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 |
|---|---|---|---|---|
| Ghs clsd red med malleolus fx without manip CPT 27760 | not published | not published | $300.06 – $670.08 | 9 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $654.70 | $654.70 | $137.16 – $334.12 | 9 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $654.75 | $654.75 | $135.58 – $330.27 | 9 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $668.55 | $668.55 | $138.20 – $336.63 | 9 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $466.70 | $466.70 | $96.47 – $234.98 | 9 |
| Ghs community re-entry 15 minutes CPT 97537 | $188.00 | $188.00 | $31.20 – $175.22 | 9 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $107.15 | $107.15 | $22.43 – $54.63 | 9 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $94.65 | $94.65 | $20.34 – $49.54 | 9 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $111.00 | $111.00 | $22.95 – $55.91 | 9 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $116.05 | $116.05 | $23.97 – $58.38 | 9 |
| Ghs cricothyroidotomy CPT 31605 | $509.60 | $509.60 | $105.87 – $257.88 | 9 |
| Ghs cutdown placement age 1 and over CPT 36425 | not published | not published | $38.22 – $79.31 | 8 |
| Ghs cutdown placement under 1 yr CPT 36420 | $70.90 | $70.90 | $27.65 – $67.36 | 9 |
| Ghs diphtheria toxoid ab igg CPT 86648 | not published | not published | $15.21 – $31.85 | 7 |
| Ghs dislocation elbow closed treatment CPT 24600 | $466.70 | $466.70 | $96.47 – $234.98 | 9 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | not published | not published | $102.18 – $218.26 | 8 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $64.30 | $64.30 | $13.57 – $33.06 | 9 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,594.05 | $1,594.05 | $103.74 – $520.71 | 9 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $382.30 – $719.81 | 5 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $16.00 – $58.46 | 8 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $14.63 – $29.82 | 8 |
| Ghs elect vertical elct CPT 92547 | not published | not published | $2.48 – $20.55 | 8 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | not published | not published | $68.56 – $292.96 | 9 |
| Ghs excision ingrown nail CPT 11765 | $256.10 | $256.10 | $53.18 – $129.53 | 9 |
| Ghs eye exam CPT 92002 | not published | not published | $44.94 – $163.19 | 9 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $162.20 | $162.20 | $33.77 – $82.27 | 9 |
| Ghs fat & muscle CPT 89160 | not published | not published | $4.85 – $10.16 | 7 |
| Ghs fb removal foot - deep - left CPT 28192 | $654.70 | $654.70 | $135.58 – $330.27 | 9 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | $237.09 – $896.25 | 9 |
| Ghs fb removal - incisional CPT 10121 | $301.50 | $301.50 | $62.56 – $152.38 | 9 |
| Ghs fb removal - non-incisional CPT 20520 | not published | not published | $141.50 – $422.75 | 9 |
| Ghs febrile agglutinns(mayo) CPT 86000 | not published | not published | $6.98 – $14.63 | 7 |
| Ghs fish cytogen CPT 88271 | $230.80 | $230.80 | $21.85 – $216.95 | 9 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $127.20 | $127.20 | $49.61 – $119.57 | 9 |
| Ghs flow volume loop CPT 94375 | not published | not published | $14.07 – $28.48 | 8 |
| Ghs gastric intub aspiration lavage CPT 43753 | $117.70 | $117.70 | $20.80 – $109.70 | 9 |
| Ghs hcv amplificaiton CPT 87521 | not published | not published | $35.09 – $73.19 | 7 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $22.97 – $48.13 | 7 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | not published | not published | $15.49 – $32.46 | 7 |
| Ghs hgb stability-thal CPT 83068 | $23.70 | $23.70 | $9.24 – $22.28 | 9 |
| Ghs histoplasma antigen CPT 87385 | $174.40 | $174.40 | $13.25 – $163.94 | 9 |
| Ghs HIV antibody CPT 86703 | $163.65 | $163.65 | $13.71 – $153.83 | 9 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $106.14 – $222.33 | 7 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $544.30 | $544.30 | $77.18 – $188.01 | 9 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $702.55 | $702.55 | $145.49 – $354.40 | 9 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $358.25 | $358.25 | $74.04 – $180.36 | 9 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $142.60 | $142.60 | $30.26 – $73.72 | 9 |
| Ghs immun0electrophoresis CPT 86320 | not published | not published | $17.39 – $35.92 | 8 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $242.10 | $242.10 | $50.60 – $123.26 | 9 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | $312.80 | $312.80 | $65.19 – $158.79 | 9 |
| Ghs inf midline insertion CPT 36140 | not published | not published | $84.04 – $969.49 | 9 |
