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 |
|---|---|---|---|---|
| Close nephrovisceral fistula CPT 50525 | not published | not published | $1,400.63 – $3,010.78 | 8 |
| Close nephrovisceral fistula CPT 50526 | not published | not published | $1,500.32 – $3,222.95 | 8 |
| Close tear duct opening CPT 68760 | not published | not published | $138.81 – $421.45 | 9 |
| Close tear duct opening CPT 68761 | not published | not published | $112.16 – $280.11 | 9 |
| Close tear system fistula CPT 68770 | not published | not published | $598.34 – $1,263.42 | 8 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $16.00 – $33.21 | 7 |
| Clos txnose fx without stablz 21315 CPT 21315 | $730.20 | $730.20 | $57.97 – $295.53 | 9 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $826.59 – $1,760.92 | 8 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $1,517.48 – $3,224.98 | 8 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $966.27 – $2,053.07 | 8 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $1,329.76 – $2,835.23 | 8 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $719.35 | $719.35 | $194.21 – $568.59 | 9 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $90.96 – $349.50 | 9 |
| Closure of salivary fistula CPT 42600 | not published | not published | $345.64 – $1,060.71 | 9 |
| Closure of valve CPT 33600 | not published | not published | $1,616.49 – $3,454.07 | 8 |
| Closure of valve CPT 33602 | not published | not published | $1,569.33 – $3,355.11 | 8 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $321.19 – $864.12 | 9 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $3,037.68 – $3,037.68 | 1 |
| Closure ureter/bowel fistula CPT 50930 | not published | not published | $1,058.65 – $2,233.36 | 8 |
| Closure ureter/skin fistula CPT 50920 | not published | not published | $848.10 – $1,794.82 | 8 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $18.93 – $39.67 | 7 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $20.42 – $42.70 | 7 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $18.93 – $39.67 | 7 |
| Clot factor xii hageman CPT 85280 | not published | not published | $19.35 – $40.55 | 7 |
| Clot factor xiii fibrin scrn CPT 85291 | $218.65 | $218.65 | $9.11 – $205.97 | 9 |
| Clot factor xiii fibrin stab CPT 85290 | not published | not published | $16.34 – $34.24 | 7 |
| Clotting assay whole blood CPT 85396 | not published | not published | $18.87 – $38.64 | 8 |
| Clozapine, 25 mg HCPCS S0136 | not published | not published | $0.66 – $2.03 | 2 |
| Clsd ostomy pouch w/flange HCPCS A5054 | not published | not published | $2.00 – $5.26 | 3 |
| Clsd ostomy pouch without barr HCPCS A5052 | not published | not published | $1.65 – $4.36 | 3 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $682.95 | $682.95 | $274.34 – $642.72 | 9 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $619.60 | $619.60 | $299.07 – $675.87 | 9 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $755.75 | $755.75 | $303.58 – $676.45 | 9 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $508.80 | $508.80 | $204.38 – $478.83 | 9 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $498.05 | $498.05 | $200.07 – $468.71 | 9 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $720.75 | $720.75 | $282.72 – $662.60 | 9 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $404.85 | $404.85 | $223.93 – $494.80 | 9 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $431.90 | $431.90 | $173.49 – $406.46 | 9 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $186.15 – $413.45 | 9 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $929.90 | $929.90 | $373.54 – $816.07 | 9 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $583.10 | $583.10 | $299.02 – $653.40 | 9 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $255.10 | $255.10 | $77.99 – $203.02 | 9 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $1,670.90 | $1,670.90 | $671.20 – $1,560.97 | 9 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $527.11 – $1,119.72 | 8 |
