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 |
|---|---|---|---|---|
| Suction lipectomy head&neck CPT 15876 | not published | not published | $864.75 – $16,843.02 | 2 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $16,843.02 – $16,843.02 | 1 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $864.75 – $1,512.97 | 2 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $770.96 – $8,415.75 | 2 |
| Suction socket HCPCS L6686 | not published | not published | $746.28 – $1,979.70 | 3 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $510.74 – $1,354.87 | 3 |
| Sugars multiple quant CPT 84379 | not published | not published | $11.53 – $24.16 | 7 |
| Sugars single quant CPT 84378 | not published | not published | $11.53 – $24.16 | 7 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $4,064.40 | $4,064.40 | $411.97 – $1,003.51 | 9 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $79.93 | $79.93 | $31.17 – $75.93 | 9 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $7.77 – $50.16 | 3 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $70.12 | $70.12 | $27.35 – $66.61 | 9 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $2.64 – $7.08 | 3 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $3.23 – $32.13 | 9 |
| Supply of digital device HCPCS G0552 | not published | not published | $592.88 – $592.88 | 1 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $19.71 – $52.78 | 3 |
| Support clav 29.6-40.5in med HCPCS L3650 | not published | not published | $64.01 – $169.79 | 3 |
| Supprelin la implant HCPCS J9226 | not published | not published | $44,158.25 – $89,474.69 | 8 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $72.24 – $147.08 | 7 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $62.37 – $127.42 | 7 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $100.56 – $216.90 | 8 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $778.57 – $1,672.81 | 8 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $778.79 – $1,673.50 | 8 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $409.70 – $871.66 | 8 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $1,096.39 – $2,353.32 | 8 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $640.17 – $1,382.04 | 8 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $707.33 – $1,526.40 | 8 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $883.31 – $1,900.56 | 8 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $648.75 – $1,401.01 | 8 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $842.39 – $1,778.54 | 8 |
| Surgical opening esophagus CPT 43351 | not published | not published | $1,245.61 – $2,673.25 | 8 |
| Surgical opening esophagus CPT 43352 | not published | not published | $1,008.90 – $2,164.90 | 8 |
| Surgical opening of stomach CPT 43510 | not published | not published | $906.17 – $1,952.74 | 8 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $748.67 – $1,617.24 | 8 |
| Surgical opening of throat CPT 42955 | not published | not published | $731.79 – $1,541.99 | 8 |
| Surgical pathology level 1 gross examination only CPT 88300 | $98.50 | $98.50 | $4.24 – $91.80 | 9 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $139.70 | $139.70 | $6.60 – $130.20 | 9 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $165.00 | $165.00 | $10.95 – $153.78 | 9 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $256.80 | $256.80 | $36.16 – $239.34 | 9 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $330.00 | $330.00 | $79.63 – $307.56 | 9 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $447.20 | $447.20 | $140.22 – $416.79 | 9 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $1,283.08 – $2,751.18 | 8 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $1,452.91 – $3,117.88 | 8 |
| Surgical revision intestine CPT 44680 | not published | not published | $1,026.01 – $2,203.52 | 8 |
| Surgical trays HCPCS A4550 | not published | not published | $39.98 – $39.98 | 1 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $85.00 – $209.54 | 3 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $406.14 – $1,092.19 | 9 |
| Susceptibility agar dilution per agent CPT 87181 | $167.65 | $167.65 | $4.75 – $157.59 | 9 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $11.55 | $11.55 | $4.50 – $10.86 | 9 |
| Susceptibility mic per plate CPT 87186 | $167.65 | $167.65 | $8.65 – $157.59 | 9 |
