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 |
|---|---|---|---|---|
| Tube trach disp innr can 5 xlt HCPCS A7521 | not published | not published | $52.29 – $137.73 | 3 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | not published | not published | $7.28 – $19.19 | 3 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | not published | not published | $52.78 – $138.99 | 3 |
| Tubing (oxygen) per foot HCPCS A4616 | not published | not published | $0.06 – $0.17 | 3 |
| Tubular dressing HCPCS A6457 | not published | not published | $1.26 – $3.33 | 3 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $70.11 – $145.05 | 7 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,117.29 – $2,343.83 | 8 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,038.44 – $2,179.80 | 8 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $477.36 – $1,266.31 | 3 |
| Tx atrial fib pulm vein isol CPT 93656 | not published | not published | $898.82 – $1,878.85 | 8 |
| Tx closed distal humerus fx CPT 24999 | $808.55 | $808.55 | $167.39 – $407.74 | 9 |
| Tx closed hip disl traumatic without anes CPT 27250 | $972.55 | $972.55 | $173.68 – $481.01 | 9 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $1,672.30 | $1,672.30 | $44.62 – $108.68 | 9 |
| Tx closed tib shaft fx without manip CPT 27750 | $276.80 | $276.80 | $107.95 – $262.96 | 9 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $107.25 – $309.02 | 9 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $69.86 – $210.09 | 9 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $904.25 – $1,941.21 | 8 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $857.51 – $1,842.94 | 8 |
| Tx l/r atrial fib addl CPT 93657 | not published | not published | $290.84 – $609.35 | 8 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $717.30 – $1,547.42 | 8 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | not published | not published | $487.56 – $1,058.72 | 8 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $530.99 – $1,153.62 | 8 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $428.66 – $909.61 | 8 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $613.15 – $1,302.73 | 8 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $575.63 – $1,247.16 | 8 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $443.22 – $950.95 | 8 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | not published | not published | $185.73 – $421.45 | 9 |
| Tympanic membrane repair CPT 69610 | not published | not published | $278.93 – $743.98 | 9 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $530.44 – $1,111.59 | 8 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $21.71 – $44.07 | 8 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $127.72 – $392.54 | 9 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,358.29 – $2,854.21 | 8 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,235.30 – $2,606.83 | 8 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $366.01 | 7 |
| Typhoid vaccine oral CPT 90690 | not published | not published | $66.43 – $169.29 | 3 |
| U2af1 gene common variants CPT 81357 | not published | not published | $123.70 – $404.65 | 7 |
| Ua w/micro/comp poc CPT 81000 | $24.45 | $24.45 | $4.02 – $22.98 | 9 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $67.66 – $136.45 | 8 |
| Ue triple control harness HCPCS L6677 | not published | not published | $276.10 – $732.42 | 3 |
| Ugt1a1 gene analy common variants CPT 81350 | $585.00 | $585.00 | $61.49 – $549.90 | 9 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $2.58 – $5.43 | 8 |
| Ultrasound breast complete CPT 76641 | $614.85 | $614.85 | $34.58 – $573.04 | 9 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $308.70 | $308.70 | $32.22 – $287.71 | 9 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $867.60 | $867.60 | $23.45 – $808.60 | 9 |
| Ultrasound dx ophth b-scan CPT 76512 | $265.85 | $265.85 | $29.91 – $247.77 | 9 |
| Ultrasound elastography ea l target les CPT 76983 | not published | not published | $24.44 – $47.54 | 8 |
| Ultrasound elastography parenchyma CPT 76981 | not published | not published | $28.17 – $57.60 | 8 |
| Ultrasound encephalogram CPT 76506 | not published | not published | $29.87 – $61.00 | 8 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $1,297.50 | $1,297.50 | $35.62 – $1,209.27 | 9 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $1,687.40 | $1,687.40 | $36.14 – $1,572.66 | 9 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $759.90 | $759.90 | $30.00 – $74.35 | 9 |
| Ultrasound guidance for vascular access CPT 76937 | $377.95 | $377.95 | $13.77 – $352.25 | 9 |
| Ultrasound guide intraoperative CPT 76998 | not published | not published | $58.80 – $94.21 | 8 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $96.47 – $190.17 | 8 |
| Ultrasound hips infant dynamic CPT 76885 | $709.30 | $709.30 | $34.92 – $661.07 | 9 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $29.53 – $59.64 | 8 |
| Ultrasound joint complete left CPT 76881 | $560.25 | $560.25 | $18.89 – $522.15 | 9 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $24.66 – $109.87 | 8 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $2,334.20 | $2,334.20 | $46.66 – $2,175.47 | 9 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $653.40 | $653.40 | $36.39 – $608.97 | 9 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,328.15 | $1,328.15 | $89.72 – $1,237.84 | 9 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $867.60 | $867.60 | $40.16 – $808.60 | 9 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $31.80 – $65.06 | 8 |
| Ultrasound spinal canal and contents CPT 76800 | not published | not published | $58.44 – $127.42 | 8 |
| Ultrasound transabd ea addl gest CPT 76812 | not published | not published | $84.01 – $170.13 | 8 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $76.26 – $154.54 | 8 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $39.97 – $81.34 | 8 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.00 – $16.95 | 8 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $66.60 – $136.25 | 8 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $492.02 – $1,058.72 | 8 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $926.01 – $1,003.82 | 3 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $11,206.70 – $29,517.41 | 3 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $112.69 – $112.69 | 1 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $112.69 – $112.69 | 1 |
| Unlisted chemotherapy px CPT 96549 | $64.15 | $64.15 | $0.67 – $60.30 | 9 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $1,068.39 – $1,068.39 | 1 |
| Unlisted CT procedure CPT 76497 | not published | not published | $44.07 – $405.07 | 2 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $1,848.71 – $1,848.71 | 1 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $245.82 – $245.82 | 1 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $245.82 – $245.82 | 1 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $719.81 – $719.81 | 1 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $1,848.71 – $1,848.71 | 1 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $925.54 – $925.54 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $71.16 – $405.07 | 2 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $1,848.71 – $1,848.71 | 1 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $1,848.71 – $1,848.71 | 1 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | $925.54 – $925.54 | 1 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px esoph CPT 43289 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px lymphtc sys CPT 38589 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px ovidct ovry CPT 58679 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px renal CPT 50549 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px spleen CPT 38129 | not published | not published | $26,842.17 – $26,842.17 | 1 |
| Unlisted laps px testis CPT 54699 | not published | not published | $26,842.17 – $26,842.17 | 1 |
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.