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 |
|---|---|---|---|---|
| Perq tx malar fracture CPT 21355 | not published | not published | $318.90 – $873.11 | 9 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $442.69 – $1,410.86 | 9 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $730.69 – $1,548.09 | 8 |
| Pertussis ag if CPT 87265 | not published | not published | $11.98 – $25.08 | 7 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $16,727.94 | $16,727.94 | $14.72 – $15,724.26 | 9 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $66.32 – $126.27 | 8 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | not published | not published | $55.21 – $145.47 | 3 |
| Pessary reusable rub anytype HCPCS A4561 | not published | not published | $22.18 – $58.40 | 3 |
| Pet CT skull-mid thgh initial CPT 78815 | not published | not published | $112.15 – $228.42 | 8 |
| Pet CT whole body initial CPT 78816 | not published | not published | $113.07 – $229.76 | 8 |
| Pet fdg brain metoblic eval sb CPT 78608 | not published | not published | $68.22 – $138.28 | 8 |
| Pet image full body CPT 78813 | not published | not published | $90.02 – $183.02 | 8 |
| Pet image ltd area CPT 78811 | not published | not published | $69.59 – $143.01 | 8 |
| Pet image skull-thigh CPT 78812 | not published | not published | $88.98 – $179.62 | 8 |
| Pet image w/ct lmtd CPT 78814 | not published | not published | $101.13 – $204.01 | 8 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $1,848.71 – $1,848.71 | 1 |
| Pet scan brain perf study CPT 78609 | not published | not published | $70.89 – $143.68 | 7 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $5,950.00 | $5,950.00 | $32.76 – $79.80 | 9 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $57.25 | $57.25 | $21.80 – $46.26 | 9 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $84.05 | $84.05 | $31.07 – $64.39 | 9 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $29.35 | $29.35 | $11.06 – $25.05 | 9 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $270.01 – $807.59 | 9 |
| Pharmacologic management w/psytx CPT 90863 | not published | not published | $23.44 – $48.19 | 8 |
| Ph body fluid CPT 83986 | $10.55 | $10.55 | $3.58 – $9.92 | 9 |
| Phencyclidine (pcp) CPT 83992 | $263.70 | $263.70 | $16.80 – $247.88 | 9 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $396.32 | $396.32 | $31.43 – $143.52 | 9 |
| Phenobarbital therapeutic drug level CPT 80184 | $284.30 | $284.30 | $15.30 – $267.24 | 9 |
| Phentolaine mesylate inj HCPCS J2760 | $2,208.11 | $2,208.11 | $399.33 – $2,075.62 | 9 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $5.00 | $5.00 | $0.02 – $4.70 | 9 |
| Phenylep ketorolac opth soln HCPCS J1097 | not published | not published | $120.36 – $247.26 | 3 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | not published | not published | $0.43 – $0.92 | 8 |
| Phenytoin total therapeutic drug level CPT 80185 | $206.30 | $206.30 | $13.25 – $193.92 | 9 |
| Phlebotomy therapeutic CPT 99195 | $283.45 | $283.45 | $90.19 – $264.18 | 9 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $255.46 – $806.29 | 9 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $313.06 – $948.28 | 9 |
| Phone e/m phys/qhp 11-20 min CPT 99442 | not published | not published | $49.60 – $174.75 | 8 |
| Phone e/m phys/qhp 21-30 min CPT 99443 | not published | not published | $73.61 – $247.35 | 8 |
| Phone e/m phys/qhp 5-10 min CPT 99441 | not published | not published | $25.60 – $108.58 | 8 |
| Phosphorus CPT 84100 | $95.80 | $95.80 | $4.74 – $90.05 | 9 |
| Phosphorus 24 hour urine CPT 84105 | $14.45 | $14.45 | $5.64 – $13.58 | 9 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $110.25 – $237.92 | 8 |
| Photochemotherapy puva CPT 96912 | not published | not published | $94.06 – $201.98 | 8 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $142.46 – $306.37 | 8 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $24.60 – $50.16 | 8 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $52.62 – $109.13 | 8 |
| Photo patch test CPT 95052 | not published | not published | $5.85 – $12.21 | 8 |
| Photopheresis CPT 36522 | not published | not published | $93.22 – $2,564.07 | 9 |
| Photosensitivity tests CPT 95056 | not published | not published | $47.37 – $107.77 | 8 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $48.09 – $96.93 | 9 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $47.78 – $97.61 | 9 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $47.78 – $96.93 | 9 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $455.60 | $455.60 | $98.55 – $424.62 | 9 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $455.60 | $455.60 | $98.55 – $424.62 | 9 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $455.60 | $455.60 | $98.55 – $424.62 | 9 |
