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 |
|---|---|---|---|---|
| Revision of scrotum CPT 55180 | not published | not published | $663.51 – $1,407.80 | 8 |
| Revision of spinal shunt CPT 63744 | not published | not published | $645.95 – $1,491.15 | 8 |
| Revision of testis CPT 54660 | not published | not published | $345.48 – $739.48 | 8 |
| Revision of thigh muscles CPT 27430 | not published | not published | $715.61 – $1,541.32 | 8 |
| Revision of toe CPT 28312 | not published | not published | $326.56 – $1,051.72 | 9 |
| Revision of tricuspid valve CPT 33468 | not published | not published | $2,299.69 – $4,894.39 | 8 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | not published | not published | $2,251.27 – $4,774.43 | 8 |
| Revision of ulna CPT 25360 | not published | not published | $634.43 – $1,369.83 | 8 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $719.61 – $1,552.15 | 8 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $715.64 – $1,546.05 | 8 |
| Revision of upper arm CPT 24940 | not published | not published | $2,088.29 – $2,258.44 | 3 |
| Revision of ureter CPT 50700 | not published | not published | $890.38 – $1,883.61 | 8 |
| Revision of urethra CPT 53450 | not published | not published | $394.33 – $841.15 | 8 |
| Revision of urethra CPT 53460 | not published | not published | $441.01 – $937.39 | 8 |
| Revision of urethra CPT 57220 | not published | not published | $335.29 – $710.33 | 8 |
| Revision of urinary tract CPT 51820 | not published | not published | $1,043.31 – $2,204.88 | 8 |
| Revision open av fistula without thromb CPT 36832 | not published | not published | $708.14 – $1,508.11 | 8 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $810.97 – $1,732.46 | 8 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $722.10 – $1,558.94 | 8 |
| Revision tips CPT 37183 | not published | not published | $359.75 – $10,934.77 | 9 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $1,543.46 – $3,295.47 | 8 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $1,666.26 – $3,556.41 | 8 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $178.13 – $403.10 | 3 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $184.99 – $793.14 | 8 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $1,158.64 – $2,464.48 | 8 |
| Revj fem anast nonautog grf CPT 35883 | not published | not published | $1,119.82 – $2,370.94 | 8 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $989.43 – $2,068.66 | 8 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $1,080.26 – $2,257.75 | 8 |
| Revj open gstr rstcv px CPT 43848 | not published | not published | $1,841.07 – $3,949.54 | 8 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,358.55 – $2,863.04 | 8 |
| Revj/rmvl nea pn w/int nstim CPT 64598 | not published | not published | $472.44 – $15,821.85 | 2 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $1,057.13 – $2,208.95 | 8 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $357.62 – $616.79 | 8 |
| Rev/rmvl gstr nstim eltrd CPT 43882 | not published | not published | $1,548.34 – $1,800.92 | 3 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $137.64 – $467.71 | 9 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $122.21 – $702.85 | 9 |
| Rev rplcm arthrp 1ntrspc crv CPT 22861 | not published | not published | $2,176.96 – $4,800.18 | 8 |
| Rev rplcm rthrp 1ntrspc lmbr CPT 22862 | not published | not published | $2,177.11 – $4,802.21 | 8 |
| Rev/rplcmt sk-mnt crnl nstm CPT 61891 | not published | not published | $1,078.10 – $98,659.23 | 6 |
| Rev rplc/rmv thrc vrt tethrg CPT 22838 | not published | not published | $3,446.41 – $3,896.00 | 5 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | not published | not published | $837.43 – $1,765.68 | 8 |
| Revsc opn/prq tib/pero stent CPT 37234 | not published | not published | $263.39 – $6,853.83 | 9 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | not published | not published | $9.95 – $30.69 | 4 |
| Rf abltj nrv nrvtg si jt CPT 64625 | not published | not published | $188.36 – $911.67 | 9 |
| Rheumatoid factor qualitative CPT 86430 | not published | not published | $6.14 – $12.87 | 7 |
| Rheumatoid factor quantitative CPT 86431 | $95.80 | $95.80 | $5.67 – $90.05 | 9 |
| Rh ig IV CPT 90386 | not published | not published | $10.89 – $217.57 | 3 |
| Rh ig minidose im CPT 90385 | not published | not published | $33.42 – $92.85 | 3 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $1,184.62 – $2,495.66 | 8 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $766.82 | $766.82 | $4.76 – $720.81 | 9 |
| Rho d immune globulin 50 mcg HCPCS J2788 | not published | not published | $23.80 – $48.55 | 8 |
