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 |
|---|---|---|---|---|
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $469.65 | $469.65 | $8.29 – $442.41 | 9 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $63.61 – $139.09 | 8 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $138.32 – $205.03 | 2 |
| Talymed HCPCS Q4127 | not published | not published | $67.32 – $135.39 | 8 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | not published | not published | $0.29 – $3.39 | 2 |
| Tap block bilat cont infusion 64489 CPT 64489 | not published | not published | $76.67 – $665.59 | 9 |
| Tap block uni by cont infusion 64487 CPT 64487 | not published | not published | $62.30 – $410.53 | 9 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.43 – $0.67 | 2 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,075.05 | $2,075.05 | $759.53 – $1,954.70 | 9 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,919.60 – $6,117.83 | 7 |
| Target gsa panel organ neop CPT 81445 | $1,073.00 | $1,073.00 | $431.02 – $1,010.77 | 9 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $3,143.15 – $3,143.15 | 1 |
| Tas congenital car anomal CPT 33741 | not published | not published | $704.45 – $1,492.52 | 8 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $125.27 – $428.52 | 9 |
| Tavr perq femoral CPT 33361 | not published | not published | $1,133.55 – $2,406.86 | 8 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $2,770.33 | $2,770.33 | $0.40 – $1,636.54 | 9 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $287.07 | 7 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $38.24 – $81.34 | 8 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $9.64 – $19.66 | 8 |
| Tbs techl calculation only CPT 77091 | not published | not published | $26.18 – $55.57 | 8 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $2.42 – $6.10 | 8 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $100.00 – $209.44 | 7 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $64.25 | $64.25 | $25.81 – $60.52 | 9 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $416.38 – $106,089.99 | 6 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $1,000.30 – $106,089.99 | 6 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $858.55 – $3,630.73 | 5 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $667.15 – $106,089.99 | 4 |
| Tc-99m diag per dose HCPCS A4641 | not published | not published | $106,089.99 – $106,089.99 | 1 |
| Tc-99m disofenin HCPCS A9510 | $205.20 | $205.20 | $71.40 – $89.06 | 9 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $2,303.90 | $2,303.90 | $925.48 – $2,168.20 | 9 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $1,327.64 – $1,748.25 | 5 |
| Tc-99m fanolesomab diag HCPCS A9566 | not published | not published | $106,089.99 – $106,089.99 | 1 |
| Tc-99m gluceptate HCPCS A9550 | not published | not published | $106,089.99 – $106,089.99 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $688.56 – $996.48 | 2 |
| Tc-99m labeled rbc HCPCS A9560 | $188.95 | $188.95 | $75.90 – $177.82 | 9 |
| Tc-99m maa HCPCS A9540 | $67.45 | $67.45 | $27.09 – $45.76 | 9 |
| Tc-99m mebrofenin HCPCS A9537 | $94.50 | $94.50 | $37.96 – $88.93 | 9 |
| Tc-99m medronate HCPCS A9503 | $35.10 | $35.10 | $13.26 – $33.03 | 9 |
| Tc-99m mertiatide HCPCS A9562 | $894.85 | $894.85 | $359.46 – $842.95 | 9 |
| Tc-99m non-heu per study dose HCPCS Q9969 | not published | not published | $0.13 – $30.33 | 3 |
| Tc-99m oxidronate HCPCS A9561 | $138.70 | $138.70 | $44.88 – $111.96 | 9 |
| Tc-99m pentetate dtpa HCPCS A9539 | $67.45 | $67.45 | $27.09 – $31.96 | 9 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $137.65 | $137.65 | $17.53 – $129.39 | 9 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $32.40 | $32.40 | $1.59 – $30.46 | 9 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $188.95 | $188.95 | $46.17 – $80.57 | 9 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $171.30 | $171.30 | $68.81 – $161.21 | 9 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $720.75 | $720.75 | $287.95 – $611.41 | 9 |
| Tc-99m sulfur colloid HCPCS A9541 | $178.15 | $178.15 | $24.42 – $57.27 | 9 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $533.10 | $533.10 | $86.98 – $501.11 | 9 |
