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 |
|---|---|---|---|---|
| Biopsy of upper nose/throat CPT 42804 | not published | not published | $118.31 – $419.52 | 9 |
| Biopsy of urethra CPT 53200 | not published | not published | $135.97 – $307.10 | 9 |
| Biopsy of wrist joint CPT 25100 | not published | not published | $339.32 – $738.81 | 8 |
| Biopsy oocyte polar body CPT 89291 | not published | not published | $788.40 – $788.40 | 1 |
| Biopsy oocyte polar body <=5 CPT 89290 | not published | not published | $788.40 – $788.40 | 1 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | $420.87 – $910.28 | 8 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | not published | not published | $449.23 – $965.87 | 8 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,910.10 | $1,910.10 | $121.85 – $976.55 | 9 |
| Biopsy roof of mouth CPT 42100 | not published | not published | $106.11 – $283.33 | 9 |
| Biopsy skin incisional single lesion CPT 11106 | $260.75 | $260.75 | $54.50 – $243.02 | 9 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | not published | not published | $150.38 – $516.54 | 9 |
| Biopsy thigh soft tissues CPT 27324 | not published | not published | $394.83 – $858.77 | 8 |
| Biopsy tongue anterior two-thirds CPT 41100 | not published | not published | $103.72 – $363.00 | 9 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | not published | not published | $141.29 – $345.01 | 9 |
| Biopsy vestibule of mouth 40808 CPT 40808 | not published | not published | $85.29 – $327.66 | 9 |
| Biopsy vrt bdy open lmbr/crv CPT 20251 | not published | not published | $401.20 – $890.62 | 8 |
| Biopsy vrt bdy open thoracic CPT 20250 | not published | not published | $370.02 – $809.97 | 8 |
| Biospy of bladder CPT 53899 | not published | not published | $1,118.93 – $1,118.93 | 1 |
| Biotinidase - quest CPT 82261 | not published | not published | $16.87 – $35.25 | 7 |
| Biovance 1 square cm HCPCS Q4154 | not published | not published | $136.26 – $285.38 | 8 |
| Biovance tri or 3l, sq cm HCPCS Q4283 | not published | not published | $1,059.21 – $1,530.00 | 3 |
| Bis xtracell fluid analysis CPT 93702 | not published | not published | $119.94 – $240.62 | 8 |
| Bivalirudin HCPCS J0583 | not published | not published | $0.19 – $0.31 | 8 |
| Bk/ak locking mechanism HCPCS L5671 | not published | not published | $471.59 – $1,251.02 | 3 |
| Bk back check HCPCS L5686 | not published | not published | $57.10 – $151.46 | 3 |
| Bk flex inner socket ext fra HCPCS L5645 | not published | not published | $842.50 – $2,234.93 | 3 |
| Bk fork strap HCPCS L5684 | not published | not published | $57.16 – $151.63 | 3 |
| Bk joint covers pair HCPCS L5678 | not published | not published | $37.64 – $99.87 | 3 |
| Bk knee joints polycentric p HCPCS L5677 | not published | not published | $623.28 – $1,653.38 | 3 |
| Bk knee joints single axis p HCPCS L5676 | not published | not published | $450.03 – $1,193.83 | 3 |
| Bk molded distal cushion HCPCS L5668 | not published | not published | $117.45 – $311.59 | 3 |
| Bk molded supracondylar susp HCPCS L5670 | not published | not published | $273.25 – $724.87 | 3 |
| Bk mold socket sach ft endo HCPCS L5301 | not published | not published | $2,325.68 – $6,169.46 | 3 |
| Bk removable medial brim sus HCPCS L5672 | not published | not published | $332.40 – $881.76 | 3 |
| Bk thigh lacer glut/ischia m HCPCS L5682 | not published | not published | $790.55 – $2,097.15 | 3 |
| Bk thigh lacer non-molded HCPCS L5680 | not published | not published | $327.60 – $869.02 | 3 |
| Bk waist belt padded and lin HCPCS L5690 | not published | not published | $123.70 – $328.15 | 3 |
| Bk waist belt webbing HCPCS L5688 | not published | not published | $67.33 – $178.59 | 3 |
| Bladder calculi irrig sol HCPCS Q2004 | not published | not published | $29.15 – $445.53 | 3 |
| Bladder Catheter Insertion (simple) CPT 51702 | $58.00 | $58.00 | $12.01 – $29.26 | 9 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $87.05 | $87.05 | $18.78 – $45.74 | 9 |
| Bladder irrigation tubing HCPCS A4355 | not published | not published | $8.43 – $22.19 | 3 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $118.32 – $251.47 | 8 |
| Bld prd mix CPT 86965 | $163.65 | $163.65 | $38.81 – $153.83 | 9 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $49.06 – $98.97 | 8 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $848.64 | $848.64 | $21.02 – $180.40 | 9 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $494.75 – $1,120.46 | 9 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $382.62 – $893.66 | 9 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $529.03 – $1,201.41 | 9 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $527.80 – $1,199.48 | 9 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | not published | not published | $138.79 – $301.47 | 8 |
