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 |
|---|---|---|---|---|
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $360.61 – $760.50 | 8 |
| Tube drain vert dev st 5-40f HCPCS A5200 | not published | not published | $12.57 – $33.11 | 3 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | not published | not published | $52.29 – $137.73 | 3 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | not published | not published | $7.28 – $19.19 | 3 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | not published | not published | $52.78 – $138.99 | 3 |
| Tubing (oxygen) per foot HCPCS A4616 | not published | not published | $0.06 – $0.17 | 3 |
| Tubular dressing HCPCS A6457 | not published | not published | $1.26 – $3.33 | 3 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $70.11 – $145.05 | 7 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,117.29 – $2,343.83 | 8 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,038.44 – $2,179.80 | 8 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $477.36 – $1,266.31 | 3 |
| Tx atrial fib pulm vein isol CPT 93656 | not published | not published | $898.82 – $1,878.85 | 8 |
| Tx closed distal humerus fx CPT 24999 | $1,051.40 | $1,051.40 | $422.35 – $881.18 | 9 |
| Tx closed hip disl traumatic without anes CPT 27250 | $396.80 | $396.80 | $159.39 – $365.34 | 9 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $1,252.50 | $1,252.50 | $560.52 – $1,225.82 | 9 |
| Tx closed tib shaft fx without manip CPT 27750 | $643.75 | $643.75 | $315.67 – $699.01 | 9 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $107.25 – $309.02 | 9 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $69.86 – $210.09 | 9 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $904.25 – $1,941.21 | 8 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $857.51 – $1,842.94 | 8 |
| Tx l/r atrial fib addl CPT 93657 | not published | not published | $290.84 – $609.35 | 8 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $717.30 – $1,547.42 | 8 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | not published | not published | $487.56 – $1,058.72 | 8 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $530.99 – $1,153.62 | 8 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $428.66 – $909.61 | 8 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $613.15 – $1,302.73 | 8 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $575.63 – $1,247.16 | 8 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $443.22 – $950.95 | 8 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $402.25 | $402.25 | $185.73 – $421.45 | 9 |
| Tympanic membrane repair CPT 69610 | not published | not published | $278.93 – $743.98 | 9 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $530.44 – $1,111.59 | 8 |
| Tympanometry & reflex thresh CPT 92550 | $194.40 | $194.40 | $21.71 – $183.12 | 9 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $127.72 – $392.54 | 9 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,358.29 – $2,854.21 | 8 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,235.30 – $2,606.83 | 8 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $366.01 | 7 |
| Typhoid vaccine oral CPT 90690 | not published | not published | $66.43 – $169.29 | 3 |
| U2af1 gene common variants CPT 81357 | not published | not published | $123.70 – $404.65 | 7 |
| Ua w/micro/comp poc CPT 81000 | $56.00 | $56.00 | $3.26 – $42.00 | 9 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $67.66 – $136.45 | 8 |
| Ue triple control harness HCPCS L6677 | not published | not published | $276.10 – $732.42 | 3 |
| Ugt1a1 gene analy common variants CPT 81350 | $1,377.25 | $1,377.25 | $61.49 – $1,297.37 | 9 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $2.58 – $5.43 | 8 |
| Ultrasound breast complete CPT 76641 | $525.10 | $525.10 | $34.58 – $494.64 | 9 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $552.05 | $552.05 | $32.22 – $111.50 | 9 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $322.60 | $322.60 | $23.45 – $303.89 | 9 |
| Ultrasound dx ophth b-scan CPT 76512 | $109.25 | $109.25 | $29.91 – $102.91 | 9 |
| Ultrasound elastography ea l target les CPT 76983 | not published | not published | $24.44 – $47.54 | 8 |
| Ultrasound elastography parenchyma CPT 76981 | not published | not published | $28.17 – $57.60 | 8 |
| Ultrasound encephalogram CPT 76506 | $596.55 | $596.55 | $29.87 – $561.95 | 9 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $642.50 | $642.50 | $35.62 – $605.24 | 9 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $616.80 | $616.80 | $27.00 – $73.19 | 9 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $674.85 | $674.85 | $29.73 – $58.97 | 9 |
| Ultrasound guidance for vascular access CPT 76937 | $637.05 | $637.05 | $10.85 – $25.43 | 9 |
| Ultrasound guide intraoperative CPT 76998 | $904.30 | $904.30 | $58.80 – $94.21 | 9 |
| Ultrasound guide tissue ablation CPT 76940 | $265.00 | $265.00 | $96.47 – $190.17 | 9 |
| Ultrasound hips infant dynamic CPT 76885 | $427.85 | $427.85 | $34.92 – $403.03 | 9 |
| Ultrasound infant hips ltd without stress CPT 76886 | $427.85 | $427.85 | $29.53 – $403.03 | 9 |
| Ultrasound joint complete left CPT 76881 | $738.30 | $738.30 | $9.00 – $82.23 | 9 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $24.66 – $109.87 | 8 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $558.75 | $558.75 | $46.66 – $526.34 | 9 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $372.55 | $372.55 | $36.39 – $350.94 | 9 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $877.25 | $877.25 | $89.72 – $179.62 | 9 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $727.50 | $727.50 | $40.16 – $81.34 | 9 |
| Ultrasound prostate/transrectal CPT 76872 | $770.75 | $770.75 | $31.80 – $65.06 | 9 |
| Ultrasound spinal canal and contents CPT 76800 | $607.35 | $607.35 | $58.44 – $572.12 | 9 |
| Ultrasound transabd ea addl gest CPT 76812 | $877.25 | $877.25 | $84.01 – $826.37 | 9 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $76.26 – $154.54 | 8 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $39.97 – $81.34 | 8 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.00 – $16.95 | 8 |
| Umbilical artery cath newborn 36660 CPT 36660 | $148.45 | $148.45 | $66.60 – $136.25 | 9 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $492.02 – $1,058.72 | 8 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $926.01 – $1,003.82 | 3 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $11,206.70 – $29,517.41 | 3 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $120.35 – $120.35 | 1 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $120.35 – $120.35 | 1 |
| Unlisted chemotherapy px CPT 96549 | $179.50 | $179.50 | $0.67 – $169.09 | 9 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $1,140.97 – $1,140.97 | 1 |
| Unlisted CT procedure CPT 76497 | not published | not published | $44.07 – $432.59 | 2 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $1,974.30 – $1,974.30 | 1 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $262.52 – $262.52 | 1 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $262.52 – $262.52 | 1 |
| Unlisted dialysis procedure CPT 90999 | $1,429.30 | $1,429.30 | $107.35 – $251.75 | 9 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $768.71 – $768.71 | 1 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $1,974.30 – $1,974.30 | 1 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $988.42 – $988.42 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $71.16 – $432.59 | 2 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $1,974.30 – $1,974.30 | 1 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $1,974.30 – $1,974.30 | 1 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | $988.42 – $988.42 | 1 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laps px esoph CPT 43289 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laps px lymphtc sys CPT 38589 | not published | not published | $28,665.71 – $28,665.71 | 1 |
| Unlisted laps px ovidct ovry CPT 58679 | not published | not published | $28,665.71 – $28,665.71 | 1 |
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.