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 |
|---|---|---|---|---|
| Antinuclear antibodies titer CPT 86039 | $71.80 | $71.80 | $11.16 – $67.49 | 9 |
| Antiphosphatidylserine antibody CPT 86148 | not published | not published | $16.07 – $33.67 | 7 |
| Antipsychotics nos 1-3 CPT 80342 | $161.05 | $161.05 | $14.00 – $151.39 | 9 |
| Antipsychotics nos 4-6 CPT 80343 | not published | not published | $32.33 – $32.33 | 1 |
| Antipsychotics nos 7/more CPT 80344 | not published | not published | $8.25 – $8.25 | 1 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.77 – $12.09 | 7 |
| Antistreptolysin o titer CPT 86060 | $127.70 | $127.70 | $7.30 – $120.04 | 9 |
| Antithrombin iii activity CPT 85300 | $93.15 | $93.15 | $11.85 – $87.56 | 9 |
| Antithrombin iii injection HCPCS J7197 | not published | not published | $3.78 – $7.84 | 8 |
| Antithrombin recombinant HCPCS J7196 | not published | not published | $143.31 – $294.41 | 3 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $3,061.32 – $8,610.52 | 8 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $904.11 – $1,878.52 | 8 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $846.02 – $1,776.51 | 8 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $22.41 – $55.89 | 8 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $20.93 – $40.47 | 8 |
| Ant thrc vrt body tethrg <7 CPT 22836 | not published | not published | $3,087.08 – $3,489.99 | 5 |
| Ant thrc vrt body tethrg 8+ CPT 22837 | not published | not published | $3,401.36 – $3,845.84 | 5 |
| Aoi transducer/actuator repl HCPCS L8694 | not published | not published | $878.95 – $2,331.65 | 3 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | $867.60 | $867.60 | $25.86 – $808.60 | 9 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $666.19 – $1,421.35 | 8 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $504.00 – $1,056.02 | 7 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,350.19 – $2,829.13 | 7 |
| Aortic hemiarch graft 33866 CPT 33866 | not published | not published | $863.32 – $1,828.71 | 8 |
| Aortic suspension CPT 33800 | not published | not published | $927.47 – $1,984.61 | 8 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $200.00 – $418.88 | 7 |
| Apc gene full sequence CPT 81201 | not published | not published | $780.00 – $1,634.17 | 7 |
| Apc gene known fam variants CPT 81202 | not published | not published | $280.00 – $586.72 | 7 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $10.23 – $23.72 | 7 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $81.01 – $3,421.78 | 9 |
| Apheresis plasma CPT 36514 | not published | not published | $90.42 – $1,281.07 | 9 |
| Apheresis platelets CPT 36513 | not published | not published | $102.50 – $217.57 | 8 |
| Apheresis rbc CPT 36512 | not published | not published | $103.43 – $212.83 | 8 |
| Apheresis wbc CPT 36511 | not published | not published | $106.24 – $224.36 | 8 |
| Apl(pml-rara) quant - sendout CPT 81315 | $539.00 | $539.00 | $128.93 – $506.66 | 9 |
| Apomorphine hydrochloride HCPCS J0364 | not published | not published | $6.10 – $35.41 | 3 |
| Appendectomy CPT 44950 | not published | not published | $613.34 – $1,316.29 | 8 |
| Appendectomy add-on 44955 CPT 44955 | not published | not published | $79.62 – $168.77 | 8 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | not published | not published | $836.82 – $1,796.17 | 8 |
| Appendico-vesicostomy CPT 50845 | not published | not published | $1,205.21 – $2,551.23 | 8 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $575.86 – $1,239.70 | 8 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $214.83 – $656.59 | 9 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | not published | not published | $53.23 – $182.45 | 9 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | not published | not published | $24.17 – $62.32 | 9 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $187.22 – $594.93 | 9 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | not published | not published | $42.65 – $156.11 | 9 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | not published | not published | $16.06 – $47.54 | 9 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $159.28 – $575.65 | 9 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $178.79 – $628.98 | 9 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $164.53 – $586.57 | 9 |
| Appl body cast sho to hips CPT 29035 | not published | not published | $136.54 – $515.90 | 9 |
| Appl cast figure-of-eight CPT 29049 | not published | not published | $66.10 – $197.24 | 9 |
