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 |
|---|---|---|---|---|
| Cerebrospinal fld flw imag CPT 78645 | not published | not published | $25.79 – $52.87 | 8 |
| Cer post col occ/man sup adj HCPCS L0180 | not published | not published | $439.64 – $1,166.26 | 3 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $14,714.21 | $14,714.21 | $4.46 – $13,831.36 | 9 |
| Cerv collar supp adj cerv ba HCPCS L0190 | not published | not published | $532.80 – $1,413.37 | 3 |
| Cervical collar molded to pt HCPCS L0170 | not published | not published | $731.84 – $1,941.40 | 3 |
| Cervical laminoplsty 2/> seg CPT 63050 | not published | not published | $1,403.99 – $3,068.41 | 8 |
| Cervical lymphadenectomy 38720 CPT 38720 | not published | not published | $1,293.79 – $2,749.84 | 8 |
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | not published | not published | $26.51 – $75.81 | 8 |
| Cerv sr wire occ/man pre ots HCPCS L0160 | not published | not published | $185.84 – $492.97 | 3 |
| Cesarean section delivery only 59514 CPT 59514 | not published | not published | $860.62 – $1,844.30 | 8 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $995.94 | $995.94 | $71.54 – $936.18 | 9 |
| #cf-97variants CPT 81220 | $436.50 | $436.50 | $170.24 – $414.68 | 9 |
| Cftr gene dup/delet variants CPT 81222 | not published | not published | $84.63 – $911.64 | 7 |
| Cftr gene intron poly t CPT 81224 | not published | not published | $113.00 – $353.60 | 7 |
| Cftr gene known fam variants CPT 81221 | not published | not published | $97.22 – $203.72 | 7 |
| Change cystostomy tube; complex 51710 CPT 51710 | $97.75 | $97.75 | $38.12 – $92.86 | 9 |
| Change cystostomy tube simple CPT 51705 | $89.60 | $89.60 | $19.29 – $46.98 | 9 |
| Change gastric port open CPT 43888 | not published | not published | $444.64 – $962.48 | 8 |
| Change g-tube to g-j perc CPT 49446 | not published | not published | $141.21 – $1,510.44 | 9 |
| Change nephroureteral cath CPT 50387 | not published | not published | $80.18 – $1,044.00 | 9 |
| Change of ureter tube/stent CPT 50688 | not published | not published | $74.20 – $159.27 | 8 |
| Change of windpipe airway 31502 CPT 31502 | $387.75 | $387.75 | $33.79 – $361.38 | 9 |
| Change stent via transureth CPT 50385 | not published | not published | $207.64 – $1,922.26 | 9 |
| Change ureter stent percut CPT 50382 | not published | not published | $242.64 – $1,892.70 | 9 |
| Charger coch impl/aoi battry HCPCS L8625 | not published | not published | $175.77 – $466.28 | 3 |
| Chct for mal hyperthermia CPT 89049 | not published | not published | $60.35 – $353.86 | 9 |
| Chemical exfoliation acne 17360 CPT 17360 | not published | not published | $89.95 – $238.36 | 9 |
| Chemical peel face epiderm 15788 CPT 15788 | not published | not published | $205.81 – $753.61 | 9 |
| Chemical peel nonfacial 15793 CPT 15793 | not published | not published | $339.34 – $920.66 | 9 |
| Chemical peel nonfacial; epidermal CPT 15792 | not published | not published | $199.37 – $649.53 | 9 |
| Chemo adm cns w/lmbr punct CPT 96450 | not published | not published | $74.81 – $311.60 | 9 |
| Chemodener muscle larynx emg CPT 64617 | not published | not published | $104.91 – $312.88 | 9 |
| Chemodenerv 1 extrem 1-4 ea 64643 CPT 64643 | not published | not published | $67.19 – $180.53 | 9 |
| Chemodenerv 1 extrem 5/> ea 64645 CPT 64645 | not published | not published | $77.59 – $233.21 | 9 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | not published | not published | $110.29 – $344.35 | 9 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | not published | not published | $100.93 – $296.82 | 9 |
| Chemodenervation anal musc CPT 46505 | not published | not published | $241.16 – $609.06 | 9 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | not published | not published | $112.82 – $267.27 | 9 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $205.14 – $466.44 | 9 |
| Chemodenerv eccrine glands CPT 64653 | not published | not published | $49.48 – $201.73 | 9 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $39.10 – $171.53 | 9 |
| Chemodenerv musc migraine 64615 CPT 64615 | not published | not published | $115.48 – $298.11 | 9 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | not published | not published | $102.21 – $269.20 | 9 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | not published | not published | $104.21 – $257.62 | 9 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $109.53 – $312.88 | 9 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | not published | not published | $126.25 – $356.57 | 9 |
| Chemo extend IV infus w/pump HCPCS G0498 | $426.50 | $426.50 | $166.34 – $397.50 | 9 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $68.40 – $140.31 | 8 |
