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 |
|---|---|---|---|---|
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $205.20 | $205.20 | $80.80 – $166.73 | 9 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $168.75 | $168.75 | $67.79 – $149.11 | 9 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $24.35 | $24.35 | $9.78 – $22.92 | 9 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $126.85 | $126.85 | $50.96 – $115.90 | 9 |
| Ghs musc test done w/n test comp CPT 95886 | not published | not published | $44.07 – $90.15 | 8 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | not published | not published | $17.64 – $36.61 | 8 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $36.08 – $73.89 | 8 |
| Ghs myocardial strain img spckl track CPT 93356 | $54.05 | $54.05 | $11.25 – $50.92 | 9 |
| Ghs nailbed repair/nail removal CPT 11760 | $409.00 | $409.00 | $106.60 – $342.78 | 9 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $857.05 | $857.05 | $23.82 – $64.25 | 9 |
| Ghs nerve blk intercostal, single level CPT 64420 | $359.00 | $359.00 | $56.78 – $176.90 | 9 |
| Ghs nerve block axillary nerve CPT 64417 | $307.70 | $307.70 | $61.74 – $289.85 | 9 |
| Ghs nerve block brachial plexus CPT 64415 | $236.60 | $236.60 | $68.00 – $222.88 | 9 |
| Ghs nerve block celiac plexus CPT 64530 | not published | not published | $91.28 – $440.73 | 9 |
| Ghs nerve block interscaline CPT 64510 | $285.95 | $285.95 | $74.05 – $266.64 | 9 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $451.60 | $451.60 | $81.27 – $420.49 | 9 |
| Ghs nerve block sciatic nerve CPT 64445 | $325.25 | $325.25 | $70.25 – $293.03 | 9 |
| Ghs nerve block suprascapular CPT 64418 | $342.85 | $342.85 | $54.17 – $166.40 | 9 |
| Ghs ng placement w fluoro guidance CPT 43752 | $90.40 | $90.40 | $27.74 – $64.98 | 9 |
| Ghs o2 saturation CPT 82810 | not published | not published | $9.77 – $20.33 | 7 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $12.25 – $25.08 | 8 |
| Ghs o2 uptake rest & indirect CPT 94690 | $72.65 | $72.65 | $3.58 – $68.44 | 9 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $140.65 – $226.68 | 2 |
| Ghs opcc repair cvp without subq port CPT 36575 | $321.05 | $321.05 | $32.24 – $269.07 | 9 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $174.53 – $656.59 | 9 |
| Ghs optokenetic CPT 92544 | $247.00 | $247.00 | $6.19 – $232.67 | 9 |
| Ghs oscillating trac CPT 92545 | $247.00 | $247.00 | $6.19 – $232.67 | 9 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $75.60 | $75.60 | $22.75 – $60.39 | 9 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $49.90 | $49.90 | $34.20 – $86.73 | 9 |
| Ghs ot dds rom CPT 95851 | not published | not published | $7.63 – $41.76 | 9 |
| Ghs ot group caregiver training CPT 97552 | $36.05 | $36.05 | $14.48 – $33.96 | 9 |
| Ghs ot prosthetic training/15 min CPT 97761 | $159.35 | $159.35 | $40.66 – $150.11 | 9 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $159.35 | $159.35 | $53.90 – $150.11 | 9 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $101.16 – $134.21 | 3 |
| Ghs pacing - transcutaneous CPT 92953 | $251.05 | $251.05 | $0.89 – $83.00 | 9 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $230.85 | $230.85 | $58.44 – $188.24 | 9 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | not published | not published | $50.27 – $175.39 | 9 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $22.04 – $50.84 | 8 |
| Ghs peritonsillar abscess i andd CPT 42700 | $399.85 | $399.85 | $131.23 – $353.48 | 9 |
| Ghs phenylketonurid CPT 84030 | $206.55 | $206.55 | $5.50 – $194.57 | 9 |
| Ghs picc line insert < 5 CPT 36568 | $939.45 | $939.45 | $89.50 – $884.96 | 9 |
| Ghs plngl fx pm cl CPT 26725 | $683.90 | $683.90 | $274.72 – $643.62 | 9 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $4.31 – $8.82 | 7 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $121.07 – $244.68 | 8 |
| Ghs pos nystagmus CPT 92542 | $247.00 | $247.00 | $7.33 – $232.67 | 9 |
| Ghs ppd (tb intradermal) CPT 86580 | $76.81 | $76.81 | $9.29 – $20.33 | 9 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $110.50 | $110.50 | $9.66 – $104.09 | 9 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.61 – $11.52 | 7 |
| Ghs protoporphyrins fract CPT 84202 | $247.85 | $247.85 | $14.35 – $233.47 | 9 |
