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 |
|---|---|---|---|---|
| Alprostadil for injection HCPCS J0270 | not published | not published | $4.74 – $10.48 | 3 |
| Alprostadil urethral suppos HCPCS J0275 | not published | not published | $25.72 – $25.72 | 2 |
| Als 1 HCPCS A0426 | $1,063.00 | $1,063.00 | $137.20 – $334.21 | 9 |
| Als1-emergency HCPCS A0427 | $1,541.70 | $1,541.70 | $600.80 – $1,449.20 | 9 |
| Als 2 HCPCS A0433 | $1,863.90 | $1,863.90 | $726.92 – $1,752.07 | 9 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $834.51 | $834.51 | $88.97 – $784.44 | 9 |
| Alt/sgpt CPT 84460 | $149.85 | $149.85 | $5.30 – $140.86 | 9 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.63 – $9.18 | 8 |
| Aluminum - quest CPT 82108 | $290.65 | $290.65 | $25.48 – $273.21 | 9 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $233.35 – $740.76 | 9 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $39.29 – $109.21 | 9 |
| Amantadine (symmetrel)-sendout CPT 80375 | $117.15 | $117.15 | $21.53 – $110.12 | 9 |
| Ambl bp mntr w/software CPT 93784 | not published | not published | $43.52 – $93.54 | 8 |
| Ambl bp mntr w/sw a/r CPT 93788 | $369.05 | $369.05 | $4.92 – $343.95 | 9 |
| Ambl bp mntr w/sw i&r CPT 93790 | $445.30 | $445.30 | $17.74 – $222.65 | 9 |
| Amifostine HCPCS J0207 | not published | not published | $888.59 – $1,135.69 | 3 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | not published | not published | $0.79 – $1.15 | 8 |
| Amines vaginal fluid qual CPT 82120 | not published | not published | $5.99 – $12.55 | 7 |
| Amino acid screen, urine CPT 82128 | not published | not published | $13.87 – $29.06 | 7 |
| Amino acid single qual CPT 82127 | not published | not published | $14.18 – $29.71 | 7 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $19.61 – $41.09 | 7 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.65 – $3.39 | 8 |
| Aminolevulinic acid delta CPT 82135 | $248.40 | $248.40 | $16.45 – $233.50 | 9 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $392.32 – $781.37 | 8 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $74.58 | $74.58 | $5.13 – $70.11 | 9 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $267.70 | $267.70 | $2.42 – $189.01 | 9 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $14.09 | $14.09 | $0.51 – $13.24 | 9 |
| Amitriptyline (elavil) -sendout CPT 80335 | $135.10 | $135.10 | $5.00 – $126.99 | 9 |
| Amitriptyline injection HCPCS J1320 | not published | not published | $2.24 – $2.24 | 2 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | not published | not published | $19.98 – $42.62 | 8 |
| Ammonia CPT 82140 | $186.30 | $186.30 | $14.57 – $175.12 | 9 |
| Amnioarmor 1 sq cm HCPCS Q4188 | not published | not published | $543.20 – $833.00 | 3 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $76.01 – $229.37 | 9 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $168.36 – $361.94 | 8 |
| Amniocore per sq cm HCPCS Q4227 | not published | not published | $96.19 – $2,176.42 | 8 |
| Amnio-maxx or lite per sq cm HCPCS Q4239 | not published | not published | $68.68 – $5,164.83 | 3 |
| Amniotic fluid scan CPT 82143 | not published | not published | $9.35 – $19.59 | 7 |
| Amniowrap2 per sq cm HCPCS Q4221 | not published | not published | $1,696.00 – $4,219.98 | 3 |
| Amobarbital 125 mg inj HCPCS J0300 | not published | not published | $23.72 – $346.43 | 4 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $872.20 | $872.20 | $340.16 – $828.59 | 9 |
| Amphetamine confirm urine -sendout CPT 80324 | $265.45 | $265.45 | $15.16 – $249.52 | 9 |
| Amphetamines 5 or more CPT 80326 | $168.75 | $168.75 | $9.23 – $160.31 | 9 |
| Ampho b cholesteryl sulfate HCPCS J0288 | not published | not published | $14.00 – $148.44 | 3 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $278.13 | $278.13 | $9.54 – $261.44 | 9 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $10.71 – $37.95 | 5 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $21.63 – $47.40 | 8 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $147.24 | $147.24 | $0.88 – $18.66 | 9 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $65.02 | $65.02 | $1.77 – $61.12 | 9 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $551.08 – $870.00 | 2 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $407.03 – $866.23 | 8 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $680.48 – $1,451.17 | 8 |
