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 |
|---|---|---|---|---|
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $83.03 – $273.04 | 9 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $113.94 – $348.85 | 9 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $131.62 – $398.33 | 9 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $91.84 – $290.39 | 9 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $101.48 – $322.52 | 9 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $116.61 – $365.56 | 9 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $67.96 – $193.38 | 9 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $83.34 – $287.83 | 9 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $106.38 – $345.65 | 9 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $117.62 – $373.92 | 9 |
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $185.01 – $844.84 | 9 |
| Destroy cth facet jnt addl 64634 CPT 64634 | not published | not published | $64.90 – $492.76 | 9 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | not published | not published | $145.37 – $418.89 | 9 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | not published | not published | $52.47 – $131.06 | 9 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $205.93 – $539.02 | 9 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $129.06 – $373.92 | 9 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $78.95 – $257.62 | 9 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $344.14 – $866.68 | 9 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $677.85 | $677.85 | $264.36 – $623.51 | 9 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | not published | not published | $504.92 – $1,231.61 | 9 |
| Destruction 2-14 lesions 17003 CPT 17003 | not published | not published | $2.01 – $12.85 | 9 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $129.39 – $512.04 | 9 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $174.06 – $1,072.91 | 9 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $132.24 – $465.78 | 9 |
| Destruction benign lesions < 14 lesions CPT 17110 | $213.25 | $213.25 | $64.25 – $198.75 | 9 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $183.84 – $495.35 | 9 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | not published | not published | $57.27 – $462.58 | 9 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $185.32 – $851.92 | 9 |
| Destruction ciliary body CPT 66700 | not published | not published | $373.28 – $868.61 | 9 |
| Destruction ciliary body CPT 66720 | not published | not published | $390.63 – $900.09 | 9 |
| Destruction ciliary body CPT 66740 | not published | not published | $373.28 – $843.56 | 9 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $136.53 – $504.98 | 9 |
| Destruction laser surgery anal lesions 46917 CPT 46917 | not published | not published | $124.15 – $855.76 | 9 |
| Destruction les conjunctiva CPT 68135 | not published | not published | $142.97 – $303.65 | 9 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $131.97 – $405.40 | 9 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $161.76 – $473.50 | 9 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $125.52 – $400.90 | 9 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $147.98 – $455.51 | 9 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $102.53 – $280.76 | 9 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | not published | not published | $165.36 – $431.74 | 9 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $95.29 – $323.80 | 9 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $672.42 – $1,428.12 | 8 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $180.13 – $479.93 | 9 |
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $111.20 – $325.73 | 9 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $92.08 – $267.91 | 9 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $30.03 – $62.93 | 7 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $43.67 – $91.51 | 7 |
| Determination venous press CPT 93770 | not published | not published | $1.36 – $14.78 | 7 |
| Determine refractive state CPT 92015 | not published | not published | $18.28 – $37.28 | 8 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $9.92 – $23.72 | 7 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $122.92 – $239.00 | 9 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $9,038.64 | $9,038.64 | $3,525.07 – $8,586.71 | 9 |
| Device intraute mirena HCPCS J7298 | $1,489.51 | $1,489.51 | $580.91 – $1,415.03 | 9 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $35.86 – $72.52 | 8 |
| Devise bowel pouch CPT 44316 | not published | not published | $1,347.12 – $2,892.85 | 8 |
| Devlopment test interpt&rep HCPCS G0451 | not published | not published | $9.92 – $23.72 | 8 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $55.21 – $115.64 | 9 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $380.60 | $380.60 | $9.64 – $354.72 | 9 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $141.53 – $223.27 | 3 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.17 – $2.41 | 3 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $1.03 | $1.03 | $0.07 – $0.60 | 9 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $20.28 | $20.28 | $0.11 – $4.70 | 9 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $195.36 – $406.35 | 8 |
| Dexamethasone panel CPT 80420 | not published | not published | $157.59 – $338.89 | 7 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $1.63 – $2.34 | 2 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $100.67 – $159.88 | 8 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $17.77 – $158.60 | 3 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $14.52 – $14.52 | 2 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.67 – $1.05 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.16 – $2.33 | 8 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | not published | not published | $7.89 – $16.72 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $12.92 | $12.92 | $1.66 – $12.14 | 9 |
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $3.33 – $7.10 | 8 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $85.75 | $85.75 | $22.23 – $80.61 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $165.00 | $165.00 | $9.71 – $155.10 | 9 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $16.42 – $137.06 | 5 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $211.99 – $558.37 | 3 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $34.00 – $94.84 | 3 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $34.00 – $94.84 | 3 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $34.00 – $94.84 | 3 |
| Diab manage trn ind/group HCPCS G0109 | $30.80 | $30.80 | $12.01 – $29.26 | 9 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $70.68 – $186.18 | 3 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $34.00 – $94.84 | 3 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $163.62 – $337.55 | 8 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $314.32 – $679.84 | 8 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $89.66 – $289.12 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $119.71 – $400.26 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $70.60 | $70.60 | $14.10 – $34.34 | 9 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $266.20 | $266.20 | $30.61 – $250.23 | 9 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $266.20 | $266.20 | $30.61 – $250.23 | 9 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $204.65 | $204.65 | $47.29 – $173.46 | 9 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $117.30 | $117.30 | $24.49 – $59.66 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $397.95 | $397.95 | $46.73 – $370.89 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $214.25 | $214.25 | $37.96 – $199.68 | 9 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $405.07 – $405.07 | 1 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $191.13 – $3,568.26 | 9 |
| Dialysis one evaluation CPT 90945 | not published | not published | $83.07 – $174.19 | 8 |
| Dialysis repeated eval CPT 90947 | not published | not published | $119.62 – $246.05 | 8 |
| Dialysis training complete CPT 90989 | not published | not published | $805.00 – $913.56 | 3 |
| Dialysis training incompl CPT 90993 | not published | not published | $157.50 – $185.05 | 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.