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 |
|---|---|---|---|---|
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $629.64 – $1,267.28 | 8 |
| Motion analysis video/3d CPT 96000 | not published | not published | $82.33 – $168.10 | 8 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $107.55 – $214.87 | 8 |
| Motor &/ sens nrve cndj test CPT 95905 | not published | not published | $2.58 – $5.43 | 8 |
| Mouth piece HCPCS A4617 | not published | not published | $3.44 – $9.07 | 3 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $274.11 – $717.64 | 9 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $24.74 – $49.47 | 8 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $910.80 | $910.80 | $62.38 – $848.87 | 9 |
| M/phmtrc alysishquant/semiq CPT 88369 | not published | not published | $32.24 – $67.10 | 8 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $80.44 – $141.98 | 8 |
| Mpl gene analysis common variants CPT 81338 | not published | not published | $96.21 – $315.01 | 7 |
| M.pneumon dna dir probe CPT 87580 | not published | not published | $20.05 – $42.01 | 7 |
| M.pneumon dna quant CPT 87582 | not published | not published | $91.32 – $634.12 | 7 |
| Mpsv4 vaccine subq CPT 90733 | not published | not published | $137.95 – $195.28 | 3 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $84.17 – $170.80 | 8 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $84.52 – $170.80 | 8 |
| MRA chest w IV cont HCPCS C8909 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA chest wo IV cont HCPCS C8910 | not published | not published | $1,112.08 – $1,112.08 | 1 |
| MRA chest wwo IV cont HCPCS C8911 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA ext low(run-off)pst cntrst CPT 73725 | not published | not published | $84.55 – $172.16 | 8 |
| MRA pelvis CPT 72198 | not published | not published | $84.17 – $171.49 | 8 |
| MRA pelvis w IV cont HCPCS C8918 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA pelvis wo IV cont HCPCS C8919 | not published | not published | $1,112.08 – $1,112.08 | 1 |
| MRA spinal canal CPT 72159 | not published | not published | $85.11 – $171.49 | 8 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $81.75 – $161.31 | 8 |
| MRA w/cont, abd HCPCS C8900 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA w/cont, lwr ext HCPCS C8912 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| Mra, w/dye, spinal canal HCPCS C8931 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA without cont, abd HCPCS C8901 | not published | not published | $1,112.08 – $1,112.08 | 1 |
| MRA without cont, lwr ext HCPCS C8913 | not published | not published | $1,112.08 – $1,112.08 | 1 |
| Mra, without dye, spinal canal HCPCS C8932 | not published | not published | $1,112.08 – $1,112.08 | 1 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $1,112.08 – $1,112.08 | 1 |
| MRA without fol w/cont, abd HCPCS C8902 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| MRA without fol w/cont, pelvis HCPCS C8920 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | not published | not published | $1,643.05 – $1,643.05 | 1 |
| Mr elastography CPT 76391 | not published | not published | $51.89 – $105.07 | 8 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $2,471.94 – $57,372.19 | 2 |
| MRI brain w/dye CPT 70558 | not published | not published | $163.50 – $337.55 | 8 |
| MRI brain without dye CPT 70557 | not published | not published | $152.17 – $305.01 | 8 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $155.84 – $319.93 | 8 |
| MRI breast c- unilateral CPT 77046 | $778.15 | $778.15 | $67.96 – $725.24 | 9 |
| MRI breast c-+ w/cad uni CPT 77048 | $778.15 | $778.15 | $98.84 – $725.24 | 9 |
| MRI breast without cont bi CPT 77047 | $933.45 | $933.45 | $75.25 – $869.98 | 9 |
| MRI breast w IV cont bi CPT 77049 | $933.45 | $933.45 | $108.16 – $869.98 | 9 |
| MRI cardiac morph & func wo IV cont CPT 75557 | not published | not published | $109.45 – $222.33 | 8 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | not published | not published | $121.12 – $246.72 | 8 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $137.85 – $281.96 | 8 |
| MRI chest without contrast CPT 71550 | $2,527.55 | $2,527.55 | $68.84 – $2,355.68 | 9 |
| MRI chest without & w/contrast CPT 71552 | $3,301.70 | $3,301.70 | $106.47 – $3,077.18 | 9 |
