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 |
|---|---|---|---|---|
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | not published | not published | $249.64 – $725.99 | 9 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | not published | not published | $325.78 – $702.87 | 8 |
| Ext antenna phren nerve stim HCPCS L8696 | not published | not published | $201.73 – $535.13 | 3 |
| Ext ecg>48hr<7d rev&interpj CPT 93244 | $445.30 | $445.30 | $23.05 – $222.65 | 9 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | not published | not published | $114.53 – $474.47 | 8 |
| Ext ecg>7d<15d rec scan a/r CPT 93245 | not published | not published | $261.41 – $566.65 | 8 |
| Ext ecg>7d<15d rev&interpj CPT 93248 | $445.30 | $445.30 | $25.41 – $222.65 | 9 |
| Ext ecg>7d<15d scan a/r CPT 93247 | not published | not published | $114.53 – $492.09 | 8 |
| Extended culture of oocytes CPT 89272 | not published | not published | $3,758.33 – $3,758.33 | 1 |
| Extended steel shank HCPCS L2360 | not published | not published | $46.05 – $122.14 | 3 |
| Extended visual field xm CPT 92083 | not published | not published | $26.26 – $53.54 | 8 |
| Extension drainage tubing HCPCS A4331 | not published | not published | $3.53 – $9.30 | 3 |
| Extension per extension per HCPCS L2760 | not published | not published | $54.07 – $143.43 | 3 |
| Extensive ear canal surgery 69150 CPT 69150 | not published | not published | $978.31 – $2,044.24 | 8 |
| Extensive ear/neck surgery 69155 CPT 69155 | not published | not published | $1,578.83 – $3,309.70 | 8 |
| Extensive hand surgery CPT 26250 | not published | not published | $1,022.52 – $2,202.85 | 8 |
| Extensive hysterectomy CPT 58285 | not published | not published | $1,372.25 – $2,909.11 | 8 |
| Extensive jaw surgery CPT 21045 | not published | not published | $1,161.06 – $2,450.26 | 8 |
| Extensive mastoid surgery CPT 69511 | not published | not published | $1,217.89 – $2,558.69 | 8 |
| Extensive mastoid surgery CPT 69530 | not published | not published | $1,624.06 – $3,424.26 | 8 |
| Extensive prostate surgery CPT 55810 | not published | not published | $1,255.68 – $2,648.17 | 8 |
| Extensive prostate surgery CPT 55812 | not published | not published | $1,544.22 – $3,254.13 | 8 |
| Extensive prostate surgery CPT 55815 | not published | not published | $1,690.94 – $3,561.84 | 8 |
| Extensive prostate surgery CPT 55840 | not published | not published | $1,123.51 – $2,376.37 | 8 |
| Extensive prostate surgery CPT 55842 | not published | not published | $1,123.97 – $2,370.94 | 8 |
| Extensive prostate surgery CPT 55845 | not published | not published | $1,307.42 – $2,759.33 | 8 |
| Extensive prostate surgery CPT 55862 | not published | not published | $1,053.56 – $2,222.50 | 8 |
| Extensive prostate surgery CPT 55865 | not published | not published | $1,282.29 – $2,706.46 | 8 |
| Extensive removal of liver CPT 47122 | not published | not published | $3,254.12 – $6,976.61 | 8 |
| Extensive sternum surgery CPT 21632 | not published | not published | $1,150.07 – $2,330.22 | 7 |
| Extensive surgery of throat CPT 42842 | not published | not published | $975.03 – $2,053.74 | 8 |
| Extensive surgery of throat CPT 42844 | not published | not published | $1,328.36 – $2,794.58 | 8 |
| Extensive surgery of throat CPT 42845 | not published | not published | $2,130.61 – $4,459.92 | 8 |
| Extensive testis surgery CPT 54535 | not published | not published | $716.87 – $1,517.60 | 8 |
| Extensive thyroid surgery CPT 60254 | not published | not published | $1,608.43 – $3,397.81 | 8 |
| Extensive vulva surgery CPT 56632 | not published | not published | $1,385.50 – $2,938.26 | 8 |
| External cannula declotting CPT 36860 | not published | not published | $104.42 – $447.80 | 9 |
| External chromosome analysis 20-25 cells CPT 88264 | $420.70 | $420.70 | $147.50 – $395.46 | 9 |
| External newborn metabolic screening panel HCPCS S3620 | $244.85 | $244.85 | $95.49 – $232.61 | 9 |
| External ocular photography CPT 92285 | not published | not published | $2.90 – $6.10 | 8 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | not published | not published | $41.70 – $53.90 | 3 |
| External profiling gene expression oncology (breast) mrna 21 genes CPT 81519 | not published | not published | $3,873.00 – $8,115.31 | 7 |
| External recharg sys extern HCPCS L8695 | not published | not published | $15.49 – $41.09 | 3 |
| External recharg sys intern HCPCS L8689 | not published | not published | $1,605.45 – $4,258.89 | 3 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $218.00 | $218.00 | $85.02 – $207.10 | 9 |
| Extnd color vision xm CPT 92283 | not published | not published | $8.60 – $17.62 | 8 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $75.80 | $75.80 | $17.93 – $71.25 | 9 |
