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 |
|---|---|---|---|---|
| Free skin flap microvasc CPT 15757 | not published | not published | $2,191.12 – $4,609.73 | 8 |
| Frenectomy 41115 CPT 41115 | not published | not published | $141.32 – $505.62 | 9 |
| Frenotomy 40806 CPT 40806 | not published | not published | $27.57 – $192.74 | 9 |
| Frenulotomy of penis CPT 54164 | not published | not published | $186.14 – $401.93 | 8 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $447.20 | $447.20 | $174.41 – $424.84 | 9 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $447.20 | $447.20 | $102.34 – $424.84 | 9 |
| Fresh frozen plasma thawing ea un CPT 86927 | not published | not published | $23.21 – $29.15 | 3 |
| Fr frz plasma donor retested HCPCS P9060 | not published | not published | $225.10 – $225.10 | 1 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $118.09 – $179.08 | 3 |
| Frozen blood prep CPT 86930 | not published | not published | $139.15 – $179.08 | 3 |
| Frozen blood thaw CPT 86931 | not published | not published | $104.46 – $134.30 | 3 |
| Frozen cell preparation CPT 88241 | not published | not published | $12.33 – $25.08 | 7 |
| Frozen plasma, pooled, sd HCPCS P9023 | not published | not published | $133.92 – $286.68 | 2 |
| Fructosamine glycated protein CPT 82985 | $66.80 | $66.80 | $16.76 – $62.79 | 9 |
| Ft arch suprt premold longit HCPCS L3040 | not published | not published | $43.71 – $115.96 | 3 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | not published | not published | $130.36 – $394.47 | 9 |
| Fth/gft fr trnk each addl CPT 15201 | not published | not published | $73.14 – $269.20 | 9 |
| Ft insert ucb berkeley shell HCPCS L3000 | not published | not published | $291.80 – $774.07 | 3 |
| Ftl cgen abnor 3 proteins CPT 81509 | $2,091.50 | $2,091.50 | $100.53 – $1,986.93 | 9 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $69.52 – $145.67 | 7 |
| Ftl cgen abnor four anal CPT 81511 | $359.80 | $359.80 | $140.32 – $338.21 | 9 |
| Ftl cgen abnor three anal CPT 81510 | not published | not published | $55.54 – $116.38 | 7 |
| Ftl cgen abnor two proteins CPT 81508 | $220.30 | $220.30 | $54.30 – $207.08 | 9 |
| Ft prosth multiaxial ankl/ft HCPCS L5978 | not published | not published | $352.14 – $934.12 | 3 |
| Full field erg w/i&r CPT 92273 | not published | not published | $35.65 – $71.16 | 8 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $10.65 – $22.36 | 8 |
| Full sole/heel wedge btween HCPCS L3420 | not published | not published | $50.82 – $134.80 | 3 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $984.70 | $984.70 | $14.92 – $917.74 | 9 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $811.93 – $1,934.46 | 9 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $584.08 – $1,491.16 | 9 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $65.96 – $248.63 | 9 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $761.87 – $1,799.54 | 9 |
| Functional brain mapping CPT 96020 | not published | not published | $156.12 – $314.50 | 8 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $20.62 – $39.20 | 8 |
| Furnsh initial orthosis only HCPCS L1200 | not published | not published | $1,655.12 – $4,390.61 | 3 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $62.65 | $62.65 | $8.05 – $19.61 | 9 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $0.44 – $0.75 | 8 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $3,077.87 – $6,562.46 | 8 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $1,313.71 – $2,822.36 | 8 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $1,321.01 – $2,827.79 | 8 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $1,330.55 – $2,857.61 | 8 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $1,251.51 – $2,684.76 | 8 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $1,405.79 – $3,014.85 | 8 |
| Fuse/graft added joint CPT 26863 | not published | not published | $218.00 – $460.22 | 8 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $1,452.26 – $2,938.63 | 7 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $2,820.96 – $6,159.85 | 8 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $1,590.65 – $3,410.70 | 8 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $1,245.21 – $2,671.22 | 8 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,049.12 – $2,249.62 | 8 |
| Fuse upper gi structures CPT 47721 | not published | not published | $1,291.26 – $2,770.17 | 8 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $741.65 – $1,576.56 | 8 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $832.00 – $1,769.05 | 8 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $973.37 – $2,075.42 | 8 |
| Fusion of big toe joint CPT 28750 | not published | not published | $558.13 – $1,505.94 | 9 |
| Fusion of big toe joint CPT 28755 | not published | not published | $323.07 – $973.98 | 9 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $1,194.83 – $2,537.01 | 8 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $96.84 – $206.74 | 8 |
| Fusion of finger joint CPT 26860 | not published | not published | $592.68 – $1,257.99 | 8 |
| Fusion of finger tendons CPT 26471 | not published | not published | $639.45 – $1,358.99 | 8 |
| Fusion of finger tendons CPT 26474 | not published | not published | $630.70 – $1,337.98 | 8 |
| Fusion of foot bones CPT 28730 | not published | not published | $703.42 – $1,496.58 | 8 |
| Fusion of foot bones CPT 28735 | not published | not published | $754.59 – $1,607.74 | 8 |
| Fusion of foot bones CPT 28740 | not published | not published | $596.89 – $1,595.88 | 9 |
| Fusion of hand joint CPT 26843 | not published | not published | $756.66 – $1,606.38 | 8 |
| Fusion of knee CPT 27580 | not published | not published | $1,414.33 – $3,027.74 | 8 |
| Fusion of knuckle CPT 26850 | not published | not published | $711.62 – $1,510.81 | 8 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $720.17 – $1,530.46 | 8 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $837.92 – $1,781.94 | 8 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $848.52 – $1,802.95 | 8 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $806.86 – $1,717.54 | 8 |
| Fusion of skull arteries CPT 61711 | not published | not published | $2,418.03 – $5,391.22 | 8 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $770.97 – $1,632.83 | 8 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $1,018.37 – $2,151.34 | 8 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $666.88 – $1,443.04 | 8 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $622.89 – $1,343.40 | 8 |
| Fusion of thumb CPT 26841 | not published | not published | $747.13 – $1,588.76 | 8 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $666.66 – $1,427.45 | 8 |
| Fusion of toes CPT 28280 | not published | not published | $337.06 – $973.98 | 9 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $1,339.44 – $2,882.00 | 8 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $1,166.50 – $2,509.89 | 8 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $1,107.45 – $2,337.73 | 8 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $274.83 – $575.89 | 7 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $137.00 – $287.07 | 7 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $274.83 – $575.89 | 7 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $185.20 – $388.07 | 7 |
| G0180 home health certification HCPCS G0180 | not published | not published | $50.34 – $109.13 | 8 |
| G6pc gene CPT 81250 | not published | not published | $53.78 – $122.56 | 7 |
| G6pd full gene sequence CPT 81249 | not published | not published | $600.00 – $1,257.26 | 7 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $366.01 | 7 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $786.25 | 7 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | not published | not published | $64.83 – $137.72 | 5 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $56.67 – $116.42 | 3 |
| Gabapentin non-blood CPT 80355 | not published | not published | $9.18 – $50.16 | 3 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.31 – $0.54 | 8 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $1.50 – $2.93 | 8 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $36.00 | $36.00 | $0.12 – $33.84 | 9 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $14.73 – $29.06 | 8 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $21.07 – $44.07 | 7 |
| Galactokinase - sendout CPT 82759 | not published | not published | $21.48 – $44.74 | 7 |
| Galactose transferase test CPT 82776 | not published | not published | $11.74 – $24.39 | 7 |
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.