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 |
|---|---|---|---|---|
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $360.30 | $360.30 | $11.98 – $339.40 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $56.70 | $56.70 | $11.98 – $53.41 | 9 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $109.20 | $109.20 | $35.09 – $102.87 | 9 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $175.50 | $175.50 | $35.09 – $165.32 | 9 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $209.15 | $209.15 | $37.27 – $197.02 | 9 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | not published | not published | $416.78 – $873.00 | 7 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $328.00 | $328.00 | $35.09 – $308.98 | 9 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | not published | not published | $35.09 – $73.19 | 7 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $344.65 | $344.65 | $41.68 – $324.66 | 9 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $78.30 | $78.30 | $31.45 – $73.76 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $107.00 | $107.00 | $32.83 – $79.66 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $166.60 | $166.60 | $66.92 – $156.79 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $91.29 – $298.87 | 7 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $35.09 – $73.19 | 7 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $251.05 | $251.05 | $35.09 – $236.49 | 9 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $122.05 | $122.05 | $49.03 – $114.97 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $416.78 – $873.00 | 7 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $471.85 | $471.85 | $128.29 – $444.48 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $953.60 | $953.60 | $235.16 – $898.29 | 9 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $354.60 | $354.60 | $42.84 – $334.03 | 9 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $695.15 | $695.15 | $42.84 – $654.83 | 9 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $507.45 | $507.45 | $42.84 – $478.02 | 9 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $545.25 | $545.25 | $85.10 – $513.63 | 9 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $339.25 | $339.25 | $136.28 – $319.57 | 9 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $5,085.74 | $5,085.74 | $31.71 – $2,592.65 | 9 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $2,322.60 | $2,322.60 | $21.89 – $2,183.24 | 9 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $4,395.66 | $4,395.66 | $10.66 – $4,131.92 | 9 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $21.54 – $61.00 | 7 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $40.04 – $165.06 | 3 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $23.46 – $57.08 | 3 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | $1,120.50 | $1,120.50 | $148.44 – $1,055.51 | 9 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,952.02 – $6,285.24 | 8 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,914.45 – $6,130.70 | 8 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | $268.15 | $268.15 | $107.72 – $252.60 | 9 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | $268.15 | $268.15 | $107.72 – $252.60 | 9 |
| Infuse radioactive materials CPT 77750 | not published | not published | $228.99 – $502.41 | 8 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $66.57 – $164.47 | 9 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $72.28 – $237.71 | 9 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $82.87 – $93.48 | 5 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $1,941.21 – $5,149.57 | 3 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,386.77 – $3,678.79 | 3 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $93.54 – $93.54 | 1 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,224.27 – $3,247.72 | 3 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $39.14 – $124.63 | 8 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $332.07 – $678.48 | 8 |
| Initial nursing facility care/day 35 minutes CPT 99305 | $275.35 | $275.35 | $129.88 – $269.10 | 9 |
| Initial nursing facility care/day 45 minutes CPT 99306 | $338.80 | $338.80 | $169.40 – $367.37 | 9 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | $205.20 | $205.20 | $78.41 – $162.67 | 9 |
| Initial observation care CPT 99218 | not published | not published | $132.65 – $132.65 | 1 |
| Initial observation care CPT 99219 | not published | not published | $218.03 – $218.03 | 1 |
| Initial observation care CPT 99220 | not published | not published | $306.76 – $306.76 | 1 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $60.19 – $176.68 | 9 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $120.27 – $310.95 | 8 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $37.21 – $110.51 | 8 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $5.88 – $17.95 | 3 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $8,854.05 | $8,854.05 | $6.55 – $8,322.81 | 9 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.48 – $0.48 | 1 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.05 – $0.10 | 8 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.05 – $0.08 | 8 |
| Inj, acetaminophen (hikma) HCPCS J0137 | $147.49 | $147.49 | $0.05 – $138.64 | 9 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,479.53 – $7,566.95 | 8 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $181.32 – $181.32 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $27.20 – $27.20 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $61,200.00 – $192,561.72 | 4 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.98 – $11.82 | 8 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $68.33 – $105.17 | 2 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $650.49 – $1,018.04 | 2 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.44 – $3.00 | 8 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $2.57 – $5.07 | 3 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $5.49 – $8.70 | 8 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $290.36 – $290.36 | 1 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $57.72 – $115.12 | 8 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.18 – $27.50 | 3 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $127.50 – $400.53 | 4 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $16.55 – $35.12 | 8 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,348.99 – $10,556.10 | 4 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $1.84 – $5.70 | 3 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.01 – $6.18 | 8 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $46.18 – $157.17 | 3 |
| Inj. asceniv HCPCS J1554 | not published | not published | $491.40 – $978.46 | 8 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $49.19 – $107.03 | 8 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $214.89 – $334.97 | 2 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $73.90 – $153.91 | 8 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $45.02 – $141.86 | 5 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $15,277.76 | $15,277.76 | $168.22 – $14,361.09 | 9 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $38.33 – $83.86 | 3 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $0.03 – $6,219,252.16 | 2 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.86 – $78.81 | 8 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $206.21 – $414.92 | 8 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.17 – $0.34 | 8 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $8.82 – $147.23 | 5 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $2.68 – $46.72 | 5 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $1.52 – $3.77 | 8 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $75.99 – $215.52 | 4 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $847.37 – $1,294.79 | 2 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $3,389.51 – $5,179.15 | 2 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $321.16 – $669.93 | 8 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $666.62 – $1,768.38 | 3 |
| Inj, bupivacaine liposome HCPCS J0666 | $1,681.29 | $1,681.29 | $2.85 – $1,583.78 | 9 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.49 – $1.55 | 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.