| Rho(d) immune globulin h, sd HCPCS J2792 | not published | not published | $32.96 – $64.96 | 8 |
| Rho d immune globulin inj HCPCS J2790 | not published | not published | $76.03 – $164.79 | 8 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $92.77 – $203.34 | 3 |
| R hrt cath chd abnl nt cnj CPT 93594 | not published | not published | $287.51 – $576.81 | 8 |
| R hrt cath chd nml nt cnj CPT 93593 | not published | not published | $184.55 – $375.50 | 8 |
| Rhythm ecg with report CPT 93040 | not published | not published | $12.20 – $27.11 | 8 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $725.30 | $725.30 | $12.69 – $675.98 | 9 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $911.55 | $911.55 | $15.27 – $849.56 | 9 |
| Rib cartilage graft CPT 21230 | not published | not published | $722.81 – $1,530.46 | 8 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $102.36 – $271.55 | 3 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $2,116.50 – $4,348.03 | 3 |
| Rib X-ray (3 views, both sides) CPT 71110 | $586.90 | $586.90 | $13.69 – $546.99 | 9 |
| Right heart cath congenital CPT 93530 | not published | not published | $489.14 – $489.14 | 1 |
| Right ventric recording CPT 93603 | not published | not published | $108.51 – $213.29 | 8 |
| Rilonacept injection HCPCS J2793 | not published | not published | $24.84 – $43.38 | 3 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $5.67 – $14.92 | 3 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $268.22 – $711.53 | 3 |
| Ring flange plastic/leather HCPCS L1100 | not published | not published | $172.14 – $456.64 | 3 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $199.00 | $199.00 | $77.61 – $189.05 | 9 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | not published | not published | $5.67 – $14.92 | 3 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | not published | not published | $14.99 – $29.82 | 8 |
| Risk ascvd tst once pr 12 mo HCPCS G0537 | not published | not published | $18.29 – $137.06 | 2 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $1,582.75 | $1,582.75 | $11.82 – $1,115.81 | 9 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | not published | not published | $77.68 – $151.69 | 8 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $36.53 – $72.31 | 8 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | not published | not published | $33.70 – $62.93 | 8 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $879.02 | $879.02 | $40.37 – $826.28 | 9 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $879.02 | $879.02 | $19.25 – $826.28 | 9 |
| R & l heart cath congenital CPT 93531 | not published | not published | $953.36 – $953.36 | 1 |
| R & l heart cath congenital CPT 93532 | not published | not published | $1,114.21 – $1,114.21 | 1 |
| R & l heart cath congenital CPT 93533 | not published | not published | $774.31 – $774.31 | 1 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | not published | not published | $418.19 – $832.35 | 8 |
| R&l hrt cath chd nml nt cnj CPT 93596 | not published | not published | $316.31 – $640.51 | 8 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | not published | not published | $1,053.30 – $2,290.29 | 8 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | not published | not published | $89.64 – $280.76 | 9 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | $639.96 – $1,379.32 | 8 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $328.55 – $841.63 | 9 |
| Rmvl fb upr arm/elbow deep CPT 24201 | not published | not published | $353.83 – $1,199.48 | 9 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | not published | not published | $219.97 – $682.94 | 9 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $136.35 | $136.35 | $53.18 – $129.53 | 9 |
| Rmvl hpglsl nstim ary pg CPT 64584 | not published | not published | $705.87 – $1,489.81 | 8 |
| Rmvl i-artic rx delivery dev 20705 CPT 20705 | not published | not published | $119.02 – $252.14 | 8 |
| Rmvl icd by tv extr CPT 33244 | not published | not published | $818.39 – $1,727.04 | 8 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | not published | not published | $366.68 – $776.76 | 8 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | not published | not published | $382.46 – $809.30 | 8 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | not published | not published | $353.09 – $746.94 | 8 |
| Rmvl icd pulse gen only CPT 33241 | not published | not published | $203.36 – $433.80 | 8 |
| Rmvl imed rx delivery device CPT 20703 | not published | not published | $98.25 – $212.83 | 8 |
| Rmvl left heart vent thor inscn ecmo CPT 33989 | not published | not published | $461.60 – $974.67 | 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.