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 |
|---|---|---|---|---|
| X-ray male genital tract CPT 74440 | not published | not published | $17.42 – $35.92 | 8 |
| X-ray mandible ltd <4 views CPT 70100 | $546.95 | $546.95 | $8.64 – $509.76 | 9 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $15.95 – $19.08 | 5 |
| X-ray nose to rectum for foreign body child CPT 76010 | not published | not published | $8.64 – $17.62 | 8 |
| X-ray of mammary ducts CPT 77054 | $699.95 | $699.95 | $21.01 – $652.35 | 9 |
| X-ray optic foramina CPT 70190 | $562.90 | $562.90 | $10.61 – $524.62 | 9 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $158.13 – $330.09 | 8 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $180.48 – $377.53 | 8 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,304.15 | $1,304.15 | $24.05 – $1,215.47 | 9 |
| X-ray ribs 2 views left CPT 71100 | $397.95 | $397.95 | $10.65 – $370.89 | 9 |
| X-ray sella turcica CPT 70240 | not published | not published | $8.99 – $18.29 | 8 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,044.70 | $1,044.70 | $24.57 – $973.66 | 9 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $814.35 | $814.35 | $27.83 – $758.97 | 9 |
| X-ray small intestine follow-through study CPT 74248 | $591.05 | $591.05 | $32.92 – $550.86 | 9 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $842.35 | $842.35 | $10.33 – $785.07 | 9 |
| X-ray surgical specimen CPT 76098 | $149.10 | $149.10 | $14.92 – $138.96 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $984.70 | $984.70 | $12.34 – $917.74 | 9 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $27.87 – $56.26 | 8 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $248.10 – $544.27 | 8 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $68.90 – $143.01 | 8 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $1,479.00 – $6,263.55 | 3 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $12.91 – $27.05 | 7 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.29 – $2.95 | 8 |
| Yersinia antibody CPT 86793 | not published | not published | $13.19 – $27.64 | 7 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $63,005.77 – $198,557.73 | 4 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $236.09 – $519.22 | 8 |
| Ziconotide injection HCPCS J2278 | not published | not published | $9.04 – $19.32 | 8 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $169.20 | $169.20 | $1.51 – $159.05 | 9 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.55 – $2.70 | 2 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $51.31 – $107.52 | 7 |
| Zika virus igm antibody CPT 86794 | not published | not published | $16.85 – $35.25 | 7 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.40 – $3.67 | 3 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $373.33 | $373.33 | $8.08 – $350.93 | 9 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.09 – $15.78 | 8 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $1,577.35 | $1,577.35 | $5.73 – $239.65 | 9 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $238.19 – $337.52 | 3 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $123.70 – $404.65 | 7 |
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.