| Appl cast plaster velpeau CPT 29058 | not published | not published | $89.29 – $243.50 | 9 |
| Appl cast shoulder spica CPT 29055 | not published | not published | $130.94 – $445.87 | 9 |
| Appl halo cranial 6+pins CPT 20664 | not published | not published | $836.89 – $1,860.56 | 8 |
| Appl halo type body cast CPT 29000 | not published | not published | $184.90 – $711.85 | 9 |
| Appl hip spica cast1&1/2 CPT 29325 | not published | not published | $168.75 – $544.17 | 9 |
| Appl hip spica cast 1 leg CPT 29305 | not published | not published | $150.72 – $492.76 | 9 |
| Application clubfoot cast CPT 29450 | not published | not published | $109.43 – $283.33 | 9 |
| Application finger splntstatic 29130 CPT 29130 | $60.55 | $60.55 | $12.52 – $30.50 | 9 |
| Application halo femoral CPT 20663 | not published | not published | $462.02 – $1,005.18 | 8 |
| Application halo pelvic CPT 20662 | not published | not published | $501.45 – $1,090.59 | 8 |
| Application long leg splint 29505 CPT 29505 | $93.35 | $93.35 | $19.81 – $48.26 | 9 |
| Application lower leg splint 29515 CPT 29515 | $95.85 | $95.85 | $20.34 – $49.54 | 9 |
| Application multi layer compression below knee (both sides) CPT 29581 | $310.20 | $310.20 | $26.59 – $169.62 | 9 |
| Application of body cast CPT 29010 | not published | not published | $152.60 – $547.38 | 9 |
| Application of body cast CPT 29015 | not published | not published | $171.90 – $585.92 | 9 |
| Application of cylinder cast 29365 CPT 29365 | not published | not published | $83.19 – $245.43 | 9 |
| Application of forearm cast 29075 CPT 29075 | $663.95 | $663.95 | $59.84 – $172.82 | 9 |
| Application of long arm cast 29065 CPT 29065 | $266.55 | $266.55 | $58.48 – $140.98 | 9 |
| Application of long leg cast CPT 29355 | not published | not published | $101.64 – $278.19 | 9 |
| Application of long leg cast 29345 CPT 29345 | $299.90 | $299.90 | $61.99 – $151.00 | 9 |
| Application of paste boot 29580 CPT 29580 | $291.45 | $291.45 | $18.25 – $44.46 | 9 |
| Application short leg cast 29405 CPT 29405 | $106.00 | $106.00 | $22.43 – $54.63 | 9 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | not published | not published | $90.36 – $306.45 | 9 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | not published | not published | $80.26 – $297.46 | 9 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $51.10 | $51.10 | $19.93 – $48.55 | 9 |
| Appl long leg cast brace CPT 29358 | not published | not published | $98.19 – $319.94 | 9 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $1,080.66 – $2,335.03 | 8 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $133.10 | $133.10 | $5.43 – $124.05 | 9 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | not published | not published | $11.45 – $24.39 | 8 |
| Appl modality 1+lllt po pain CPT 97037 | $145.60 | $145.60 | $56.78 – $138.32 | 9 |
| Appl multlay comprs arm/hand CPT 29584 | not published | not published | $15.76 – $154.20 | 9 |
| Appl patllr tdn bearing cast CPT 29435 | not published | not published | $77.51 – $244.13 | 9 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $573.79 – $1,234.27 | 8 |
| Apply finger cast 29086 CPT 29086 | not published | not published | $47.41 – $151.62 | 9 |
| Apply forearm splintdynamic 29126 CPT 29126 | not published | not published | $47.34 – $154.20 | 9 |
| Apply halo w/removal cranial CPT 20661 | not published | not published | $490.71 – $1,079.07 | 8 |
| Apply hand/wrist cast 29085 CPT 29085 | $96.15 | $96.15 | $19.85 – $48.36 | 9 |
| Apply interstit radiat compl CPT 77778 | not published | not published | $453.59 – $945.52 | 8 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $448.60 – $869.90 | 8 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $298.12 – $578.86 | 8 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $199.78 – $415.48 | 8 |
| Apply of finger splint 29131 CPT 29131 | $83.00 | $83.00 | $32.37 – $77.36 | 9 |
| Apply rem fixation device CPT 20660 | not published | not published | $227.66 – $492.76 | 8 |
| Apply rigid leg cast 29445 CPT 29445 | not published | not published | $95.21 – $249.28 | 9 |
| Apply r&l pulm art bands CPT 33620 | not published | not published | $1,547.57 – $3,298.84 | 8 |
| Apply short leg castambul type 29425 CPT 29425 | not published | not published | $52.11 – $147.77 | 9 |
| Apply srs headframe add-on CPT 61800 | not published | not published | $140.79 – $306.37 | 8 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $59.07 – $122.69 | 8 |
| App mdlty 1+hubbrd tnk ea 15 CPT 97036 | not published | not published | $33.36 – $71.85 | 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.