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 |
|---|---|---|---|---|
| Contrast x-ray of ankle CPT 73615 | not published | not published | $26.76 – $54.90 | 8 |
| Contrast x-ray of brain CPT 70010 | not published | not published | $31.18 – $110.51 | 8 |
| Contrast x-ray of brain CPT 70015 | not published | not published | $56.24 – $113.87 | 8 |
| Contrast x-ray of elbow CPT 73085 | not published | not published | $26.76 – $52.20 | 8 |
| Contrast x-ray of hip CPT 73525 | $1,978.85 | $1,978.85 | $27.39 – $1,844.29 | 9 |
| Contrast x-ray of knee joint CPT 73580 | not published | not published | $29.56 – $61.69 | 8 |
| Contrast x-ray of wrist CPT 73115 | $1,523.70 | $1,523.70 | $26.76 – $1,420.09 | 9 |
| Controler lvad heartmate 3 includes ebb HCPCS Q0481 | not published | not published | $13,621.09 – $35,876.68 | 3 |
| Control nosebleed pack+caut 30905 CPT 30905 | not published | not published | $102.24 – $675.23 | 9 |
| Control nose/throat bleeding comp req hospital 42971 CPT 42971 | not published | not published | $439.96 – $931.30 | 8 |
| Control nose/throat bleeding with surg ivntj 42972 CPT 42972 | not published | not published | $492.48 – $1,041.10 | 8 |
| Control nose/throat bleeding w/pst nsl packs 42970 CPT 42970 | not published | not published | $399.18 – $845.89 | 8 |
| Control of nosebleed ant comp 30903 CPT 30903 | $184.15 | $184.15 | $37.54 – $91.44 | 9 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $275.00 | $275.00 | $54.80 – $135.89 | 9 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $621.45 | $621.45 | $155.96 – $579.19 | 9 |
| Control throat bleeding CPT 42961 | not published | not published | $406.83 – $862.84 | 8 |
| Control throat bleeding CPT 42962 | not published | not published | $503.60 – $1,063.48 | 8 |
| Conversion ext bil drg cath CPT 47535 | not published | not published | $188.08 – $1,675.54 | 9 |
| Convert nephrostomy catheter CPT 50434 | not published | not published | $183.30 – $1,716.67 | 9 |
| Conv gtube to jtube CPT 44373 | not published | not published | $183.07 – $386.36 | 8 |
| Coombs direct CPT 86880 | $139.70 | $139.70 | $5.39 – $131.32 | 9 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $25.80 | $25.80 | $5.72 – $24.25 | 9 |
| Coombs indirect titer reference CPT 86886 | $133.05 | $133.05 | $5.18 – $125.07 | 9 |
| Copper cu 64 dotatate diag HCPCS A9592 | not published | not published | $981.75 – $2,016.86 | 3 |
| Copper intrauterine device HCPCS J7300 | not published | not published | $756.43 – $1,106.70 | 3 |
| Cor artery disease mrna CPT 81493 | not published | not published | $1,050.00 – $2,200.14 | 7 |
| Core ndl bx lng/med perq CPT 32408 | $2,661.00 | $2,661.00 | $147.63 – $1,617.72 | 9 |
| Corf related serv 15 mins ea HCPCS G0409 | not published | not published | $13.88 – $48.80 | 8 |
| Corf skilled nursing service HCPCS G0128 | not published | not published | $8.28 – $19.66 | 8 |
| Cor hlx vlgs double osteot CPT 28299 | not published | not published | $573.04 – $1,951.17 | 9 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | not published | not published | $497.55 – $1,703.82 | 9 |
| Cor hlx vlgs prx phlx osteot CPT 28298 | not published | not published | $488.64 – $1,611.30 | 9 |
| Cornea 1/2moon str split thick HCPCS L8609 | not published | not published | $6,064.12 – $16,086.66 | 3 |
| Corneal hysteresis deter CPT 92145 | not published | not published | $5.24 – $10.85 | 8 |
| Corneal smear CPT 65430 | not published | not published | $96.77 – $220.36 | 9 |
| Corneal transplant CPT 65710 | not published | not published | $1,090.32 – $2,290.29 | 8 |
| Corneal transplant CPT 65730 | not published | not published | $1,196.91 – $2,511.25 | 8 |
| Corneal transplant CPT 65750 | not published | not published | $1,205.73 – $2,524.81 | 8 |
| Corneal transplant CPT 65755 | not published | not published | $1,201.30 – $2,516.68 | 8 |
| Corneal trnspl endothelial CPT 65756 | not published | not published | $1,127.24 – $2,375.68 | 8 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | not published | not published | $314.01 – $659.50 | 8 |
| Coronary angio/lv gram/lt heart CPT 93458 | not published | not published | $276.80 – $581.55 | 8 |
| Coronary angio/lv gram/rt< heart CPT 93460 | not published | not published | $351.52 – $739.48 | 8 |
| Coronary artery correction CPT 33502 | not published | not published | $1,203.62 – $2,580.38 | 8 |
| Coronary artery graft CPT 33503 | not published | not published | $1,250.91 – $2,684.09 | 8 |
| Coronary artery graft CPT 33504 | not published | not published | $1,380.28 – $2,955.88 | 8 |
| Coronary art/grft angio s&i CPT 93455 | not published | not published | $261.61 – $551.06 | 8 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | not published | not published | $224.40 – $471.75 | 8 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | $437.20 | $437.20 | $48.37 – $407.47 | 9 |
| Coroners autopsy (necropsy) CPT 88045 | not published | not published | $111.08 – $118.62 | 3 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | not published | not published | $468.25 – $1,350.47 | 9 |
