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 |
|---|---|---|---|---|
| Pegaptanib sodium injection HCPCS J2503 | not published | not published | $785.50 – $1,901.90 | 3 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $24,048.55 – $53,513.73 | 8 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $16,769.57 | $16,769.57 | $39.50 – $15,763.40 | 9 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $13,674.31 | $13,674.31 | $62.38 – $12,853.85 | 9 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $13,333.28 | $13,333.28 | $122.10 – $12,533.28 | 9 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $328.64 – $589.70 | 8 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $8,484.86 | $8,484.86 | $98.39 – $7,975.77 | 9 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $194.06 – $362.78 | 8 |
| Peginesatide injection HCPCS J0890 | not published | not published | $8.20 – $8.20 | 2 |
| Peg interferon alfa-2a/180 HCPCS S0145 | not published | not published | $1,135.69 – $2,333.10 | 2 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,265.90 – $7,017.82 | 8 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $210.89 – $696.05 | 3 |
| Pelv band/spread bar thigh c HCPCS L1640 | not published | not published | $547.50 – $1,452.39 | 3 |
| Pelvic band & belt thigh fla HCPCS L2192 | not published | not published | $383.28 – $1,016.75 | 3 |
| Pelvic control band & belt b HCPCS L2640 | not published | not published | $391.62 – $1,038.87 | 3 |
| Pelvic control band & belt u HCPCS L2630 | not published | not published | $273.22 – $724.81 | 3 |
| Pelvic control hip heavy dut HCPCS L2620 | not published | not published | $317.25 – $841.59 | 3 |
| Pelvic control pelvic sling HCPCS L2580 | not published | not published | $460.84 – $1,222.48 | 3 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,604.95 | $2,604.95 | $57.28 – $2,453.86 | 9 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,055.55 | $2,055.55 | $54.58 – $1,936.33 | 9 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,732.95 | $1,732.95 | $51.22 – $1,632.44 | 9 |
| Pelvic exenteration CPT 45126 | not published | not published | $2,620.55 – $5,517.97 | 8 |
| Pelvic & hip control thigh c HCPCS L1680 | not published | not published | $1,084.27 – $2,876.32 | 3 |
| Pelvic MRI (with and without contrast) CPT 72197 | $3,390.40 | $3,390.40 | $103.23 – $3,193.76 | 9 |
| Pelvic MRI (with contrast) CPT 72196 | $2,630.60 | $2,630.60 | $81.75 – $2,478.03 | 9 |
| Pelvic MRI (without contrast) CPT 72195 | $2,460.50 | $2,460.50 | $68.84 – $2,317.79 | 9 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $1,021.24 – $2,194.05 | 8 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $963.01 – $2,072.72 | 8 |
| Pelvic Ultrasound (complete) CPT 76856 | $800.35 | $800.35 | $32.57 – $65.75 | 9 |
| Pelvic Ultrasound (limited) CPT 76857 | $435.95 | $435.95 | $18.42 – $43.15 | 9 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $359.00 | $359.00 | $8.29 – $338.18 | 9 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $529.05 | $529.05 | $12.00 – $498.37 | 9 |
| Pelv & thor control gluteal HCPCS L2650 | not published | not published | $107.07 – $284.06 | 3 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $15,410.16 | $15,410.16 | $55.73 – $14,485.55 | 9 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $12,911.73 | $12,911.73 | $3.28 – $3,530.74 | 9 |
| Pemivibart infusion HCPCS M0224 | not published | not published | $942.82 – $942.82 | 1 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $14.71 – $34.32 | 8 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $3,193.43 | $3,193.43 | $18.96 – $1,831.18 | 9 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $152.51 | $152.51 | $0.77 – $143.36 | 9 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $20.33 – $124.15 | 5 |
| Penile injection CPT 54235 | $167.60 | $167.60 | $67.32 – $157.88 | 9 |
| Penile vascular study CPT 93980 | not published | not published | $58.18 – $117.93 | 8 |
| Penile vascular study CPT 93981 | not published | not published | $20.80 – $42.70 | 8 |
| Penile venous occlusion CPT 37790 | not published | not published | $467.16 – $991.62 | 8 |
| Penis plastic surgery CPT 54360 | not published | not published | $694.82 – $1,470.83 | 8 |
| Penis study CPT 54240 | not published | not published | $63.50 – $122.07 | 8 |
| Pentamidine non-comp unit HCPCS J2545 | $1,162.88 | $1,162.88 | $52.22 – $1,093.11 | 9 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $12.72 – $12.72 | 2 |
