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 |
|---|---|---|---|---|
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | not published | not published | $18.05 – $37.82 | 7 |
| Mayo myoglobin CPT 83874 | $220.30 | $220.30 | $12.92 – $207.08 | 9 |
| Mayo nickel CPT 83885 | $71.50 | $71.50 | $24.51 – $67.21 | 9 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $52.75 | $52.75 | $17.00 – $50.11 | 9 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | $268.15 | $268.15 | $13.80 – $252.06 | 9 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $52.75 | $52.75 | $14.18 – $50.11 | 9 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $476.95 | $476.95 | $21.21 – $448.33 | 9 |
| Mayo organic acids qualitative each specimen CPT 83919 | $172.30 | $172.30 | $16.45 – $161.96 | 9 |
| Mayo oxalate 24 hour urine CPT 83945 | $175.50 | $175.50 | $14.45 – $164.97 | 9 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $11.53 – $24.16 | 7 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $30.45 | $30.45 | $11.88 – $28.93 | 9 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $121.95 | $121.95 | $12.05 – $113.66 | 9 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $87.95 | $87.95 | $34.30 – $82.67 | 9 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | not published | not published | $10.27 – $37.68 | 7 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $118.40 | $118.40 | $13.76 – $111.30 | 9 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $112.55 | $112.55 | $8.44 – $105.80 | 9 |
| Mayo pregnenolone CPT 84140 | $156.25 | $156.25 | $20.67 – $146.88 | 9 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $42.20 | $42.20 | $16.46 – $39.67 | 9 |
| Mayo proinsulin CPT 84206 | $94.90 | $94.90 | $26.69 – $89.21 | 9 |
| Mayo psaft prostate specific antigen free CPT 84154 | $157.35 | $157.35 | $18.39 – $147.91 | 9 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $329.90 | $329.90 | $18.40 – $310.11 | 9 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $33.40 | $33.40 | $13.03 – $31.40 | 9 |
| Mayo receptor assay transferrin soluble CPT 84238 | not published | not published | $36.57 – $76.59 | 7 |
| Mayo renin CPT 84244 | $183.00 | $183.00 | $21.99 – $172.02 | 9 |
| Mayo repu protein electrophoresis urine CPT 84166 | $149.10 | $149.10 | $17.39 – $138.96 | 9 |
| Mayo selenium CPT 84255 | $90.25 | $90.25 | $25.53 – $84.84 | 9 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $15.50 – $32.48 | 7 |
| Mayo serotonin CPT 84260 | $72.65 | $72.65 | $28.33 – $68.29 | 9 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $50.35 | $50.35 | $19.35 – $47.33 | 9 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $34.00 | $34.00 | $13.26 – $31.96 | 9 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $137.65 | $137.65 | $53.68 – $130.77 | 9 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $101.15 | $101.15 | $4.27 – $95.08 | 9 |
| Mayo tau phosphorylated 217 each CPT 84393 | $215.90 | $215.90 | $84.20 – $205.11 | 9 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | not published | not published | $208.92 – $437.78 | 7 |
| Mayo tgrp testosterone free CPT 84402 | $74.60 | $74.60 | $25.47 – $70.12 | 9 |
| Mayo tgrp testosterone total CPT 84403 | $245.50 | $245.50 | $25.81 – $230.77 | 9 |
| Mayo thiopurine s-methyltransferase CPT 84433 | not published | not published | $14.19 – $46.46 | 7 |
| Mayo thyroglobulin CPT 84432 | $277.50 | $277.50 | $16.06 – $260.85 | 9 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $127.70 | $127.70 | $10.18 – $120.04 | 9 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $158.20 | $158.20 | $12.39 – $148.71 | 9 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $267.20 | $267.20 | $12.30 – $251.17 | 9 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | $155.45 | $155.45 | $51.28 – $146.12 | 9 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | not published | not published | $14.16 – $29.67 | 7 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $70.50 | $70.50 | $13.54 – $66.27 | 9 |
| Mayo vasoactive intestinal peptide CPT 84586 | $550.75 | $550.75 | $35.33 – $517.71 | 9 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $87.95 | $87.95 | $20.24 – $82.67 | 9 |
| Mayo vitamin b3 (niacin) CPT 84591 | $284.35 | $284.35 | $17.06 – $267.29 | 9 |
| Mayo vitamin k CPT 84597 | $194.55 | $194.55 | $13.72 – $182.88 | 9 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $393.75 | $393.75 | $13.25 – $370.13 | 9 |
| Maze/extensive/w/card/pulm bypass 33259 CPT 33259 | not published | not published | $796.49 – $1,708.05 | 8 |
| Mcoln1 gene CPT 81290 | $92.55 | $92.55 | $36.09 – $87.00 | 9 |