| Ghs inhibitor screen CPT 85335 | $162.35 | $162.35 | $12.87 – $152.61 | 9 |
| Ghs init tx 1st degree burn CPT 16000 | $134.95 | $134.95 | $28.16 – $68.59 | 9 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | not published | not published | $171.04 – $406.03 | 9 |
| Ghs inj neurolytic other perph nerve CPT 64640 | not published | not published | $114.32 – $479.27 | 9 |
| Ghs inj tendon origin/insertion CPT 20551 | not published | not published | $37.87 – $111.14 | 9 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | not published | not published | $59.51 – $259.55 | 9 |
| Ghs inj transforaminal cerv single bil CPT 64479 | not published | not published | $126.02 – $512.68 | 9 |
| Ghs insertion of needle - bone CPT 36680 | $181.65 | $181.65 | $37.54 – $91.44 | 9 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $382.20 | $382.20 | $79.27 – $193.09 | 9 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $431.40 | $431.40 | $89.17 – $217.22 | 9 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $572.70 | $572.70 | $118.37 – $288.33 | 9 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | not published | not published | $8.86 – $59.75 | 8 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $344.85 | $344.85 | $71.29 – $173.66 | 9 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $516.10 | $516.10 | $17.68 – $481.01 | 9 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | not published | not published | $432.38 – $942.95 | 7 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | not published | not published | $432.38 – $942.95 | 7 |
| Ghs IV infusion sotrovimab HCPCS M0247 | not published | not published | $432.38 – $942.95 | 7 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $454.60 | $454.60 | $177.29 – $431.87 | 9 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $264.85 | $264.85 | $54.76 – $133.38 | 9 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $245.95 | $245.95 | $51.11 – $124.50 | 9 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $271.20 | $271.20 | $56.32 – $137.18 | 9 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $278.75 | $278.75 | $57.35 – $139.70 | 9 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $311.55 | $311.55 | $65.19 – $158.79 | 9 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $309.05 | $309.05 | $64.66 – $157.51 | 9 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $348.15 | $348.15 | $71.96 – $175.28 | 9 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $331.75 | $331.75 | $68.35 – $166.49 | 9 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $351.95 | $351.95 | $73.01 – $177.84 | 9 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $386.00 | $386.00 | $79.81 – $194.42 | 9 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $403.60 | $403.60 | $83.44 – $203.25 | 9 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $490.70 | $490.70 | $101.17 – $246.43 | 9 |
| Ghs layered repair 20.1 - 30.0 cm -12046 CPT 12046 | not published | not published | $301.50 – $968.19 | 9 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $517.15 | $517.15 | $106.90 – $260.40 | 9 |
| Ghs layered repair over 30.0 cm -12047 CPT 12047 | not published | not published | $335.29 – $1,060.08 | 9 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | not published | not published | $401.24 – $1,171.22 | 9 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | not published | not published | $8.60 – $18.02 | 7 |
| Ghs low level laser therapy CPT 97039 | not published | not published | $28.48 – $28.48 | 1 |
| Ghs mbp CPT 83873 | $51.55 | $51.55 | $17.20 – $48.46 | 9 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $49.20 | $49.20 | $9.93 – $24.18 | 9 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $160.20 | $160.20 | $32.86 – $80.04 | 9 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $132.45 | $132.45 | $27.65 – $67.36 | 9 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $27.75 | $27.75 | $6.24 – $15.20 | 9 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $104.70 | $104.70 | $21.37 – $52.06 | 9 |
| Ghs musc test done w/n test comp CPT 95886 | not published | not published | $44.07 – $90.15 | 8 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | not published | not published | $17.64 – $36.61 | 8 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $36.08 – $73.89 | 8 |
| Ghs myocardial strain img spckl track CPT 93356 | $128.60 | $128.60 | $11.25 – $71.31 | 9 |
| Ghs nailbed repair/nail removal CPT 11760 | $184.15 | $184.15 | $37.54 – $91.44 | 9 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,085.50 | $1,085.50 | $23.82 – $64.25 | 9 |
| Ghs nerve blk intercostal, single level CPT 64420 | $855.90 | $855.90 | $56.78 – $188.88 | 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.