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 |
|---|---|---|---|---|
| Ligation major artery neck CPT 37615 | not published | not published | $492.39 – $1,053.29 | 8 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $586.63 – $1,227.51 | 8 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $1,248.98 – $2,669.86 | 8 |
| Ligation of femoral vein CPT 37650 | not published | not published | $431.38 – $923.84 | 8 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,638.92 – $3,508.28 | 8 |
| Ligation of neck artery CPT 37606 | not published | not published | $689.13 – $1,527.09 | 8 |
| Ligation of salivary duct CPT 42665 | not published | not published | $209.34 – $731.13 | 9 |
| Ligation of shunt CPT 49428 | not published | not published | $410.99 – $884.53 | 8 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $849.07 – $1,771.77 | 8 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $290.15 | $290.15 | $113.16 – $275.64 | 9 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $352.20 – $752.37 | 8 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $546.50 – $1,166.49 | 8 |
| Liletta, 52 mg HCPCS J7297 | $1,142.59 | $1,142.59 | $445.61 – $1,085.46 | 9 |
| Limb exercise test CPT 95875 | not published | not published | $56.13 – $116.59 | 8 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $205.17 – $435.83 | 8 |
| Limited ankle motion ea jnt HCPCS L2200 | not published | not published | $42.31 – $112.23 | 3 |
| Limited autopsy CPT 88036 | not published | not published | $203.66 – $222.16 | 3 |
| Limited autopsy CPT 88037 | not published | not published | $177.41 – $189.11 | 3 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $114.11 – $302.75 | 3 |
| Limited visual field xm CPT 92081 | not published | not published | $15.60 – $31.85 | 8 |
| Lincomycin injection HCPCS J2010 | not published | not published | $9.84 – $13.47 | 8 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $278.13 | $278.13 | $2.62 – $261.44 | 9 |
| Lipase CPT 83690 | $99.85 | $99.85 | $6.89 – $93.86 | 9 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $337.32 – $950.21 | 9 |
| Lipoprotein blood high res frac & quant CPT 83701 | $168.75 | $168.75 | $33.86 – $158.63 | 9 |
| Lipoprotein blood quant CPT 83704 | $82.00 | $82.00 | $31.98 – $77.08 | 9 |
| Lipoprotein direct measurement hdl CPT 83718 | $197.00 | $197.00 | $8.19 – $185.18 | 9 |
| Lipoprotein direct measurement ldl CPT 83721 | $169.15 | $169.15 | $10.50 – $159.00 | 9 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $71.64 | 7 |
| Lip surgery procedure CPT 40799 | $142.60 | $142.60 | $30.26 – $73.72 | 9 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $482,927.60 – $1,021,002.79 | 6 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $27.64 | 7 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $150.10 – $398.17 | 3 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $60.20 – $159.74 | 3 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $469.73 – $1,246.09 | 3 |
| Lithium therapeutic drug level CPT 80178 | $139.70 | $139.70 | $6.61 – $131.32 | 9 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | not published | not published | $259.33 – $292.12 | 5 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $870.47 – $2,515.32 | 8 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,037.52 – $2,985.70 | 8 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,156.38 – $2,483.47 | 8 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $369.19 – $582.85 | 3 |
| Liver elastography 91200 CPT 91200 | not published | not published | $10.30 – $21.02 | 8 |
| Liver Function Test CPT 80076 | $164.90 | $164.90 | $8.17 – $155.01 | 9 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,366.92 – $2,896.92 | 8 |
| Liver imaging CPT 78201 | not published | not published | $20.04 – $40.67 | 8 |
| Liver imag w/vasclr flow CPT 78202 | $3,046.40 | $3,046.40 | $23.08 – $2,839.24 | 9 |
| Liver/spleen imag static only CPT 78215 | $1,442.75 | $1,442.75 | $22.71 – $1,344.64 | 9 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $26.23 – $54.90 | 8 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $69.95 – $147.08 | 8 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $451.38 – $1,274.01 | 9 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $2,642.35 – $7,009.50 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $1.06 – $2.39 | 8 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $38.64 – $114.74 | 2 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $195.65 – $419.32 | 8 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $139.74 – $370.68 | 3 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $25.26 | $25.26 | $1.03 – $23.74 | 9 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $72.40 – $123.55 | 3 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | not published | not published | $72.40 – $192.05 | 3 |
| Loudness balance test CPT 92562 | not published | not published | $44.65 – $101.00 | 8 |
| Low back disk surgery CPT 63030 | not published | not published | $867.39 – $1,901.90 | 8 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $2,816.22 – $2,816.22 | 1 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $8,415.75 – $8,415.75 | 1 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $2,816.22 – $2,816.22 | 1 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $2,816.22 – $2,816.22 | 1 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $762.55 | $762.55 | $50.88 – $710.70 | 9 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | not published | not published | $59.86 – $120.66 | 8 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,394.15 | $1,394.15 | $57.28 – $1,299.35 | 9 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,267.40 | $1,267.40 | $46.73 – $1,181.22 | 9 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,301.70 | $3,301.70 | $107.81 – $3,077.18 | 9 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,133.25 | $2,133.25 | $84.11 – $1,988.19 | 9 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,442.30 | $1,442.30 | $69.85 – $1,344.22 | 9 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $644.10 | $644.10 | $10.65 – $600.30 | 9 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $951.50 | $951.50 | $12.34 – $886.80 | 9 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $1,518.35 | $1,518.35 | $14.58 – $1,415.10 | 9 |
| Lower jaw bone graft CPT 21215 | not published | not published | $761.87 – $7,811.10 | 9 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $480.40 | $480.40 | $7.63 – $447.73 | 9 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $17.81 – $824.28 | 9 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $15.30 – $31.43 | 3 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $709.23 – $1,493.19 | 8 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $818.40 – $1,718.22 | 8 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $806.32 – $1,693.15 | 8 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $880.94 – $1,848.36 | 8 |
| Lso corset front HCPCS L0972 | not published | not published | $91.58 – $242.94 | 3 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $77.94 – $132.96 | 3 |
| Lso full corset HCPCS L0976 | not published | not published | $152.10 – $403.50 | 3 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $150.44 – $399.08 | 3 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,225.15 – $3,250.02 | 3 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $1,087.69 – $1,882.73 | 3 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $150.44 – $256.69 | 3 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $870.42 – $2,309.00 | 3 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,402.00 – $3,719.17 | 3 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $266.38 – $706.64 | 3 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $266.38 – $454.52 | 3 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $972.04 – $2,578.60 | 3 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,087.69 – $2,885.39 | 3 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $21.99 – $46.08 | 7 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.51 – $4.67 | 3 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $56.61 – $150.18 | 3 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $75.12 – $199.25 | 3 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $39.29 – $79.98 | 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.