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 |
|---|---|---|---|---|
| Injection treatment of nose CPT 30200 | not published | not published | $57.27 – $213.95 | 9 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $80.27 – $316.74 | 9 |
| Inject/treat eye socket CPT 67500 | not published | not published | $61.80 – $148.41 | 9 |
| Inject/treat eye socket CPT 67505 | not published | not published | $69.63 – $164.47 | 9 |
| Inject/treat eye socket CPT 67515 | not published | not published | $45.42 – $98.29 | 9 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $31.92 – $100.47 | 3 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $26.17 – $43.75 | 8 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $366.67 – $744.40 | 8 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $50.65 – $102.82 | 8 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $855.90 | $855.90 | $96.85 – $316.10 | 9 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $855.90 | $855.90 | $77.96 – $260.85 | 9 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $1.74 – $4.71 | 8 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.08 – $2.39 | 8 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | not published | not published | $3.82 – $7.61 | 4 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $163.20 – $335.27 | 3 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $175.70 – $368.29 | 8 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $15.06 – $35.58 | 8 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $4,609,957.80 – $4,609,957.80 | 1 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $8.78 – $18.84 | 8 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $34.82 – $69.67 | 8 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $62.05 – $106,089.99 | 3 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $18.86 – $41.07 | 8 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $131.82 – $269.81 | 8 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.03 – $0.06 | 3 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.10 – $2.18 | 8 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $7.55 – $15.21 | 2 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $6.58 – $6.58 | 1 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $121.33 – $246.34 | 2 |
| Inj follitropin beta 75 iu HCPCS S0128 | not published | not published | $115.23 – $221.85 | 2 |
| Inj for ext venography CPT 36005 | $172.50 | $172.50 | $45.74 – $160.77 | 9 |
| Inj for mammo ductogram CPT 19030 | $119.00 | $119.00 | $46.41 – $113.05 | 9 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.17 – $2.04 | 8 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $400.51 – $1,300.95 | 8 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $3.16 – $5.64 | 4 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $4.00 – $64.66 | 8 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $3.13 – $64.29 | 5 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $3.91 – $11.26 | 3 |
| Inj, ganciclovir (exela) HCPCS J1574 | not published | not published | $51.00 – $104.77 | 3 |
| Inj ganirelix acetat 250 mcg HCPCS S0132 | not published | not published | $159.97 – $187.68 | 2 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $3.76 – $18.46 | 8 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $111.92 – $228.26 | 8 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $2,707.93 – $8,207.79 | 3 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | not published | not published | $3.98 – $3.98 | 1 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | not published | not published | $3.35 – $3.35 | 1 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $163.20 – $503.58 | 4 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $5.63 – $10.90 | 8 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $134.77 – $223.28 | 4 |
| Inj., haegarda 10 units HCPCS J0599 | not published | not published | $10.80 – $24.39 | 3 |
| Inj, hemgenix, per tx dose HCPCS J1411 | not published | not published | $0.03 – $7,696,324.55 | 2 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | not published | not published | $3.42 – $6.96 | 8 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $64.61 – $124.66 | 8 |
| Inj, hercessi, 10 mg HCPCS Q5146 | not published | not published | $184.82 – $184.82 | 1 |
| Inj herzuma 10 mg HCPCS Q5113 | $4,815.69 | $4,815.69 | $20.58 – $1,616.70 | 9 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $44.39 – $92.85 | 8 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $49.34 – $102.34 | 8 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $51.72 – $109.80 | 8 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $25.30 – $54.23 | 8 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $25.16 – $51.51 | 8 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.32 – $2.93 | 8 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | not published | not published | $10.54 – $15.25 | 2 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | not published | not published | $13.91 – $55.13 | 4 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $71.00 – $152.48 | 8 |
| Inj, idacio, 1 mg HCPCS Q5144 | not published | not published | $23.55 – $23.55 | 1 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | not published | not published | $2.43 – $4.95 | 8 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $59.57 – $151.48 | 8 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | not published | not published | $0.27 – $0.27 | 1 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $472.13 – $957.57 | 8 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $136.97 – $599.43 | 9 |
| Inj. infugem, 100 mg HCPCS J9198 | not published | not published | $25.16 – $84.40 | 8 |
| Inj. insulin (fiasp) HCPCS J1812 | not published | not published | $1.48 – $3.04 | 3 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $29.02 – $111.14 | 9 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $44.16 – $135.56 | 9 |
| Inj, invega hafyera/trinza HCPCS J2427 | $26,211.17 | $26,211.17 | $12.21 – $8,228.68 | 9 |
| Inj ivig privigen 500 mg HCPCS J1459 | $9,235.52 | $9,235.52 | $48.13 – $1,085.17 | 9 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $1.72 – $4.36 | 8 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.22 – $4.84 | 8 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $1.37 – $2.93 | 8 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | not published | not published | $2.13 – $3.31 | 8 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $84.46 – $178.70 | 3 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $42.34 – $60.96 | 8 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $1.34 – $2.62 | 8 |
| Inj lefamulin 1 mg HCPCS J0691 | not published | not published | $0.70 – $2.18 | 5 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $21.92 – $43.46 | 8 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $225.26 | $225.26 | $30.54 – $211.74 | 9 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.02 – $0.28 | 5 |
| Inj, levothyroxine, freskabi HCPCS J0651 | not published | not published | $7.54 – $8.07 | 2 |
| Inj, levothyroxine, hikma HCPCS J0652 | not published | not published | $10.16 – $17.56 | 2 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $64.83 | $64.83 | $0.02 – $4.70 | 9 |
| Inj, linezolid (hospira) HCPCS J2021 | not published | not published | $14.01 – $20.06 | 8 |
| Inj, lovotibeglogene autotem HCPCS J3394 | not published | not published | $0.03 – $6,885,600.61 | 2 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $316.99 – $628.65 | 8 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $22.51 – $49.01 | 8 |
| Inj luxturna 1 billion vec g HCPCS J3398 | not published | not published | $2,890.00 – $8,717.29 | 3 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $855.90 | $855.90 | $73.93 – $747.20 | 9 |
| Inj. meloxicam 1 mg HCPCS J1738 | not published | not published | $3.19 – $6.56 | 4 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $148.02 – $264.30 | 8 |
| Inj, melphalan flufenami 1mg HCPCS J9247 | not published | not published | $484.50 – $1,294.57 | 5 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $1,529.67 – $2,346.55 | 2 |
| Inj menotropins 75 iu HCPCS S0122 | not published | not published | $106.41 – $238.08 | 2 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $19.70 | $19.70 | $2.50 – $18.52 | 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.