Stephens Memorial Hospital
181 Main St, Norway, ME · MaineHealth · · NPI 1346299815
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | not published | not published | $29.28 – $61.35 | 7 |
| 17-hydroxypregnenolone CPT 84143 | $509.70 | $509.70 | $22.81 – $479.12 | 9 |
| 17-ketosteroids CPT 83586 | not published | not published | $12.80 – $26.82 | 7 |
| 1pc ost pch drain hgh output HCPCS A4435 | not published | not published | $6.41 – $16.87 | 3 |
| 1 pc ost pouch w filter HCPCS A5056 | not published | not published | $5.20 – $13.68 | 3 |
| 1 pc ost pou w built-in conv HCPCS A5057 | not published | not published | $10.68 – $28.10 | 3 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | not published | not published | $90.96 – $185.72 | 8 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | not published | not published | $875.86 – $1,787.36 | 8 |
| 1st psyc collab care mgmt CPT 99492 | not published | not published | $90.83 – $295.53 | 9 |
| 1st/sbsq psyc collab care CPT 99494 | not published | not published | $39.70 – $114.36 | 9 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $22.99 – $75.23 | 7 |
| 24 hr ambulatory b/p monitor CPT 93786 | $318.25 | $318.25 | $20.87 – $296.61 | 9 |
| 2d tee w or without fol w/con,in HCPCS C8925 | not published | not published | $3,634.81 – $3,634.81 | 1 |
| 2d tte w or without fol w/con,co HCPCS C8923 | not published | not published | $3,634.81 – $3,634.81 | 1 |
| 2nd order venous cath CPT 36012 | not published | not published | $164.35 – $1,577.89 | 9 |
| 2vhpv vaccine 3 dose im CPT 90650 | not published | not published | $148.50 – $210.24 | 2 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $719.81 – $719.81 | 1 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $719.81 – $719.81 | 1 |
| 3d ech img cgen car anomal CPT 93319 | not published | not published | $23.50 – $106.65 | 9 |
| 3-d radiotherapy plan CPT 77295 | not published | not published | $222.09 – $461.58 | 8 |
| 3d recon without postprocess indpndt CPT 76376 | $457.80 | $457.80 | $9.32 – $426.67 | 9 |
| 4-bar link above knee w/swng HCPCS L5614 | not published | not published | $1,570.57 – $4,166.33 | 3 |
| 5% dextrose and 0.45% saline HCPCS S5010 | not published | not published | $8.06 – $10.12 | 2 |
| 5% dextrose with potassium HCPCS S5012 | not published | not published | $4.85 – $9.68 | 2 |
| 5' nucleotidase - sendout CPT 83915 | $126.55 | $126.55 | $11.15 – $118.96 | 9 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | not published | not published | $33.50 – $69.38 | 8 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | not published | not published | $72.24 – $210.09 | 8 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | not published | not published | $76.95 – $219.72 | 8 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | not published | not published | $81.66 – $228.08 | 8 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | not published | not published | $65.73 – $188.88 | 8 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | not published | not published | $72.24 – $201.10 | 8 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | not published | not published | $72.24 – $200.44 | 8 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | not published | not published | $81.66 – $219.08 | 8 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | not published | not published | $95.92 – $256.35 | 8 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $2,949.88 – $6,267.61 | 8 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $1,856.22 | $1,856.22 | $43.16 – $1,744.85 | 9 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $41.00 | $41.00 | $12.01 – $38.54 | 9 |
| Abciximab injection HCPCS J0130 | not published | not published | $1,170.55 – $1,429.07 | 3 |
| Abd aorta w/runoff s&i CPT 75630 | not published | not published | $91.15 – $177.32 | 8 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $1,150.40 – $2,473.98 | 8 |
| Abd/low ext cath 1st CPT 36245 | not published | not published | $223.15 – $2,345.01 | 9 |
| Abd/low ext cath 2nd CPT 36246 | not published | not published | $237.17 – $1,579.18 | 9 |
| Abd/low ext cath 3rd CPT 36247 | not published | not published | $283.03 – $2,682.94 | 9 |
| Abd/low ext cath addl CPT 36248 | not published | not published | $46.37 – $220.36 | 9 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $786.25 | $786.25 | $54.23 – $732.79 | 9 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | not published | not published | $37.31 – $75.92 | 8 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,647.60 | $1,647.60 | $65.61 – $1,535.56 | 9 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,394.15 | $1,394.15 | $59.86 – $1,299.35 | 9 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,267.40 | $1,267.40 | $55.94 – $1,181.22 | 9 |