| Clsd tx fracture of radius 25500 CPT 25500 | $506.10 | $506.10 | $252.61 – $575.65 | 9 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $325.25 | $325.25 | $121.22 – $272.59 | 9 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $355.00 | $355.00 | $139.30 – $303.65 | 9 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | not published | not published | $316.88 – $700.17 | 9 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,185.05 | $1,185.05 | $476.03 – $1,079.74 | 9 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $514.30 | $514.30 | $254.05 – $586.57 | 9 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,007.80 | $1,007.80 | $404.83 – $949.35 | 9 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $499.35 | $499.35 | $254.86 – $559.19 | 9 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $870.60 | $870.60 | $349.60 – $819.32 | 9 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $705.90 | $705.90 | $343.94 – $770.96 | 9 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $1,198.55 | $1,198.55 | $326.97 – $731.13 | 9 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $850.30 | $850.30 | $341.57 – $757.77 | 9 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $1,513.00 | $1,513.00 | $461.44 – $1,138.45 | 9 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $426.50 | $426.50 | $216.26 – $477.84 | 9 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $543.95 | $543.95 | $280.77 – $620.19 | 9 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $697.80 | $697.80 | $280.31 – $637.81 | 9 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $493.11 – $1,056.69 | 8 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $523.70 | $523.70 | $222.02 – $516.54 | 9 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | not published | not published | $199.18 – $435.83 | 9 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $709.90 | $709.90 | $91.73 – $418.89 | 9 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $57.22 – $57.22 | 1 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $739.65 | $739.65 | $319.06 – $739.48 | 9 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $784.15 | $784.15 | $314.99 – $725.92 | 9 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $599.30 | $599.30 | $294.78 – $655.96 | 9 |
| Clsd tx pelvic ring fx CPT 27197 | $1,122.95 | $1,122.95 | $128.14 – $478.48 | 9 |
| Clsd tx pelvic ring fx CPT 27198 | $1,679.05 | $1,679.05 | $303.60 – $715.35 | 9 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $792.25 | $792.25 | $251.10 – $588.84 | 9 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | not published | not published | $185.16 – $410.08 | 9 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | not published | not published | $240.83 – $533.89 | 9 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $2,770.90 | $2,770.90 | $394.76 – $903.31 | 9 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $430.50 | $430.50 | $237.24 – $524.61 | 9 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $940.60 | $940.60 | $377.84 – $851.31 | 9 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,020.35 | $1,020.35 | $486.38 – $1,103.11 | 9 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $897.50 | $897.50 | $360.53 – $844.64 | 9 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $676.20 | $676.20 | $329.61 – $755.54 | 9 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $214.60 | $214.60 | $30.04 – $202.15 | 9 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $256.45 | $256.45 | $89.86 – $226.65 | 9 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $596.55 | $596.55 | $287.15 – $666.88 | 9 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $2,159.50 | $2,159.50 | $428.87 – $983.61 | 9 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $484.55 | $484.55 | $237.87 – $535.82 | 9 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $622.25 | $622.25 | $285.97 – $622.22 | 9 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $565.50 | $565.50 | $279.19 – $616.12 | 9 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $564.20 | $564.20 | $278.85 – $621.26 | 9 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $973.10 | $973.10 | $486.55 – $1,121.75 | 9 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | not published | not published | $300.91 – $664.31 | 9 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $538.45 | $538.45 | $262.56 – $590.43 | 9 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $1,772.21 – $3,776.71 | 8 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $1,766.18 – $3,757.05 | 8 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $776.05 | $776.05 | $394.17 – $899.45 | 9 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $884.00 | $884.00 | $433.91 – $984.25 | 9 |
| Cltx craniofacial separation CPT 21431 | $1,527.85 | $1,527.85 | $669.78 – $1,419.32 | 9 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | $778.70 | $778.70 | $347.54 – $774.82 | 9 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $1,419.90 | $1,419.90 | $289.35 – $670.08 | 9 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,012.25 | $1,012.25 | $494.06 – $1,109.54 | 9 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $701.80 | $701.80 | $306.73 – $710.57 | 9 |
| Cltx lunate dislc w/mnpj CPT 25690 | $1,058.15 | $1,058.15 | $425.06 – $995.82 | 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.