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 |
|---|---|---|---|---|
| CT guid cryo ablat intramuscular CPT 20999 | $556.30 | $556.30 | $115.25 – $280.73 | 9 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $179.83 – $367.37 | 8 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | not published | not published | $27.52 – $55.57 | 8 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $118.99 – $243.32 | 8 |
| CT hrt w/3d image CPT 75572 | not published | not published | $81.68 – $165.39 | 8 |
| CT limited or localized follow-up study CPT 76380 | not published | not published | $44.92 – $90.82 | 8 |
| Ctlso a-p-l control molded HCPCS L0700 | not published | not published | $1,998.85 – $5,302.46 | 3 |
| Ctlso a-p-l control with inter HCPCS L0710 | not published | not published | $2,156.60 – $5,720.96 | 3 |
| Ctlso axilla sling HCPCS L1010 | not published | not published | $65.91 – $174.89 | 3 |
| Ctlso milwauke initial model HCPCS L1000 | not published | not published | $2,279.70 – $6,047.49 | 3 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,395.45 | $2,395.45 | $56.97 – $2,232.56 | 9 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $128.40 | $128.40 | $50.08 – $121.98 | 9 |
| CT scan for localization CPT 77011 | not published | not published | $60.52 – $124.03 | 8 |
| CT scan for therapy guide CPT 77014 | not published | not published | $44.04 – $92.18 | 8 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,901.10 | $1,901.10 | $94.25 – $1,771.83 | 9 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,837.75 | $1,837.75 | $85.80 – $1,712.78 | 9 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $1,267.40 | $1,267.40 | $82.10 – $1,181.22 | 9 |
| CT t-spine w /wo contrast CPT 72130 | not published | not published | $59.86 – $121.33 | 8 |
| CT uppr extremity w/o&w/dye CPT 73202 | not published | not published | $57.28 – $115.23 | 8 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $1,240.90 – $3,291.82 | 3 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $788.40 – $2,271.98 | 3 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $788.40 – $2,362.81 | 3 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $699.08 – $1,533.56 | 9 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $608.52 – $1,363.96 | 9 |
| Culture aerobic additional method definitive id each CPT 87077 | $105.20 | $105.20 | $8.08 – $98.89 | 9 |
| Culture afb any source CPT 87116 | $141.00 | $141.00 | $10.80 – $132.54 | 9 |
| Culture anaerobic additional method definitive id each CPT 87076 | $87.70 | $87.70 | $8.08 – $82.44 | 9 |
| Culture anaerobic except blood CPT 87075 | $266.20 | $266.20 | $9.47 – $250.23 | 9 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $9.66 – $20.24 | 7 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $22.30 – $36.61 | 3 |
| Culture bact stool aero addl path ea CPT 87046 | $37.25 | $37.25 | $9.44 – $35.02 | 9 |
| Culture body fluid CPT 87070 | $136.45 | $136.45 | $8.62 – $128.26 | 9 |
| Culture fungi definitive id mold CPT 87107 | $26.85 | $26.85 | $10.32 – $25.24 | 9 |
| Culture fungi definitive id yeast CPT 87106 | $53.25 | $53.25 | $10.32 – $50.06 | 9 |
| Culture fungi other (except blood) CPT 87102 | $165.00 | $165.00 | $8.41 – $155.10 | 9 |
| Culture fungi skin/hair/nail CPT 87101 | $220.95 | $220.95 | $7.71 – $207.69 | 9 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $14.61 – $30.51 | 7 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $15.39 – $32.25 | 7 |
| Culture of specimen by kit CPT 87084 | not published | not published | $15.27 – $56.72 | 7 |
| Culture quantitative aerobic other source CPT 87071 | $288.80 | $288.80 | $9.89 – $271.47 | 9 |
| Culture screening strep group a CPT 87081 | $85.10 | $85.10 | $6.63 – $79.99 | 9 |
| Culture type pulse field gel CPT 87152 | not published | not published | $7.74 – $16.22 | 7 |
| Culture typing added method CPT 87158 | not published | not published | $7.74 – $16.22 | 7 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $12.52 – $26.23 | 7 |
| Culture typing immunologic CPT 87147 | not published | not published | $5.18 – $10.85 | 7 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $139.56 – $456.85 | 7 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $87.75 | $87.75 | $34.22 – $82.49 | 9 |
| Culture urine each isolate CPT 87088 | not published | not published | $8.09 – $16.95 | 7 |