| Abdominal MRI (with and without contrast) CPT 74183 | $3,105.85 | $3,105.85 | $103.23 – $2,894.65 | 9 |
| Abdominal MRI (with contrast) CPT 74182 | $3,105.85 | $3,105.85 | $81.45 – $2,894.65 | 9 |
| Abdominal MRI (without contrast) CPT 74181 | $3,228.60 | $3,228.60 | $68.84 – $3,009.06 | 9 |
| Abdominal pad HCPCS L1270 | not published | not published | $75.12 – $199.25 | 3 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,007.45 | $1,007.45 | $102.50 – $559.59 | 9 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,373.35 | $1,373.35 | $37.96 – $1,279.96 | 9 |
| Abdominal Ultrasound (limited) CPT 76705 | $753.20 | $753.20 | $27.87 – $701.98 | 9 |
| Abdominal X-ray (2 views) CPT 74019 | $464.45 | $464.45 | $10.99 – $432.87 | 9 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $911.55 | $911.55 | $15.27 – $849.56 | 9 |
| Abdominal X-ray (single view) CPT 74018 | $351.30 | $351.30 | $8.64 – $327.41 | 9 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $1,122.91 – $2,412.29 | 8 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $59.30 | $59.30 | $12.52 – $30.50 | 9 |
| Abduct control hip semi-flex HCPCS L1630 | not published | not published | $201.06 – $533.35 | 3 |
| Abduction bar jointed adjust HCPCS L2300 | not published | not published | $239.60 – $635.61 | 3 |
| Abduction bar-straight HCPCS L2310 | not published | not published | $109.48 – $290.43 | 3 |
| Abduction rotation bar shoe HCPCS L3140 | not published | not published | $82.72 – $219.41 | 3 |
| Abduct rotation bar without shoe HCPCS L3150 | not published | not published | $75.61 – $200.58 | 3 |
| Abl1 gene CPT 81170 | not published | not published | $300.00 – $628.32 | 7 |
| Ablat 1/+thyr ndul addl prq rf CPT 60661 | not published | not published | $445.32 – $445.32 | 1 |
| Ablate arrhythmia add on CPT 93655 | not published | not published | $290.84 – $608.66 | 8 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $1,280.61 – $2,736.28 | 8 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $1,810.57 – $3,849.90 | 8 |
| Ablate atria without bypass ext CPT 33255 | not published | not published | $1,527.50 – $3,253.44 | 8 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $611.82 – $1,306.13 | 8 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $1,731.38 – $3,689.94 | 8 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | not published | not published | $330.39 – $9,622.20 | 9 |
| Ablate bone tumor(s) perq CPT 20982 | not published | not published | $352.52 – $6,611.61 | 9 |
| Ablate heart dysrhythm focus CPT 93650 | not published | not published | $551.65 – $1,155.65 | 8 |
| Ablate heart dysrhythm focus CPT 33250 | not published | not published | $1,368.72 – $2,915.21 | 8 |
| Ablate heart dysrhythm focus CPT 33251 | not published | not published | $1,530.13 – $3,266.32 | 8 |
| Ablate heart dysrhythm focus CPT 33261 | not published | not published | $1,514.37 – $3,223.62 | 8 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $196.35 – $538.39 | 9 |
| Ablate inf turbinate superf 30801 CPT 30801 | not published | not published | $146.77 – $423.38 | 9 |
| Ablate pulm tumor perq crybl CPT 32994 | not published | not published | $422.07 – $9,146.78 | 9 |
| Ablate pulm tumor perq rf CPT 32998 | not published | not published | $422.96 – $5,840.01 | 9 |
| Ablation cardiac vagal inputs atrium CPT 93799 | not published | not published | $719.81 – $719.81 | 1 |
| Ablation cryo abd perit om CPT 49999 | not published | not published | $4,313.43 – $4,313.43 | 1 |
| Ablation cryo adrenal tumor CPT 60699 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | not published | not published | $1,103.63 – $1,103.63 | 1 |
| Ablation cryo pq liver tumor(s) CPT 47383 | not published | not published | $433.46 – $11,106.01 | 9 |
| Ablation cryo retro lymph node CPT 38999 | not published | not published | $2,011.32 – $2,011.32 | 1 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $1,103.63 – $1,103.63 | 1 |
| Ablation of upper extremity nerves rf CPT 64999 | $855.90 | $855.90 | $28.68 – $69.87 | 9 |
| Abltj 1/+thyr ndul 1lobe prq CPT 60660 | not published | not published | $643.24 – $7,454.22 | 2 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $941.94 – $1,993.41 | 8 |
| Ablt trurl prst8 tis thrm Ultrasound CPT 55881 | not published | not published | $986.89 – $986.89 | 1 |
| Ablt trurl prst8 tis trnsdcr CPT 55882 | not published | not published | $1,213.95 – $59,774.27 | 2 |
| Abobotulinumtoxina HCPCS J0586 | not published | not published | $8.38 – $16.85 | 8 |
| Abortion CPT 59850 | not published | not published | $373.44 – $806.57 | 8 |
| Abortion (mpr) CPT 59866 | not published | not published | $225.06 – $485.97 | 8 |
| Above elbow prosth tiss shap HCPCS L6500 | not published | not published | $3,299.66 – $8,753.24 | 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.