| Physical Therapy Re-Evaluation CPT 97164 | $455.60 | $455.60 | $67.87 – $424.62 | 9 |
| Physician standby services CPT 99360 | not published | not published | $57.45 – $117.26 | 7 |
| Phys review of motion tests CPT 96004 | not published | not published | $105.95 – $214.87 | 8 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $283.73 | $283.73 | $2.85 – $148.17 | 9 |
| Pierce earlobes 69090 CPT 69090 | not published | not published | $59.75 – $62.36 | 3 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | not published | not published | $558.45 – $1,865.35 | 4 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $175.90 – $575.89 | 7 |
| Pild/placebo control clin tr HCPCS G0276 | not published | not published | $359.26 – $741.51 | 8 |
| Pillow shldr abduc inflat univ HCPCS L3960 | not published | not published | $760.38 – $2,017.09 | 3 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $442.00 – $1,135.23 | 9 |
| Pin finger dislocation CPT 26776 | not published | not published | $437.00 – $948.92 | 8 |
| Pin finger fracture each CPT 26756 | not published | not published | $412.98 – $894.02 | 8 |
| Pin hand dislocation CPT 26676 | not published | not published | $495.34 – $1,075.00 | 8 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $434.96 – $944.85 | 8 |
| Pin service 60m per month HCPCS G0023 | not published | not published | $90.38 – $425.58 | 5 |
| Pinworm exam CPT 87172 | $157.05 | $157.05 | $4.27 – $147.63 | 9 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $4.27 – $8.82 | 7 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $376.63 | $376.63 | $0.91 – $354.03 | 9 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $579.48 – $1,213.95 | 7 |
| Place breast cath for rad CPT 19297 | not published | not published | $89.55 – $189.78 | 8 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $309.69 – $1,673.62 | 9 |
| Place cath intracranial art CPT 36228 | not published | not published | $229.82 – $2,474.78 | 9 |
| Place cath xtrnl carotid CPT 36227 | not published | not published | $112.41 – $467.71 | 9 |
| Place cecostomy tube perc CPT 49442 | not published | not published | $198.84 – $1,502.08 | 9 |
| Place device/marker, non pro HCPCS C9728 | not published | not published | $6,294.97 – $6,294.97 | 1 |
| Place duod/jej tube perc CPT 49441 | not published | not published | $228.94 – $1,820.11 | 9 |
| Place endorectal app HCPCS C9725 | not published | not published | $4,194.50 – $4,194.50 | 1 |
| Place gastrostomy tube open 43832 CPT 43832 | not published | not published | $995.28 – $2,143.88 | 8 |
| Place gastrostomy tube perc CPT 49440 | not published | not published | $195.43 – $1,572.76 | 9 |
| Placement bile duct support CPT 47801 | not published | not published | $1,063.87 – $2,265.21 | 8 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,819.15 | $1,819.15 | $96.01 – $463.22 | 9 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $167.65 | $167.65 | $48.39 – $156.25 | 9 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $867.60 | $867.60 | $82.20 – $700.92 | 9 |
| Placement nephrostomy catheter (both sides) CPT 50432 | not published | not published | $196.69 – $1,717.31 | 9 |
| Placement of drain pancreas CPT 48001 | not published | not published | $2,191.37 – $4,693.78 | 8 |
| Placement of seton CPT 46020 | not published | not published | $111.58 – $239.26 | 8 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | not published | not published | $414.51 – $5,184.05 | 9 |
| Place ndl musc/tis for right CPT 20555 | not published | not published | $326.91 – $691.35 | 8 |
| Place needles h&n for right CPT 41019 | not published | not published | $476.54 – $1,004.51 | 8 |
| Place needles pelvic for right CPT 55920 | not published | not published | $449.02 – $945.52 | 8 |
| Place non-slctv cath thoracic arta CPT 36221 | not published | not published | $187.56 – $1,870.85 | 9 |
| Placental lactogen CPT 83632 | not published | not published | $20.22 – $42.37 | 7 |
| Place po breast cath for rad CPT 19296 | not published | not published | $199.71 – $6,922.57 | 9 |
| Place right device/marker pros CPT 55876 | not published | not published | $97.86 – $292.32 | 9 |
| Place slctv cath carotd art uni CPT 36224 | not published | not published | $343.15 – $3,937.66 | 9 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | not published | not published | $267.47 – $2,346.28 | 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.