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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $91.29 – $298.87 | 7 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $35.09 – $73.19 | 7 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $255.55 | $255.55 | $35.09 – $240.22 | 9 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $191.95 | $191.95 | $74.86 – $180.43 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $416.78 – $873.00 | 7 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $579.95 | $579.95 | $128.29 – $545.15 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $1,188.90 | $1,188.90 | $235.16 – $1,117.57 | 9 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $548.30 | $548.30 | $42.84 – $515.40 | 9 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $618.80 | $618.80 | $42.84 – $581.67 | 9 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $846.30 | $846.30 | $42.84 – $795.52 | 9 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $753.20 | $753.20 | $85.10 – $708.01 | 9 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $152.10 | $152.10 | $59.32 – $144.50 | 9 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,432.10 | $1,432.10 | $31.71 – $1,346.17 | 9 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $613.15 | $613.15 | $21.89 – $576.36 | 9 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $1,160.43 | $1,160.43 | $10.66 – $1,090.80 | 9 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $21.54 – $61.00 | 7 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $40.04 – $165.06 | 3 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $23.46 – $57.08 | 3 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | $855.90 | $855.90 | $148.44 – $804.55 | 9 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,952.02 – $6,285.24 | 8 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,914.45 – $6,130.70 | 8 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | $837.10 | $837.10 | $161.31 – $786.87 | 9 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | $837.10 | $837.10 | $153.87 – $786.87 | 9 |
| Infuse radioactive materials CPT 77750 | not published | not published | $228.99 – $502.41 | 8 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $66.57 – $164.47 | 9 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $72.28 – $237.71 | 9 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $956.00 | $956.00 | $82.87 – $890.99 | 9 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $1,941.21 – $5,149.57 | 3 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,386.77 – $3,678.79 | 3 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $93.54 – $93.54 | 1 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,224.27 – $3,247.72 | 3 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $39.14 – $124.63 | 8 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $332.07 – $678.48 | 8 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $129.88 – $269.10 | 8 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $177.86 – $367.37 | 8 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $78.41 – $162.67 | 8 |
| Initial observation care CPT 99218 | not published | not published | $132.65 – $132.65 | 1 |
| Initial observation care CPT 99219 | not published | not published | $218.03 – $218.03 | 1 |
| Initial observation care CPT 99220 | not published | not published | $306.76 – $306.76 | 1 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $60.19 – $176.68 | 9 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $120.27 – $310.95 | 8 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $37.21 – $110.51 | 8 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $5.88 – $17.95 | 3 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $3,561.72 | $3,561.72 | $6.55 – $2,511.01 | 9 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.48 – $0.48 | 1 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.05 – $0.10 | 8 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.05 – $0.08 | 8 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.05 – $0.10 | 8 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,479.53 – $7,566.95 | 8 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $181.32 – $181.32 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $27.20 – $27.20 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $61,200.00 – $192,561.72 | 4 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.98 – $11.82 | 8 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $68.33 – $105.17 | 2 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $650.49 – $1,018.04 | 2 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.44 – $3.00 | 8 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $2.57 – $5.07 | 3 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $5.49 – $8.70 | 8 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $290.36 – $290.36 | 1 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $57.72 – $115.12 | 8 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.18 – $27.50 | 3 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $127.50 – $400.53 | 4 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $16.55 – $35.12 | 8 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,348.99 – $10,556.10 | 4 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $1.84 – $5.70 | 3 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.01 – $6.18 | 8 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $46.18 – $157.17 | 3 |
| Inj. asceniv HCPCS J1554 | not published | not published | $491.40 – $978.46 | 8 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $49.19 – $107.03 | 8 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $214.89 – $334.97 | 2 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $73.90 – $153.91 | 8 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $45.02 – $141.86 | 5 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $168.22 – $327.94 | 8 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $38.33 – $83.86 | 3 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $0.03 – $6,219,252.16 | 2 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $4,659.94 | $4,659.94 | $39.86 – $4,380.34 | 9 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $206.21 – $414.92 | 8 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.17 – $0.34 | 8 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $8.82 – $147.23 | 5 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $2.68 – $46.72 | 5 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $1.52 – $3.77 | 8 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $75.99 – $215.52 | 4 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $847.37 – $1,294.79 | 2 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $3,389.51 – $5,179.15 | 2 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $321.16 – $669.93 | 8 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $666.62 – $1,768.38 | 3 |
| Inj, bupivacaine liposome HCPCS J0666 | $1,087.43 | $1,087.43 | $2.85 – $1,022.18 | 9 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.49 – $1.55 | 3 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $157.71 – $334.47 | 8 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $0.78 – $2.70 | 4 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $18.40 – $787.54 | 3 |
| Inj cefazolin sodium, baxter HCPCS J0689 | $36.96 | $36.96 | $1.21 – $34.74 | 9 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $61.77 | $61.77 | $1.04 – $58.06 | 9 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $2.20 – $3.28 | 2 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $5.47 – $11.34 | 8 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $5.13 – $9.72 | 8 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.17 – $4.51 | 8 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $6.84 – $16.11 | 8 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $105.77 – $232.30 | 3 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $14.96 – $31.10 | 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.