| Chemo ia infusion up to 1 hr CPT 96422 | not published | not published | $147.33 – $302.31 | 8 |
| Chemo ia push tecnique CPT 96420 | not published | not published | $96.06 – $197.91 | 8 |
| Chemo intralesional over 7 CPT 96406 | not published | not published | $43.39 – $249.92 | 9 |
| Chemo intralesional up to 7 96405 CPT 96405 | not published | not published | $28.25 – $159.97 | 9 |
| Chemotaxis assay CPT 86155 | not published | not published | $15.99 – $33.21 | 7 |
| Chemotherapy injection 96542 CPT 96542 | not published | not published | $40.73 – $251.85 | 9 |
| Chemotx admn pertl cav impl CPT 96446 | not published | not published | $23.18 – $346.97 | 9 |
| Chest 2 vws w oblique CPT 71048 | $827.80 | $827.80 | $14.70 – $771.51 | 9 |
| Chest apical lordotic proj CPT 71047 | $622.80 | $622.80 | $12.99 – $580.45 | 9 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,408.10 | $2,408.10 | $58.63 – $2,244.35 | 9 |
| Chest CT scan (with contrast) CPT 71260 | $1,552.55 | $1,552.55 | $54.90 – $1,446.98 | 9 |
| Chest CT scan (without contrast) CPT 71250 | $855.55 | $855.55 | $50.88 – $797.37 | 9 |
| Chest Physiotherapy (first session) CPT 94667 | $148.40 | $148.40 | $21.73 – $138.31 | 9 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $100.30 | $100.30 | $33.93 – $93.48 | 9 |
| Chest Ultrasound CPT 76604 | $614.85 | $614.85 | $27.23 – $573.04 | 9 |
| Chest X-ray CPT 71046 | $480.40 | $480.40 | $10.33 – $447.73 | 9 |
| Chest X-ray (single view) CPT 71045 | $361.95 | $361.95 | $8.64 – $337.34 | 9 |
| Chg pr pul rehab for copd patients CPT 94626 | not published | not published | $26.51 – $154.84 | 9 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $481.75 | $481.75 | $32.92 – $448.99 | 9 |
| Chikungunya vaccine live im CPT 90589 | not published | not published | $288.12 – $288.12 | 1 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $207.46 – $434.47 | 7 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $260.79 – $546.30 | 7 |
| Chiropractic manj 5 regions CPT 98942 | not published | not published | $45.30 – $97.65 | 9 |
| Chiropract manj 1-2 regions CPT 98940 | not published | not published | $21.76 – $52.69 | 9 |
| Chiropract manj 3-4 regions CPT 98941 | not published | not published | $33.53 – $75.81 | 9 |
| Chiropract manj xtrspinl 1/> CPT 98943 | not published | not published | $22.43 – $49.46 | 8 |
| Chlamydia culture CPT 87110 | $138.25 | $138.25 | $19.60 – $129.96 | 9 |
| Chlamydia trachomatis ag if CPT 87270 | not published | not published | $11.98 – $25.08 | 7 |
| Chlamydia type CPT 87140 | $14.50 | $14.50 | $5.57 – $13.63 | 9 |
| Chlmyd pneum dna dir probe CPT 87485 | not published | not published | $20.05 – $42.01 | 7 |
| Chlmyd pneum dna quant CPT 87487 | not published | not published | $42.84 – $89.48 | 7 |
| Chlnggrphy intraop addl s&i CPT 74301 | not published | not published | $9.99 – $20.33 | 8 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $41.08 – $50.26 | 4 |
| Chlordiazepoxide injection HCPCS J1990 | not published | not published | $21.05 – $42.01 | 3 |
| Chloride CPT 82435 | $95.80 | $95.80 | $4.60 – $90.05 | 9 |
| Chloride 24 hour urine CPT 82436 | $39.90 | $39.90 | $5.75 – $37.51 | 9 |
| Chloroprocaine (clorotekal) HCPCS J2402 | not published | not published | $0.31 – $0.65 | 3 |
| Chloroprocaine hcl injection HCPCS J2401 | $154.89 | $154.89 | $0.03 – $145.60 | 9 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $0.63 – $1.91 | 4 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | not published | not published | $63.79 – $121.35 | 8 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $191.80 | $191.80 | $29.79 – $180.29 | 9 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | not published | not published | $0.36 – $0.73 | 3 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $128.98 – $1,437.84 | 9 |
| Cholangiogram percutaneous compl CPT 47532 | not published | not published | $202.16 – $1,590.74 | 9 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $964.80 | $964.80 | $12.91 – $899.19 | 9 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $1,212.96 – $2,600.73 | 8 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $1,075.94 – $2,309.27 | 8 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $1,102.17 – $2,365.52 | 8 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | not published | not published | $319.09 – $668.99 | 8 |
| Cholera vaccine live oral CPT 90625 | not published | not published | $308.00 – $576.24 | 3 |
| Cholesterol CPT 82465 | $158.35 | $158.35 | $4.35 – $148.85 | 9 |
| Cholesterol body fluid CPT 84999 | $1,001.90 | $1,001.90 | $390.74 – $951.81 | 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.