| Mcp joint arthroscopy dx CPT 29900 | not published | not published | $486.53 – $1,059.41 | 8 |
| Mcp joint arthroscopy surg CPT 29901 | not published | not published | $521.81 – $1,133.97 | 8 |
| Mcp joint arthroscopysurg 29902 CPT 29902 | not published | not published | $553.20 – $1,201.06 | 8 |
| Mcrscp xm hair pluck/clipped CPT 96902 | not published | not published | $19.62 – $41.76 | 8 |
| Mdfc flap w/prsrv vasc pedcl CPT 15730 | not published | not published | $881.92 – $2,741.39 | 9 |
| Md inr test revie inter mgmt HCPCS G0250 | not published | not published | $8.64 – $17.62 | 8 |
| Md service required for pmd HCPCS G0372 | not published | not published | $8.60 – $17.62 | 8 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $18.51 – $37.28 | 8 |
| Measure kidney pressure CPT 50396 | not published | not published | $111.86 – $233.16 | 8 |
| Measurement post void urine by ultrasound CPT 51798 | $24.15 | $24.15 | $9.42 – $22.94 | 9 |
| Measure ureter pressure CPT 50686 | not published | not published | $84.39 – $276.90 | 9 |
| Mecasermin injection HCPCS J2170 | not published | not published | $14.23 – $149.99 | 3 |
| Mech hip extension assist HCPCS L5855 | not published | not published | $292.80 – $776.74 | 3 |
| Mechlorethamine hcl inj HCPCS J9230 | not published | not published | $265.70 – $321.72 | 3 |
| #mec-opiates CPT 80356 | $94.90 | $94.90 | $15.90 – $89.21 | 9 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $97.42 – $314.32 | 7 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $527.87 – $1,106.12 | 7 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $14.28 – $251.45 | 7 |
| Med genetics&genetic counseling svcs each 30 min CPT 96041 | not published | not published | $105.07 – $105.07 | 1 |
| Medial canthopexy CPT 21280 | not published | not published | $564.03 – $1,202.42 | 8 |
| Mediastinoscpy w/lmph nod bx CPT 39402 | not published | not published | $378.77 – $811.33 | 8 |
| Mediastinoscpy w/medstnl bx 39401 CPT 39401 | not published | not published | $290.04 – $622.22 | 8 |
| Medical services after hrs CPT 99050 | not published | not published | $34.70 – $42.27 | 3 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $849.50 – $2,002.23 | 8 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $144.86 | $144.86 | $0.54 – $136.17 | 9 |
| Med serv 10pm-8am 24 hr fac CPT 99053 | not published | not published | $34.70 – $135.94 | 3 |
| Med serv eve/wkend/holiday CPT 99051 | not published | not published | $34.70 – $135.94 | 3 |
| Megestrol 20 mg tabs 100 each bottle HCPCS S0179 | not published | not published | $0.20 – $0.67 | 2 |
| Meg evoked each addl CPT 95967 | not published | not published | $178.89 – $344.99 | 8 |
| Meg evoked single CPT 95966 | not published | not published | $204.21 – $399.89 | 8 |
| Meg spontaneous CPT 95965 | not published | not published | $400.73 – $818.79 | 8 |
| Melphalan oral 2 mg HCPCS J8600 | not published | not published | $9.34 – $12.00 | 3 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | not published | not published | $305.58 – $520.59 | 8 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | not published | not published | $132.88 – $283.51 | 8 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | not published | not published | $21.82 – $56.79 | 3 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $129.08 – $360.14 | 8 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | not published | not published | $31,905.54 – $127,119.59 | 3 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $339.63 – $379.65 | 3 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $67.56 – $145.13 | 8 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | not published | not published | $78.34 – $117.70 | 8 |
| Menacwy-tt menb-fhbp vacc im CPT 90623 | not published | not published | $483.52 – $483.52 | 1 |
| Meniscal trnspl knee w/scpe CPT 29868 | not published | not published | $1,598.22 – $3,428.99 | 8 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $53.18 | $53.18 | $6.02 – $49.99 | 9 |
| Meperidine/promethazine inj HCPCS J2180 | not published | not published | $3.79 – $15.59 | 3 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | not published | not published | $29.96 – $60.66 | 8 |
| Mercaptopurine 50 mg HCPCS S0108 | not published | not published | $2.91 – $5.43 | 2 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $70.12 | $70.12 | $0.32 – $39.71 | 9 |
| Mesh/prosth/ pelvic floor rpr/vag 57267 CPT 57267 | not published | not published | $242.26 – $506.32 | 8 |
| Mesh tiss ovitex lpr 15x15x25cm 6mm oval HCPCS C9364 | not published | not published | $18.39 – $18.39 | 1 |
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.