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 |
|---|---|---|---|---|
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $77.94 – $132.96 | 3 |
| Lso full corset HCPCS L0976 | not published | not published | $152.10 – $403.50 | 3 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $150.44 – $399.08 | 3 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,225.15 – $3,250.02 | 3 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $1,087.69 – $1,882.73 | 3 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $150.44 – $256.69 | 3 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $870.42 – $2,309.00 | 3 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,402.00 – $3,719.17 | 3 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $266.38 – $706.64 | 3 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $266.38 – $454.52 | 3 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $972.04 – $2,578.60 | 3 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,087.69 – $2,885.39 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $46.08 | 7 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.51 – $4.67 | 3 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $56.61 – $150.18 | 3 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $75.12 – $199.25 | 3 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $39.29 – $79.98 | 8 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $69.43 – $184.17 | 3 |
| Lumbar sling HCPCS L1090 | not published | not published | $81.57 – $216.37 | 3 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,505.90 – $3,255.47 | 8 |
| Lumizyme injection HCPCS J0221 | not published | not published | $192.02 – $398.61 | 8 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $483.20 | $483.20 | $10.02 – $455.17 | 9 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $2.58 – $5.43 | 8 |
| Lung Function Test (Spirometry) CPT 94010 | $224.05 | $224.05 | $7.98 – $211.06 | 9 |
| Lung perfusion imaging CPT 78580 | $1,599.35 | $1,599.35 | $34.30 – $1,506.59 | 9 |
| Lung transplant double CPT 32853 | not published | not published | $4,292.76 – $9,178.09 | 8 |
| Lung transplant single CPT 32851 | not published | not published | $3,073.91 – $6,560.43 | 8 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,327.17 – $7,062.69 | 8 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,549.30 – $9,700.67 | 8 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,386.34 – $2,969.44 | 8 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $192.14 – $405.05 | 8 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $31,609.35 | $31,609.35 | $39.23 – $12,105.48 | 9 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $285.07 – $896.23 | 4 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $232.14 – $727.65 | 4 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $478.70 – $1,260.87 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $31.19 – $110.51 | 9 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $276.08 – $732.38 | 3 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $20.05 – $42.01 | 7 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $678.33 – $1,453.88 | 8 |
| Lymphatics/lymph node imaging CPT 78195 | $3,370.20 | $3,370.20 | $55.03 – $111.16 | 9 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $76.59 | 7 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $49.03 – $102.74 | 7 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $114.39 – $397.11 | 7 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $47.59 – $99.64 | 7 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $40.71 – $86.75 | 8 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $55.24 – $111.83 | 8 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $38.28 – $77.95 | 8 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $51.94 – $105.07 | 8 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $144.96 – $623.19 | 9 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $149.46 – $357.21 | 9 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $193.20 – $497.26 | 9 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $15.53 – $30.59 | 8 |
| Macro exam dissect molec study ea CPT 88387 | $22.95 | $22.95 | $9.22 – $21.62 | 9 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $4.27 – $8.82 | 7 |
| Macroscopic exam parasite CPT 87169 | $72.85 | $72.85 | $4.31 – $68.62 | 9 |
| Magnesium CPT 83735 | $114.65 | $114.65 | $6.70 – $108.00 | 9 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $151.67 | $151.67 | $0.50 – $39.30 | 9 |
| Magnetic image bone marrow CPT 77084 | $2,110.95 | $2,110.95 | $75.56 – $1,988.51 | 9 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $20.14 – $43.85 | 3 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $27.64 | 7 |
| Male sling procedure CPT 53440 | not published | not published | $724.99 – $1,534.53 | 8 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,870.71 – $6,115.78 | 8 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $342.86 – $761.17 | 8 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $418.34 – $886.56 | 8 |
| Manipulation of hip joint CPT 27275 | not published | not published | $177.05 – $384.99 | 8 |
| Manipulation of spine CPT 22505 | not published | not published | $124.57 – $310.44 | 8 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $75.24 – $228.71 | 9 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $2.60 – $6.42 | 8 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $0.67 – $6.71 | 3 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $80.27 – $212.92 | 3 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $10.62 | 7 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $165.86 – $325.73 | 8 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $130.12 – $278.57 | 8 |
| Map tachycard site(s) CPT 93609 | not published | not published | $201.27 – $509.48 | 8 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $45.94 – $97.65 | 8 |
| Marker biop eviva buckle ss HCPCS A4648 | $308.20 | $308.20 | $25.34 – $59.43 | 9 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,084.10 – $2,320.78 | 8 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $105.91 – $214.17 | 2 |
| Mastectomy form HCPCS L8020 | not published | not published | $190.19 – $504.54 | 3 |
| Mastectomy partial CPT 19301 | not published | not published | $630.54 – $1,356.27 | 8 |
| Mast mod rad CPT 19307 | not published | not published | $1,125.98 – $2,420.42 | 8 |
| Mastoidectomy CPT 69501 | not published | not published | $690.66 – $1,447.11 | 8 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $917.45 – $1,918.85 | 8 |
| Mastoids complete CPT 70130 | $449.45 | $449.45 | $16.27 – $423.38 | 9 |
| Mastoid surgery revision CPT 69603 | not published | not published | $1,244.18 – $2,614.27 | 8 |
| Mastopexy CPT 19316 | not published | not published | $759.93 – $1,630.79 | 8 |
| Mast radical CPT 19305 | not published | not published | $1,098.78 – $2,351.29 | 8 |
| Mast rad urban type CPT 19306 | not published | not published | $1,163.94 – $2,507.86 | 8 |
| Mast simple complete CPT 19303 | not published | not published | $914.19 – $1,970.36 | 8 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $93.25 – $168.10 | 8 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $1,870.00 – $4,609.96 | 3 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $18.55 – $40.63 | 8 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $35.09 – $73.19 | 7 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $56.93 | 7 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $42.84 – $89.48 | 7 |
| Maxillofacial fixation CPT 21100 | not published | not published | $342.63 – $1,194.34 | 9 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $35.65 | $35.65 | $14.32 – $33.58 | 9 |
| Mayo aathr protein s free CPT 85306 | $135.60 | $135.60 | $15.32 – $127.74 | 9 |
| Mayo activated protein c resistance assay CPT 85307 | not published | not published | $15.32 – $31.85 | 7 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $404.10 | $404.10 | $24.69 – $380.66 | 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.