 |
| Shoulder harness HCPCS L5699 | not published | not published | $228.68 – $606.63 | 3 |
| Shoulder lock actuator HCPCS L6647 | not published | not published | $483.26 – $1,281.99 | 3 |
| 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 prosthesis removal CPT 23334 | not published | not published | $1,016.26 – $2,193.36 | 8 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $1,215.73 – $2,604.10 | 8 |
| Shoulder universal joint HCPCS L6650 | not published | not published | $349.94 – $928.30 | 3 |
| Shoulder X-ray CPT 73030 | $425.20 | $425.20 | $8.95 – $400.54 | 9 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $309.05 | $309.05 | $7.28 – $291.13 | 9 |
| Shrinker prosth above knee HCPCS L8460 | not published | not published | $72.70 – $192.86 | 3 |
| Shrinker prosth below knee HCPCS L8440 | not published | not published | $44.59 – $118.29 | 3 |
| Shrinker upper limb HCPCS L8465 | not published | not published | $48.59 – $128.89 | 3 |
| Shunt as-aort to pulm art CPT 33755 | not published | not published | $1,241.11 – $2,659.00 | 8 |
| Shunt central w/prostc graft CPT 33764 | not published | not published | $1,241.11 – $2,659.00 | 8 |
| Shunt desc aorta to pulm art CPT 33762 | not published | not published | $1,206.38 – $2,576.32 | 8 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | not published | not published | $22.78 – $46.10 | 8 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $1,188.10 – $2,535.64 | 8 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $1,254.07 – $2,674.59 | 8 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $1,337.79 – $2,852.85 | 8 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $12.22 – $25.61 | 7 |
| Sialography s&i CPT 70390 | $978.55 | $978.55 | $17.96 – $921.79 | 9 |
| Sialolithotomy 42330 CPT 42330 | not published | not published | $160.25 – $454.86 | 9 |
| Sickling rbc CPT 85660 | $51.25 | $51.25 | $5.51 – $48.28 | 9 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $68.83 – $551.24 | 9 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $244.25 | $244.25 | $98.12 – $230.08 | 9 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $112.61 – $943.14 | 9 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $63.81 – $559.59 | 9 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $153.81 – $4,359.13 | 9 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $475.10 | $475.10 | $100.10 – $534.53 | 9 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $147.29 – $309.08 | 8 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $189.92 – $397.19 | 8 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $114.87 – $576.29 | 9 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $118.32 – $249.44 | 8 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $163.30 – $341.62 | 8 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $89.40 – $631.54 | 9 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $12.00 – $25.08 | 8 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $74.79 – $874.40 | 9 |
| Sildenafil citrate, 25 mg HCPCS S0090 | not published | not published | $0.27 – $25.75 | 2 |
| Silicon gel insert w/wo lock HCPCS L6692 | not published | not published | $590.39 – $1,566.17 | 3 |
| Sim ang w/prs cath rad emb HCPCS C8004 | not published | not published | $55,719.09 – $55,719.09 | 1 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $73.53 – $151.84 | 8 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $909.06 | $909.06 | $98.64 – $230.82 | 9 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $10.65 – $22.36 | 8 |
| Single pivot hinge pair HCPCS L6605 | not published | not published | $175.60 – $465.82 | 3 |
| Single transfer toe-hand CPT 26553 | not published | not published | $3,137.42 – $6,674.97 | 8 |
| 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 |
| Sinus/juglr venogram s&i CPT 75860 | not published | not published | $52.60 – $108.44 | 8 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $341.94 – $812.72 | 9 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $577.84 – $1,216.65 | 8 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $501.85 – $1,054.65 | 8 |
| Sinus X-ray (complete) CPT 70220 | $430.50 | $430.50 | $10.33 – $405.53 | 9 |
| Sinus X-ray (limited) CPT 70210 | $288.80 | $288.80 | $8.29 – $272.05 | 9 |
| Sio flex pelvisacral custom HCPCS L0622 | not published | not published | $306.53 – $813.15 | 3 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | not published | not published | $164.38 – $279.78 | 3 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $53,426.66 – $109,785.98 | 8 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $1.34 – $3.85 | 8 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $106.63 – $232.17 | 8 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $255.24 – $677.10 | 3 |
| Skeletal muscle relaxant 1/2 CPT 80369 | not published | not published | $13.35 – $50.16 | 3 |
| Skel musc relaxant 3 or more CPT 80370 | not published | not published | $11.79 – $11.79 | 1 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,017.41 – $2,185.90 | 8 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $6.97 – $18.36 | 3 |
| Skin Biopsy CPT 11102 | $214.60 | $214.60 | $36.59 – $186.30 | 9 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $642.78 – $1,626.72 | 9 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $101.16 – $336.01 | 9 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $705.83 – $1,707.04 | 9 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $699.19 – $1,752.64 | 9 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $105.41 – $357.21 | 9 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $5.85 – $12.89 | 8 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $2,352.39 – $5,181.11 | 8 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $3,922.33 – $8,628.40 | 8 |
| Skull X-ray (1 to 3 views) CPT 70250 | $430.50 | $430.50 | $8.64 – $405.53 | 9 |
| Skull X-ray (complete) CPT 70260 | $543.95 | $543.95 | $13.34 – $512.40 | 9 |
| Skyla, 13.5 mg HCPCS J7301 | $4,404.46 | $4,404.46 | $935.70 – $4,140.19 | 9 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $366.01 | 7 |
| Sleep study attended CPT 95807 | $707.20 | $707.20 | $57.97 – $666.18 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $3,829.05 | $3,829.05 | $115.88 – $3,606.97 | 9 |
| Sleep study unattended CPT 95806 | not published | not published | $43.05 – $87.44 | 8 |
| Sleeve fing rolyan med HCPCS L3933 | $170.05 | $170.05 | $68.31 – $160.19 | 9 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $2,866.95 – $6,101.55 | 8 |
| Sling arm deluxe w/pad xs HCPCS A4565 | not published | not published | $8.55 – $22.55 | 3 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $96.13 – $156.09 | 3 |
| Sling suprapubic suburetheral HCPCS C1771 | $2,133.00 | $2,133.00 | $856.83 – $2,009.29 | 9 |
| Slitting of prepuce CPT 54000 | not published | not published | $106.15 – $317.37 | 9 |
| Slitting of prepuce CPT 54001 | $607.35 | $607.35 | $135.12 – $385.48 | 9 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $31.19 – $64.39 | 8 |
| Slp eval non-spch gen comm dev CPT 92605 | $844.95 | $844.95 | $84.23 – $794.25 | 9 |
| Slp pure tone screening CPT 92551 | $56.70 | $56.70 | $11.17 – $53.41 | 9 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $39.67 – $81.34 | 8 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $67.09 – $150.98 | 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.