| Correct cock-up 5th toe/plast clos 28286 CPT 28286 | not published | not published | $287.68 – $854.48 | 9 |
| Correct finger deformity CPT 26567 | not published | not published | $697.00 – $1,479.63 | 8 |
| Correct inverted nipple(s) CPT 19355 | not published | not published | $593.16 – $1,462.25 | 9 |
| Correction claw finger other CPT 26499 | not published | not published | $843.05 – $1,792.10 | 8 |
| Correction eyelid w/implant CPT 67912 | not published | not published | $463.98 – $1,726.30 | 9 |
| Correction hallux valgus sesamoidectomy;prox meta osteotomy CPT 28295 | not published | not published | $588.09 – $2,019.92 | 9 |
| Correction of astigmatism CPT 65772 | not published | not published | $385.94 – $875.68 | 9 |
| Correction of astigmatism CPT 65775 | not published | not published | $547.94 – $1,156.99 | 8 |
| Correction of bladder defect CPT 51940 | not published | not published | $1,575.14 – $3,317.83 | 8 |
| Correction of everted punctum 68705 CPT 68705 | not published | not published | $158.00 – $501.76 | 9 |
| Correction trichiasis epilation forcep 67820 CPT 67820 | not published | not published | $21.21 – $44.74 | 9 |
| Correction trichiasis inccision lid margin 67830 CPT 67830 | not published | not published | $131.20 – $517.83 | 9 |
| Correct malrotation of bowel 44055 CPT 44055 | not published | not published | $1,415.39 – $3,046.72 | 8 |
| Correct metacarpal flaw CPT 26565 | not published | not published | $691.42 – $1,466.76 | 8 |
| Correct rectal prolapse CPT 45541 | not published | not published | $900.40 – $1,920.22 | 8 |
| Correct rectal prolapse; abdominal approach 45540 CPT 45540 | not published | not published | $1,011.41 – $2,134.39 | 8 |
| Correct skin color 6.0 cm/< CPT 11920 | not published | not published | $104.36 – $388.05 | 9 |
| Correct skin color ea 20.0cm CPT 11922 | not published | not published | $27.95 – $118.21 | 9 |
| Corrj halux rigdus w/implt CPT 28291 | not published | not published | $471.42 – $1,327.97 | 9 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | $445.84 – $1,328.62 | 9 |
| Corticorelin ovine triflutal HCPCS J0795 | not published | not published | $8.82 – $9.67 | 3 |
| Cortisol acth stimulation test - sendout CPT 80400 | $513.60 | $513.60 | $32.62 – $482.78 | 9 |
| Cortisol total am CPT 82533 | $270.15 | $270.15 | $16.30 – $253.94 | 9 |
| Costotransversectomy CPT 21610 | not published | not published | $1,074.97 – $2,513.96 | 8 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | not published | not published | $21.73 – $66.09 | 8 |
| Co-treatment - group 15 mins, st CPT 92508 | $144.85 | $144.85 | $23.20 – $135.00 | 9 |
| Counseling smoke cess interm >10mins CPT 99407 | $102.95 | $102.95 | $24.44 – $52.69 | 9 |
| Counseling visit to discuss need for ldct g0296 HCPCS G0296 | not published | not published | $25.13 – $53.32 | 8 |
| Cov-19 amp prb hgh thruput HCPCS U0003 | not published | not published | $32.83 – $32.83 | 1 |
| Cover eye w/membrane CPT 65778 | not published | not published | $51.42 – $2,446.66 | 9 |
| Cover eye w/membrane suture CPT 65779 | not published | not published | $141.36 – $2,227.42 | 9 |
| Covers for upright each HCPCS L1120 | not published | not published | $35.34 – $93.75 | 3 |
| Cover wrist HCPCS L3984 | not published | not published | $376.35 – $998.37 | 3 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $50.00 | $50.00 | $25.00 – $83.82 | 9 |
| Covid-19 convalescent plasma HCPCS C9507 | not published | not published | $1,027.04 – $1,958.16 | 2 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | not published | not published | $432.38 – $942.95 | 7 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | not published | not published | $432.38 – $1,571.58 | 7 |
| Covid-19 lab test non-cdc HCPCS U0002 | not published | not published | $32.83 – $107.52 | 7 |
| #covid19rsv-rsv CPT 87634 | $87.70 | $87.70 | $34.20 – $83.32 | 9 |
| #coxa-coxsackie a serotype a16 CPT 86658 | not published | not published | $13.03 – $27.11 | 7 |
| CPAP or BiPAP Setup (first day) CPT 94660 | $736.75 | $736.75 | $36.07 – $124.63 | 9 |
| C-peptide CPT 84681 | $135.65 | $135.65 | $20.81 – $127.51 | 9 |
| CPR (Cardiopulmonary Resuscitation) CPT 92950 | $538.65 | $538.65 | $112.11 – $273.08 | 9 |
| Cptr-asst dir ms px CPT 20985 | not published | not published | $138.24 – $293.49 | 8 |
| Cptrized corneal topography CPT 92025 | not published | not published | $18.89 – $36.63 | 8 |
| Cptr ophth dx img post segmt CPT 92134 | not published | not published | $24.22 – $46.90 | 8 |
| Cptrz oph img pst sg rta oct CPT 92137 | not published | not published | $48.80 – $1,432.64 | 2 |
| Cr-51 sodium chromate HCPCS A9553 | not published | not published | $359.32 – $106,089.99 | 4 |
| Cranial cervical orthosis HCPCS L0112 | not published | not published | $1,300.13 – $3,448.96 | 3 |
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.