| Pentazocine injection HCPCS J3070 | not published | not published | $55.57 – $108.39 | 3 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $14.23 – $53.88 | 4 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $11,995.78 | $11,995.78 | $2,273.15 – $11,276.03 | 9 |
| Perc cryo ablate renal tum CPT 50593 | not published | not published | $440.52 – $7,092.82 | 9 |
| Perc d-e cor revasc chro sin HCPCS C9607 | not published | not published | $88,225.93 – $88,225.93 | 1 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | not published | not published | $55,719.09 – $55,719.09 | 1 |
| Perc d-e cor stent ather s HCPCS C9602 | not published | not published | $88,225.93 – $88,225.93 | 1 |
| Perc drug-el cor stent sing HCPCS C9600 | not published | not published | $55,719.09 – $55,719.09 | 1 |
| Perc rf ablate renal tumor CPT 50592 | not published | not published | $329.87 – $5,304.19 | 9 |
| Percut ablate liver rf CPT 47382 | not published | not published | $710.91 – $6,891.09 | 9 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $300.92 – $3,047.86 | 8 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $892.87 | $892.87 | $41.79 – $839.30 | 9 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $203.69 – $416.84 | 8 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $2,323.12 – $4,946.59 | 8 |
| Pericardiocentesis wwo imaging CPT 33016 | not published | not published | $220.79 – $467.01 | 8 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $778.16 – $1,669.41 | 8 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $684.79 – $1,470.16 | 8 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $263.60 – $555.12 | 8 |
| Peripheral vascular rehab CPT 93668 | $115.70 | $115.70 | $13.36 – $108.99 | 9 |
| Peri-proc device eval icd CPT 93287 | $100.25 | $100.25 | $21.73 – $94.44 | 9 |
| Peri-proc device eval pm CPT 93286 | $83.50 | $83.50 | $14.35 – $78.66 | 9 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $401.27 – $844.54 | 8 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $21.87 – $44.07 | 8 |
| Perit-vens shunt pat tst CPT 78291 | not published | not published | $41.33 – $84.05 | 8 |
| Permanent tear duct plug HCPCS A4263 | not published | not published | $54.23 – $54.23 | 1 |
| Peroneal straps pair pre ots HCPCS L0980 | not published | not published | $20.72 – $54.96 | 3 |
| Perp bk ptb thermopls direct HCPCS L5520 | not published | not published | $1,810.77 – $4,803.51 | 3 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.55 – $1.36 | 3 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $6.38 – $6.38 | 2 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $796.48 – $1,721.61 | 8 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $736.89 – $1,550.12 | 8 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $122.19 – $1,209.12 | 9 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $96.46 – $496.62 | 9 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $1,082.61 – $2,278.77 | 8 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $670.50 – $1,418.63 | 8 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $826.81 – $1,758.89 | 8 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $701.54 – $1,492.52 | 8 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $726.24 – $1,546.05 | 8 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | not published | not published | $552.52 – $1,175.98 | 8 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $277.43 – $589.68 | 8 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $224.81 – $7,063.91 | 9 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $407.43 – $7,943.45 | 9 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $421.13 – $7,926.74 | 9 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $283.40 | $283.40 | $83.28 – $642.47 | 9 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $514.80 – $1,126.51 | 8 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $475.15 – $1,032.30 | 8 |
| Perq transcath closure each CPT 93592 | not published | not published | $376.54 – $765.92 | 8 |
| Perq transcath closure pda CPT 93582 | not published | not published | $619.20 – $1,312.22 | 8 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $853.36 – $1,760.92 | 8 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $1,034.06 – $2,124.23 | 8 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $693.92 – $1,471.50 | 8 |
| Perq trluml angp nt/recr coa CPT 33897 | not published | not published | $543.98 – $1,152.26 | 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.