| Ghs pr without cont pulse ox CPT 94625 | $172.70 | $172.70 | $16.47 – $142.62 | 9 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | not published | not published | $12.25 – $25.67 | 7 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $253.67 – $338.22 | 3 |
| Ghs quinidine CPT 80194 | $137.85 | $137.85 | $14.60 – $129.85 | 9 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $83.49 – $176.90 | 8 |
| Ghs removal intranasal foreign body CPT 30300 | $287.50 | $287.50 | $70.50 – $165.32 | 9 |
| Ghs removal pharyngeal foreign body CPT 42809 | $452.20 | $452.20 | $122.11 – $378.99 | 9 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,217.40 | $1,217.40 | $489.03 – $1,145.70 | 9 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $957.90 | $957.90 | $384.79 – $901.48 | 9 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $40.45 | $40.45 | $15.89 – $38.10 | 9 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.31 – $8.82 | 7 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $72.85 | $72.85 | $13.91 – $68.62 | 9 |
| Ghs sedimentation rate CPT 85651 | $76.95 | $76.95 | $3.46 – $47.25 | 9 |
| Ghs semen analysis fert CPT 89320 | $376.60 | $376.60 | $12.31 – $354.76 | 9 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $20.33 | 7 |
| Ghs sensitivity (per antimicro) CPT 87184 | $94.50 | $94.50 | $7.48 – $89.02 | 9 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $340.20 | $340.20 | $91.12 – $318.75 | 9 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $377.95 | $377.95 | $123.20 – $320.47 | 9 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $352.25 | $352.25 | $112.05 – $320.47 | 9 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $340.20 | $340.20 | $136.66 – $311.78 | 9 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $340.20 | $340.20 | $71.96 – $276.26 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $309.05 | $309.05 | $70.24 – $257.62 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $340.20 | $340.20 | $90.75 – $310.52 | 9 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $404.85 | $404.85 | $136.66 – $320.47 | 9 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $340.20 | $340.20 | $136.66 – $320.16 | 9 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $39.67 – $77.95 | 8 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $26.62 – $52.87 | 8 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $43.77 – $90.15 | 8 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $423.80 | $423.80 | $47.48 – $399.22 | 9 |
| Ghs sphenopalatine ganglion block CPT 64505 | $249.45 | $249.45 | $98.59 – $234.98 | 9 |
| Ghs spont nystagmus CPT 92541 | $247.00 | $247.00 | $7.33 – $232.67 | 9 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $100.92 – $211.47 | 8 |
| Ghs st - eval for alt comm CPT 92567 | $97.15 | $97.15 | $10.58 – $31.48 | 9 |
| Ghs strapping shoulder - 29240 CPT 29240 | $116.05 | $116.05 | $17.99 – $57.18 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | $692.45 | $692.45 | $70.73 – $652.29 | 9 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $14.89 – $33.21 | 8 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $131.09 – $281.29 | 8 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $590.45 | $590.45 | $180.80 – $546.56 | 9 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $135.26 – $343.72 | 9 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $307.53 – $644.60 | 8 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $15.30 | 7 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $668.35 | $668.35 | $268.48 – $594.26 | 9 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $232.00 – $618.05 | 9 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $50.84 | 7 |
| Ghs urine, porphyrins quant CPT 84120 | $53.45 | $53.45 | $14.71 – $50.35 | 9 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $763.06 – $1,626.04 | 8 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $1,373.34 – $2,606.97 | 5 |
| Ghs windowing of cast CPT 29730 | not published | not published | $42.70 – $127.20 | 9 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $28.48 | 7 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.72 – $30.84 | 7 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $40.16 – $81.34 | 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.