| Amputate hand at wrist CPT 25922 | not published | not published | $624.40 – $1,340.68 | 8 |
| Amputate hand at wrist CPT 25920 | not published | not published | $704.77 – $1,514.20 | 8 |
| Amputate leg at thigh CPT 27591 | not published | not published | $926.70 – $1,993.41 | 8 |
| Amputate leg at thigh CPT 27592 | not published | not published | $638.26 – $1,376.62 | 8 |
| Amputate lower leg at knee CPT 27598 | not published | not published | $663.45 – $1,422.03 | 8 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $738.22 – $1,569.10 | 8 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $745.79 – $1,588.76 | 8 |
| Amputate upper arm & implant CPT 24931 | not published | not published | $894.97 – $1,925.62 | 8 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $550.58 – $1,192.24 | 8 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $593.86 – $1,284.44 | 8 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $661.90 – $1,428.79 | 8 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $578.71 – $1,252.57 | 8 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $771.15 – $1,636.89 | 8 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $480.06 – $1,039.06 | 8 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $551.03 – $1,185.47 | 8 |
| Amputation follow-up surgery CPT 24930 | not published | not published | $745.14 – $1,606.38 | 8 |
| Amputation follow-up surgery CPT 25924 | not published | not published | $688.53 – $1,477.60 | 8 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $855.90 – $1,823.28 | 8 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $617.47 – $1,325.78 | 8 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $607.48 – $1,305.44 | 8 |
| Amputation of foot at ankle CPT 27888 | not published | not published | $616.46 – $1,165.15 | 8 |
| Amputation of forearm CPT 25900 | not published | not published | $691.13 – $1,499.98 | 8 |
| Amputation of forearm CPT 25905 | not published | not published | $677.09 – $1,460.67 | 8 |
| Amputation of forearm CPT 25915 | not published | not published | $1,119.91 – $2,404.16 | 8 |
| Amputation of hand CPT 25927 | not published | not published | $833.57 – $1,771.77 | 8 |
| Amputation of leg at hip CPT 27290 | not published | not published | $1,555.33 – $3,334.09 | 8 |
| Amputation of leg at hip CPT 27295 | not published | not published | $1,206.02 – $2,574.95 | 8 |
| Amputation of lower leg CPT 27882 | not published | not published | $562.02 – $1,203.09 | 8 |
| Amputation of lower leg CPT 27881 | not published | not published | $812.80 – $1,687.73 | 8 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $511.38 – $1,083.80 | 8 |
| Amputation of upper arm CPT 24900 | not published | not published | $709.87 – $1,588.76 | 8 |
| Amputation of upper arm CPT 24920 | not published | not published | $706.98 – $1,525.06 | 8 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $685.22 – $1,442.35 | 8 |
| Amputation toe interphalangeal joint CPT 28825 | $913.20 | $913.20 | $167.71 – $562.16 | 9 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $173.00 – $571.15 | 9 |
| Amylase CPT 82150 | $95.80 | $95.80 | $6.48 – $90.05 | 9 |
| Anabolic steroid 1 or 2 CPT 80327 | not published | not published | $22.18 – $50.16 | 3 |
| Anabolic steroid 3 or more CPT 80328 | not published | not published | $24.87 – $24.87 | 1 |
| Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 | not published | not published | $58.42 – $176.86 | 4 |
| Ana ds-dna CPT 86226 | not published | not published | $12.11 – $25.08 | 7 |
| Analgesics non-opioid 3-5 CPT 80330 | not published | not published | $5.10 – $5.10 | 1 |
| Analgesics non-opioid 6/more CPT 80331 | not published | not published | $8.15 – $8.15 | 1 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $352.65 | $352.65 | $11.46 – $331.49 | 9 |
| Anal pressure record CPT 91122 | not published | not published | $85.64 – $174.86 | 8 |
| Anal/urinary muscle study CPT 51784 | not published | not published | $35.94 – $70.03 | 8 |
| Anal/urinary muscle study CPT 51785 | not published | not published | $86.74 – $187.75 | 8 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | not published | not published | $50.48 – $101.00 | 9 |
| Analysis gene f2 20210g>a variant CPT 81240 | $1,113.90 | $1,113.90 | $65.69 – $1,047.07 | 9 |
| Analysis gene f5 leiden variant CPT 81241 | $155.75 | $155.75 | $60.74 – $147.96 | 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.