| Tc-99m tilmanocept diag HCPCS A9520 | not published | not published | $674.81 – $984.44 | 3 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $392.35 – $1,031.80 | 9 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $58.13 – $118.62 | 8 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $57.36 – $117.26 | 8 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $49.23 – $96.38 | 7 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $77.17 – $159.27 | 7 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $282.45 | $282.45 | $30.10 – $266.07 | 9 |
| T cells absolute cd 4 count CPT 86361 | not published | not published | $24.06 – $56.12 | 7 |
| T cells total count CPT 86359 | $277.80 | $277.80 | $25.08 – $261.69 | 9 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $316.74 – $1,529.97 | 5 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $494.06 – $1,529.97 | 5 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $190.65 – $669.11 | 5 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $440.01 – $977.39 | 8 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $961.82 – $2,043.57 | 8 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $34.55 – $70.49 | 7 |
| Team conf without pat by phys CPT 99367 | not published | not published | $53.05 – $107.77 | 7 |
| Team conf w/pat by hc prof CPT 99366 | $562.80 | $562.80 | $39.25 – $266.40 | 9 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $202.84 – $424.54 | 8 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $3,881.74 – $3,881.74 | 1 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $3,881.74 – $3,881.74 | 1 |
| Teflon or equal cable lining HCPCS L6665 | not published | not published | $53.10 – $140.86 | 3 |
| Telavancin injection HCPCS J3095 | not published | not published | $7.05 – $14.63 | 8 |
| Telehealth original site facility fee HCPCS Q3014 | $234.90 | $234.90 | $29.21 – $221.28 | 9 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $150.17 – $291.03 | 8 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $72.57 – $150.47 | 8 |
| Temozolomide HCPCS J8700 | not published | not published | $0.19 – $0.52 | 8 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $4,368.45 | $4,368.45 | $10.40 – $4,106.34 | 9 |
| Temperature gradient studies CPT 93740 | not published | not published | $2.70 – $14.78 | 7 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $2,671.93 – $2,671.93 | 1 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $24,391.51 | $24,391.51 | $30.27 – $22,928.02 | 9 |
| Tendon lengthening CPT 26476 | not published | not published | $622.46 – $1,321.03 | 8 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $560.78 – $1,213.26 | 8 |
| Tendon shortening CPT 26477 | not published | not published | $606.11 – $1,291.21 | 8 |
| Tendon transfer with graft CPT 26492 | not published | not published | $896.35 – $1,906.66 | 8 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | not published | not published | $146.56 – $321.10 | 8 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $346.95 – $2,545.87 | 3 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $581.25 – $1,264.78 | 8 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $587.05 – $1,237.67 | 8 |
| Tenolysis triceps CPT 24332 | not published | not published | $594.70 – $1,289.85 | 8 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $752.17 – $1,621.97 | 8 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $500.33 – $1,084.47 | 8 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $690.46 – $1,500.65 | 8 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $284.56 – $854.48 | 9 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | not published | not published | $232.87 – $727.27 | 9 |
| Tension based scoliosis orth HCPCS L1005 | not published | not published | $2,973.14 – $7,887.05 | 3 |
| Tens suppl 2 lead per month HCPCS A4595 | not published | not published | $9.83 – $29.73 | 3 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $70.84 | $70.84 | $0.86 – $66.59 | 9 |
| Teriparatide injection HCPCS J3110 | not published | not published | $16.26 – $51.34 | 3 |
| Term dev auto grasp feature HCPCS L6881 | not published | not published | $3,805.05 – $10,093.90 | 3 |
| Term device, multi art digit HCPCS L6715 | not published | not published | $2,938.43 – $7,794.96 | 3 |
| Term dev mech hand vol close HCPCS L6709 | not published | not published | $1,148.64 – $3,047.06 | 3 |
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.