| Culture virus isolation CPT 87250 | not published | not published | $19.56 – $40.67 | 7 |
| Curette/treat cornea CPT 65435 | not published | not published | $65.91 – $158.04 | 9 |
| Curette/treat cornea CPT 65436 | not published | not published | $352.60 – $747.61 | 9 |
| Cus elbo skt in for con/atyp HCPCS L6696 | not published | not published | $1,224.27 – $3,247.72 | 3 |
| Cus elbo skt in not con/atyp HCPCS L6697 | not published | not published | $1,224.27 – $3,247.72 | 3 |
| Custom glove for term device HCPCS L6895 | not published | not published | $705.86 – $1,872.48 | 3 |
| Custom shape cover ak HCPCS L5705 | not published | not published | $1,032.71 – $2,739.51 | 3 |
| Custom shape cover bk HCPCS L5704 | not published | not published | $563.30 – $1,494.32 | 3 |
| Custom shape cvr hip disart HCPCS L5707 | not published | not published | $1,353.28 – $3,589.94 | 3 |
| Custom shape cvr knee disart HCPCS L5706 | not published | not published | $1,007.29 – $2,672.08 | 3 |
| Cv line/pic reposition CPT 36597 | not published | not published | $58.48 – $211.36 | 9 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $13.72 – $28.48 | 8 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $20.79 – $42.01 | 8 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $14.32 – $29.82 | 7 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $48.64 | $48.64 | $1.11 – $45.72 | 9 |
| Cyclic citrullinated peptide antibody CPT 86200 | $232.85 | $232.85 | $12.95 – $218.88 | 9 |
| Cyclophosphamide 100 mg inj HCPCS J9070 | not published | not published | $17.94 – $127.78 | 8 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $1,796.53 | $1,796.53 | $1.74 – $1,688.74 | 9 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $0.62 – $1.66 | 8 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | not published | not published | $39.89 – $141.06 | 4 |
| Cyclosporine 2 hour CPT 80158 | $206.30 | $206.30 | $18.05 – $193.92 | 9 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | not published | not published | $0.70 – $1.63 | 8 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $2.19 – $4.34 | 8 |
| Cygnus matrix, per sq cm HCPCS Q4199 | not published | not published | $273.20 – $719.15 | 8 |
| Cygnus, per sq cm HCPCS Q4170 | not published | not published | $45.56 – $276.53 | 8 |
| Cymetra injectable HCPCS Q4112 | not published | not published | $872.08 – $872.08 | 2 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $251.45 – $610.53 | 7 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $147.30 – $366.01 | 7 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $260.60 – $944.85 | 7 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $366.01 | 7 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $366.01 | 7 |
| Cystatin c CPT 82610 | $48.15 | $48.15 | $18.52 – $45.26 | 9 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $1,045.62 | 7 |
| Cystine urine quantitative CPT 82131 | $173.40 | $173.40 | $22.98 – $163.00 | 9 |
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $458.68 – $969.24 | 8 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $2,227.75 | $2,227.75 | $14.95 – $2,076.26 | 9 |
| Cysto impl 4 or more HCPCS C9740 | not published | not published | $42,543.36 – $42,543.36 | 1 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $332.80 – $42,543.36 | 2 |
| Cysto, litho, vacuum kidney HCPCS C9761 | not published | not published | $42,543.36 – $42,543.36 | 1 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $102.29 – $212.14 | 8 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $861.74 – $1,819.89 | 8 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $716.55 – $1,517.60 | 8 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $291.37 – $23,388.23 | 5 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $158.39 – $865.41 | 9 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $228.66 – $481.91 | 8 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $167.96 – $1,433.34 | 9 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $194.49 – $1,497.59 | 9 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $234.94 – $494.80 | 8 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $275.54 – $579.51 | 8 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $374.27 – $786.25 | 8 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $201.45 – $424.30 | 8 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $155.21 – $717.64 | 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.