| MRI chest w IV cont CPT 71551 | not published | not published | $81.45 – $164.70 | 8 |
| MRI compatible system HCPCS L0859 | not published | not published | $1,151.73 – $3,055.23 | 3 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $87.46 – $178.26 | 8 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $141.62 – $288.75 | 8 |
| MRI guid ndl plc s&i CPT 77021 | not published | not published | $69.69 – $142.34 | 8 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $199.10 – $401.25 | 8 |
| MRI hyperpolarized xenon129 HCPCS C9791 | not published | not published | $2,620.34 – $2,620.34 | 1 |
| MRI loex nonjt w IV cont CPT 73719 | not published | not published | $76.26 – $154.54 | 8 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,139.80 | $2,139.80 | $63.57 – $1,994.29 | 9 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $3,301.70 | $3,301.70 | $101.19 – $3,077.18 | 9 |
| MRI orbit fac&nck w IV cont CPT 70542 | $485.10 | $485.10 | $76.26 – $452.11 | 9 |
| MRI tmj CPT 70336 | $2,527.55 | $2,527.55 | $69.23 – $2,355.68 | 9 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,139.80 | $2,139.80 | $63.88 – $1,994.29 | 9 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $3,301.70 | $3,301.70 | $101.19 – $3,077.18 | 9 |
| MRI upper extremity w/dye CPT 73219 | not published | not published | $76.26 – $154.54 | 8 |
| MRI w/cont, breast, bi HCPCS C8906 | $933.45 | $933.45 | $364.05 – $886.78 | 9 |
| Mr safety determination physician/other qhp CPT 76016 | $220.15 | $220.15 | $56.93 – $206.94 | 9 |
| Mr safety implant elec prepj CPT 76018 | $229.50 | $229.50 | $71.16 – $215.73 | 9 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | not published | not published | $107.77 – $107.77 | 1 |
| Mr safety implt pos&/immoblj CPT 76019 | $148.50 | $148.50 | $56.26 – $139.59 | 9 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $61.20 | $61.20 | $22.36 – $57.53 | 9 |
| Mr sfty med physics xm cstmz CPT 76017 | $604.30 | $604.30 | $72.52 – $568.04 | 9 |
| Mr spectroscopy CPT 76390 | not published | not published | $91.18 – $159.73 | 4 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $213.30 – $446.66 | 7 |
| Msh2 gene full seq CPT 81295 | not published | not published | $381.70 – $799.81 | 7 |
| Msh2 gene known variants CPT 81296 | not published | not published | $144.91 – $707.63 | 7 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $238.00 – $498.71 | 7 |
| Msh6 gene full seq CPT 81298 | not published | not published | $641.85 – $1,344.75 | 7 |
| Msh6 gene known variants CPT 81299 | not published | not published | $144.91 – $645.27 | 7 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $2,626.30 – $5,619.64 | 8 |
| Mthfr gene analy common variants CPT 81291 | not published | not published | $65.34 – $136.92 | 7 |
| M.tuberculo dna dir probe CPT 87555 | not published | not published | $26.88 – $56.26 | 7 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $42.84 – $89.48 | 7 |
| Mucin synovial fluid CPT 83872 | not published | not published | $5.86 – $12.20 | 7 |
| Mucopolysaccharides CPT 83864 | not published | not published | $28.50 – $59.64 | 7 |
| Mucormycosis antibody CPT 86732 | not published | not published | $15.00 – $31.18 | 7 |
| Mult fam adapt bhv tx gdn CPT 97157 | not published | not published | $8.44 – $61.69 | 3 |
| Multi-axial knee/shin system HCPCS L5840 | not published | not published | $3,512.33 – $9,317.35 | 3 |
| Multi-axial rotation unit HCPCS L5986 | not published | not published | $614.98 – $1,631.40 | 3 |
| Multi den insert custom mold HCPCS A5513 | not published | not published | $43.01 – $113.32 | 3 |
| Multi den insert direct form HCPCS A5512 | not published | not published | $28.83 – $75.94 | 3 |
| Multi-durometer below knee HCPCS L5665 | not published | not published | $647.25 – $1,717.00 | 3 |
| Multi-durometer symes HCPCS L5661 | not published | not published | $769.26 – $2,040.70 | 3 |
| Multi family grp psychotherapy CPT 90849 | not published | not published | $28.35 – $72.60 | 9 |
| Multifocal erg w/i&r CPT 92274 | not published | not published | $32.26 – $66.43 | 8 |
| Multiple sleep latency test CPT 95805 | not published | not published | $55.82 – $113.87 | 8 |
| Multipo locking shoulder jnt HCPCS L6646 | not published | not published | $2,935.51 – $7,787.22 | 3 |
| Mumps antibody igg CPT 86735 | $119.55 | $119.55 | $13.05 – $112.38 | 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.