| Blind cor sinus reducer impl HCPCS C9783 | not published | not published | $52,174.57 – $52,174.57 | 1 |
| Blinded conv. tx mdd clin tr HCPCS G2000 | not published | not published | $214.62 – $214.62 | 1 |
| Blink reflex test CPT 95933 | not published | not published | $30.37 – $62.36 | 8 |
| Blm gene CPT 81209 | $92.55 | $92.55 | $36.09 – $87.00 | 9 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | not published | not published | $13.63 – $35.92 | 3 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | not published | not published | $76.67 – $155.90 | 8 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | not published | not published | $70.92 – $145.72 | 8 |
| Block paracervical nrv CPT 64435 | not published | not published | $41.76 – $155.47 | 9 |
| Block plantar digital nerve CPT 64455 | $344.95 | $344.95 | $32.91 – $96.38 | 9 |
| Block tap inj(s) w/wo img bi CPT 64488 | $3,360.00 | $3,360.00 | $67.39 – $264.69 | 9 |
| Block tap inj(s) w/wo img uni CPT 64486 | $855.90 | $855.90 | $54.19 – $214.59 | 9 |
| Blood clot lysis time CPT 85175 | not published | not published | $8.49 – $42.68 | 7 |
| Blood clot retraction CPT 85170 | not published | not published | $7.92 – $33.88 | 7 |
| Blood Clotting (PT/INR) Test CPT 85610 | $101.15 | $101.15 | $4.29 – $95.08 | 9 |
| Blood Clotting (PTT) Test CPT 85730 | $117.10 | $117.10 | $6.01 – $110.07 | 9 |
| Blood component/product noc HCPCS P9099 | not published | not published | $225.10 – $225.10 | 1 |
| Blood Count (CBC) Test CPT 85025 | $130.40 | $130.40 | $7.77 – $122.58 | 9 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $101.15 | $101.15 | $6.47 – $95.08 | 9 |
| Blood count spun microhematocrit CPT 85013 | not published | not published | $5.18 – $14.67 | 7 |
| Blood Culture Test CPT 87040 | $158.35 | $158.35 | $10.32 – $148.85 | 9 |
| Blood draw capillary 36416 CPT 36416 | $27.85 | $27.85 | $9.10 – $26.18 | 9 |
| Blood Draw (Venipuncture) CPT 36415 | $20.30 | $20.30 | $4.09 – $19.08 | 9 |
| Blood gases o2 saturation direct measurement CPT 82805 | $207.60 | $207.60 | $62.12 – $195.14 | 9 |
| Blood gases ph venous CPT 82800 | $235.50 | $235.50 | $11.00 – $221.37 | 9 |
| Blood, l/r, irradiated HCPCS P9056 | not published | not published | $387.23 – $387.23 | 1 |
| Blood mucoprotein HCPCS P2038 | not published | not published | $4.95 – $10.16 | 7 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $108.20 | $108.20 | $15.92 – $101.71 | 9 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $99.85 | $99.85 | $4.23 – $93.01 | 9 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | not published | not published | $4.38 – $9.18 | 7 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $15.95 | $15.95 | $5.32 – $14.99 | 9 |
| Blood smear interpretation CPT 85060 | $220.00 | $220.00 | $23.34 – $205.04 | 9 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | not published | not published | $3.80 – $7.96 | 7 |
| Blood split unit HCPCS P9011 | not published | not published | $75.56 – $124.03 | 3 |
| Blood thymol turbidity HCPCS P2033 | not published | not published | $4.95 – $10.16 | 7 |
| Blood Transfusion CPT 36430 | $805.15 | $805.15 | $36.42 – $750.40 | 9 |
| Blood typing abo CPT 86900 | $87.85 | $87.85 | $2.99 – $82.58 | 9 |
| Blood typing ag donor ea ag CPT 86902 | $352.65 | $352.65 | $6.35 – $331.49 | 9 |
| Blood typing antigen system CPT 86911 | not published | not published | $26.43 – $33.98 | 3 |
| Blood typing paternity test CPT 86910 | not published | not published | $30.55 – $39.78 | 3 |
| Blood typing patient serum CPT 86904 | not published | not published | $16.34 – $34.24 | 7 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $100.80 | $100.80 | $3.83 – $94.75 | 9 |
| Blood typing rh (d) CPT 86901 | $87.85 | $87.85 | $2.99 – $82.58 | 9 |
| Blood typing rh phenotype complete reference CPT 86906 | $148.80 | $148.80 | $7.75 – $139.87 | 9 |
| Blood volume CPT 78122 | not published | not published | $20.38 – $41.34 | 8 |
| Bls-emergency HCPCS A0429 | $1,218.15 | $1,218.15 | $475.08 – $1,145.06 | 9 |
| Body jacket mold to patient HCPCS L1300 | not published | not published | $1,581.28 – $4,194.77 | 3 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $282.10 | $282.10 | $8.99 – $262.92 | 9 |
| Bone biopsy open superficial CPT 20240 | not published | not published | $135.53 – $284.69 | 8 |
| Bone Density Scan (DEXA) CPT 77080 | $956.80 | $956.80 | $9.32 – $891.74 | 9 |
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.