| Suscept studies macrobroth dilution ea CPT 87188 | not published | not published | $6.64 – $13.91 | 7 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $958.28 – $2,028.65 | 8 |
| Suspension of testis CPT 54620 | not published | not published | $287.70 – $609.35 | 8 |
| Suspension of uterus CPT 58410 | not published | not published | $792.32 – $1,663.31 | 8 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $449.89 – $943.49 | 8 |
| Suspension sleeve lower ext HCPCS L2397 | not published | not published | $109.73 – $291.08 | 3 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $1,005.91 – $2,146.58 | 8 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $1,314.61 – $2,819.64 | 8 |
| Svc venogram s&i CPT 75827 | not published | not published | $52.25 – $107.10 | 8 |
| Swallowing Evaluation (Bedside) CPT 92610 | $545.70 | $545.70 | $68.98 – $164.47 | 9 |
| Swallowing Therapy Session CPT 92526 | $547.15 | $547.15 | $56.39 – $463.62 | 9 |
| Sweat collection by iontophoresis CPT 89230 | $258.15 | $258.15 | $2.42 – $240.60 | 9 |
| Symes ankle without (sach) foot HCPCS L5703 | not published | not published | $2,241.47 – $5,946.07 | 3 |
| Symes met fr leath socket ar HCPCS L5060 | not published | not published | $2,618.61 – $6,946.54 | 3 |
| Symes type medial opening so HCPCS L5636 | not published | not published | $322.10 – $854.43 | 3 |
| Symes type poster opening so HCPCS L5634 | not published | not published | $375.21 – $995.35 | 3 |
| Symes type ptb brim design s HCPCS L5632 | not published | not published | $239.92 – $636.49 | 3 |
| Syme typ expandabl wall sckt HCPCS L5630 | not published | not published | $484.52 – $1,285.32 | 3 |
| Sympathectomy cervical CPT 64802 | not published | not published | $800.17 – $1,773.12 | 8 |
| Sympathectomy digital artery CPT 64820 | not published | not published | $737.30 – $1,584.69 | 8 |
| Sympathectomy lumbar CPT 64818 | not published | not published | $747.86 – $1,607.74 | 8 |
| Sympathectomy supfc palmar CPT 64823 | not published | not published | $761.42 – $1,642.99 | 8 |
| Sympathectomy thoracolumbar CPT 64809 | not published | not published | $1,029.11 – $2,273.34 | 8 |
| Synch audio-only est high 40 CPT 98015 | $317.50 | $317.50 | $158.75 – $238.13 | 3 |
| Synch audio-only est low 20 CPT 98013 | $145.30 | $145.30 | $72.65 – $108.98 | 3 |
| Synch audio-only est mod 30 CPT 98014 | $215.05 | $215.05 | $107.53 – $161.29 | 3 |
| Synch audio-only est sf 10 CPT 98012 | $79.80 | $79.80 | $39.90 – $59.85 | 3 |
| Synch audio-only new high 60 CPT 98011 | $287.45 | $287.45 | $143.73 – $215.59 | 3 |
| Synch audio-only new low 30 CPT 98009 | $188.15 | $188.15 | $94.08 – $141.11 | 3 |
| Synch audio-only new mod 45 CPT 98010 | $296.50 | $296.50 | $148.25 – $222.38 | 3 |
| Synch audio-only new sf 15 CPT 98008 | $108.35 | $108.35 | $54.18 – $81.26 | 3 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $10.29 – $17.60 | 8 |
| Synthetic sentence id test CPT 92576 | not published | not published | $37.14 – $92.18 | 8 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $8.82 – $18.10 | 8 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $91.80 | $91.80 | $4.40 – $86.29 | 9 |
| T3 (triiodothyronine) free CPT 84481 | $452.45 | $452.45 | $16.94 – $425.30 | 9 |
| T3 (triiodothyronine) total CPT 84480 | $304.70 | $304.70 | $14.18 – $286.42 | 9 |
| T4 (thyroxine) free CPT 84439 | $95.80 | $95.80 | $9.02 – $90.05 | 9 |
| T4 (thyroxine) total CPT 84436 | $147.75 | $147.75 | $6.87 – $138.89 | 9 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.53 – $1.13 | 8 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.65 – $3.56 | 8 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.24 – $0.37 | 8 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $238.60 – $503.43 | 8 |
| Tacrolimus therapeutic drug level CPT 80197 | $448.45 | $448.45 | $13.73 – $421.54 | 9 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $13.41 – $27.62 | 8 |
| Tah rad debulk/lymph remove 58954 CPT 58954 | not published | not published | $2,089.78 – $4,424.68 | 8 |
| Tah rad dissect for debulk 58953 CPT 58953 | not published | not published | $1,932.60 – $4,088.49 | 8 |
| Tah w/mmk 58152 CPT 58152 | not published | not published | $1,200.71 – $2,520.75 | 8 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $741.25 | $741.25 | $8.29 – $690.85 | 9 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $63.61 – $139.09 | 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.