| Extraction of lens CPT 66930 | not published | not published | $818.28 – $1,719.58 | 8 |
| Extraction of lens CPT 66940 | not published | not published | $748.15 – $1,575.89 | 8 |
| Extraction of lens 66920 CPT 66920 | not published | not published | $714.92 – $1,505.40 | 8 |
| Extrnl counterpulse, per tx HCPCS G0166 | not published | not published | $97.25 – $203.34 | 8 |
| Eye allergy tests CPT 95060 | not published | not published | $34.95 – $80.65 | 8 |
| Eye photodynamic ther add-on CPT 67225 | not published | not published | $26.53 – $55.25 | 9 |
| Eye Socket (Orbit) X-ray CPT 70200 | $685.35 | $685.35 | $13.34 – $638.75 | 9 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $2,408.10 | $2,408.10 | $59.55 – $2,244.35 | 9 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $1,267.40 | $1,267.40 | $53.23 – $1,181.22 | 9 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $1,394.15 | $1,394.15 | $60.52 – $1,299.35 | 9 |
| Eye surgery follow-up add-on CPT 67331 | not published | not published | $183.07 – $296.18 | 8 |
| Eye suture during surgery CPT 67335 | not published | not published | $180.46 – $374.83 | 8 |
| Ezh2 gene common variants CPT 81237 | not published | not published | $175.40 – $367.37 | 7 |
| Ezh2 gene full gene sequence CPT 81236 | not published | not published | $282.88 – $592.76 | 7 |
| F-18 fdg pet diag HCPCS A9552 | not published | not published | $450.00 – $106,089.99 | 5 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | not published | not published | $2,914.55 – $6,746.82 | 3 |
| F-18 fluciclovine per mci HCPCS A9588 | not published | not published | $489.60 – $1,035.98 | 3 |
| F-18 sodium fluoride HCPCS A9580 | not published | not published | $225.44 – $106,089.99 | 3 |
| F9 full gene sequence CPT 81238 | not published | not published | $600.00 – $1,257.26 | 7 |
| Fabrication & fitting HCPCS V2628 | not published | not published | $290.51 – $765.19 | 3 |
| Face bone graft CPT 21210 | not published | not published | $733.94 – $3,381.95 | 9 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $3,105.85 | $3,105.85 | $100.88 – $2,894.65 | 9 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $2,527.55 | $2,527.55 | $63.25 – $2,355.68 | 9 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $546.95 | $546.95 | $9.61 – $509.76 | 9 |
| Facial Bones X-ray (complete) CPT 70150 | $725.30 | $725.30 | $12.34 – $675.98 | 9 |
| Facial nerve function test CPT 92516 | not published | not published | $22.33 – $139.42 | 9 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $14,920.39 – $14,920.39 | 1 |
| Factor ix CPT 85250 | $435.15 | $435.15 | $19.04 – $409.04 | 9 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $3.11 – $7.06 | 8 |
| Factor ix complex HCPCS J7194 | not published | not published | $1.17 – $3.27 | 8 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $4.94 – $10.29 | 8 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.05 – $2.66 | 8 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $4.41 – $8.70 | 8 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.37 – $3.27 | 8 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $1.41 – $3.65 | 8 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $1.95 – $4.65 | 8 |
| Factor viii CPT 85240 | $194.25 | $194.25 | $17.90 – $182.60 | 9 |
| Factor viii HCPCS J7190 | not published | not published | $0.97 – $2.20 | 8 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $2.06 – $4.63 | 8 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $1.22 – $2.45 | 8 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $1.97 – $4.15 | 8 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.22 – $3.04 | 8 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.28 – $2.83 | 8 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $3.22 – $6.39 | 8 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $9.68 – $20.70 | 8 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $16.84 – $33.95 | 8 |
| Fallopian tube recnl CPT 58345 | not published | not published | $280.42 – $591.04 | 8 |
| Fam adapt bhv tx gdn phy/qhp CPT 97156 | not published | not published | $42.17 – $71.85 | 3 |
| Family therapy without pt 50min 90846 CPT 90846 | not published | not published | $95.17 – $206.04 | 9 |
| Family therapy with patient 50 min 90847 CPT 90847 | not published | not published | $99.25 – $214.87 | 9 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $5.00 | $5.00 | $1.95 – $4.75 | 9 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $26.14 – $56.95 | 8 |
| Fancc gene CPT 81242 | $86.70 | $86.70 | $33.81 – $81.50 | 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.