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 nerve block axillary nerve CPT 64417 | $1,085.50 | $1,085.50 | $61.74 – $309.02 | 9 |
| Ghs nerve block brachial plexus CPT 64415 | $201.05 | $201.05 | $68.00 – $187.38 | 9 |
| Ghs nerve block celiac plexus CPT 64530 | not published | not published | $91.28 – $440.73 | 9 |
| Ghs nerve block interscaline CPT 64510 | $1,085.50 | $1,085.50 | $74.05 – $282.69 | 9 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $1,085.50 | $1,085.50 | $81.27 – $444.59 | 9 |
| Ghs nerve block sciatic nerve CPT 64445 | $837.10 | $837.10 | $70.25 – $305.81 | 9 |
| Ghs nerve block suprascapular CPT 64418 | $53.55 | $53.55 | $20.88 – $50.87 | 9 |
| Ghs ng placement w fluoro guidance CPT 43752 | $70.00 | $70.00 | $35.00 – $80.65 | 9 |
| Ghs o2 saturation CPT 82810 | $105.20 | $105.20 | $9.77 – $98.89 | 9 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $12.25 – $25.08 | 8 |
| Ghs o2 uptake rest & indirect CPT 94690 | not published | not published | $3.58 – $7.46 | 8 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $140.65 – $212.26 | 2 |
| Ghs opcc repair cvp without subq port CPT 36575 | not published | not published | $32.24 – $274.97 | 9 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $174.53 – $656.59 | 9 |
| Ghs optokenetic CPT 92544 | not published | not published | $6.19 – $26.98 | 8 |
| Ghs oscillating trac CPT 92545 | not published | not published | $6.19 – $25.05 | 8 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | not published | not published | $22.75 – $60.39 | 9 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | not published | not published | $34.20 – $86.73 | 9 |
| Ghs ot dds rom CPT 95851 | not published | not published | $7.63 – $41.76 | 9 |
| Ghs ot group caregiver training CPT 97552 | $26.80 | $26.80 | $10.45 – $24.98 | 9 |
| Ghs ot prosthetic training/15 min CPT 97761 | $216.75 | $216.75 | $40.66 – $202.01 | 9 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $188.00 | $188.00 | $53.90 – $175.22 | 9 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $101.16 – $134.21 | 3 |
| Ghs pacing - transcutaneous CPT 92953 | $26.75 | $26.75 | $0.89 – $24.93 | 9 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | not published | not published | $58.44 – $188.24 | 9 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | not published | not published | $50.27 – $175.39 | 9 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $22.04 – $50.84 | 8 |
| Ghs peritonsillar abscess i andd CPT 42700 | $242.10 | $242.10 | $50.60 – $123.26 | 9 |
| Ghs phenylketonurid CPT 84030 | $244.85 | $244.85 | $5.50 – $230.16 | 9 |
| Ghs picc line insert < 5 CPT 36568 | not published | not published | $89.50 – $185.72 | 8 |
| Ghs plngl fx pm cl CPT 26725 | $726.00 | $726.00 | $91.77 – $223.54 | 9 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $4.31 – $8.82 | 7 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $121.07 – $244.68 | 8 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $7.33 – $46.90 | 8 |
| Ghs ppd (tb intradermal) CPT 86580 | $51.95 | $51.95 | $9.29 – $46.30 | 9 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $44.55 | $44.55 | $9.66 – $41.88 | 9 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.61 – $11.52 | 7 |
| Ghs protoporphyrins fract CPT 84202 | $62.10 | $62.10 | $14.35 – $58.37 | 9 |
| Ghs pr without cont pulse ox CPT 94625 | not published | not published | $16.47 – $142.62 | 9 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | not published | not published | $12.25 – $25.67 | 7 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $253.67 – $338.22 | 3 |
| Ghs quinidine CPT 80194 | $251.90 | $251.90 | $14.60 – $236.79 | 9 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $83.49 – $176.90 | 8 |
| Ghs removal intranasal foreign body CPT 30300 | $132.45 | $132.45 | $27.65 – $67.36 | 9 |
| Ghs removal pharyngeal foreign body CPT 42809 | $268.70 | $268.70 | $55.79 – $135.90 | 9 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $924.60 | $924.60 | $191.94 – $467.54 | 9 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | not published | not published | $479.47 – $1,038.39 | 8 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $43.35 | $43.35 | $15.89 – $40.75 | 9 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.31 – $8.82 | 7 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $443.20 | $443.20 | $13.91 – $416.61 | 9 |
| Ghs sedimentation rate CPT 85651 | $63.85 | $63.85 | $4.27 – $60.02 | 9 |
| Ghs semen analysis fert CPT 89320 | $214.25 | $214.25 | $12.31 – $201.40 | 9 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $20.33 | 7 |
| Ghs sensitivity (per antimicro) CPT 87184 | $122.45 | $122.45 | $7.48 – $115.10 | 9 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $320.35 | $320.35 | $66.75 – $162.59 | 9 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $437.75 | $437.75 | $90.73 – $221.02 | 9 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $211.90 | $211.90 | $43.78 – $106.64 | 9 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $243.40 | $243.40 | $50.60 – $123.26 | 9 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $278.75 | $278.75 | $57.35 – $139.70 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $253.50 | $253.50 | $53.18 – $129.53 | 9 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $358.25 | $358.25 | $74.04 – $180.36 | 9 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $139.12 – $449.09 | 9 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $166.68 – $353.14 | 8 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $39.67 – $77.95 | 8 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $26.62 – $52.87 | 8 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $43.77 – $90.15 | 8 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $47.48 – $99.64 | 8 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $98.59 – $280.76 | 9 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $7.33 – $39.83 | 8 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $100.92 – $211.47 | 8 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $10.58 – $31.48 | 9 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $17.99 – $57.18 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $70.73 – $149.11 | 8 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $14.89 – $33.21 | 8 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $131.09 – $281.29 | 8 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $336.75 | $336.75 | $69.36 – $168.96 | 9 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $114.95 | $114.95 | $44.83 – $109.20 | 9 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $307.53 – $644.60 | 8 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $15.30 | 7 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $440.25 | $440.25 | $91.22 – $222.21 | 9 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $232.00 – $618.05 | 9 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $50.84 | 7 |
| Ghs urine, porphyrins quant CPT 84120 | $164.05 | $164.05 | $14.71 – $154.21 | 9 |
| Ghs vaginal delivery only CPT 59409 | $1,976.60 | $1,976.60 | $763.06 – $1,626.04 | 9 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $1,373.34 – $2,441.13 | 5 |
| Ghs windowing of cast CPT 29730 | not published | not published | $42.70 – $127.20 | 9 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $28.48 | 7 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.72 – $30.84 | 7 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $40.16 – $81.34 | 8 |
| Gi inhouse confirmation CPT 87045 | $145.10 | $145.10 | $9.44 – $136.39 | 9 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $290.03 – $912.94 | 9 |
| Gi protein loss CPT 78282 | not published | not published | $15.24 – $30.51 | 8 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $109.66 – $223.67 | 8 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $118.26 – $241.29 | 8 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $44.21 – $90.15 | 8 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $103.16 – $210.11 | 8 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $211.89 | 7 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $128.79 | 7 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $73.19 | 7 |
| Glassia injection HCPCS J0257 | not published | not published | $5.25 – $10.90 | 8 |
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.