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 |
|---|---|---|---|---|
| Potassium serum/plasma/whole blood CPT 84132 | $95.80 | $95.80 | $4.76 – $90.05 | 9 |
| Pouch clsd w barr attached HCPCS A5051 | not published | not published | $2.30 – $6.03 | 3 |
| Pouch drainable w barrier at HCPCS A5061 | not published | not published | $3.92 – $10.35 | 3 |
| Pouch high output 2pc 50mm red HCPCS A4413 | not published | not published | $6.13 – $16.13 | 3 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | not published | not published | $4.85 – $12.76 | 3 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | not published | not published | $2.48 – $6.54 | 3 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | not published | not published | $3.99 – $10.50 | 3 |
| Powder prem protct 1oz HCPCS A4371 | not published | not published | $4.05 – $10.69 | 3 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $137.00 – $287.07 | 7 |
| Pq biliary strict dil s&i CPT 74363 | not published | not published | $41.01 – $79.98 | 8 |
| Pq dr cath chg w cont s&i CPT 75984 | not published | not published | $37.10 – $75.92 | 8 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | not published | not published | $455.25 – $10,765.80 | 9 |
| Pq thr inj ext pse CPT 36002 | not published | not published | $99.52 – $294.89 | 9 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | not published | not published | $198.38 – $1,391.58 | 9 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | not published | not published | $417.22 – $3,431.41 | 9 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | not published | not published | $391.42 – $3,427.55 | 9 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $289.14 – $738.87 | 8 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $502.37 | $502.37 | $88.43 – $472.23 | 9 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $998.95 | $998.95 | $206.49 – $502.98 | 9 |
| Pr application of long arm splint CPT 29105 | $111.00 | $111.00 | $22.95 – $55.91 | 9 |
| Pr application splint static short arm CPT 29125 | $83.25 | $83.25 | $18.25 – $44.46 | 9 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | not published | not published | $4.29 – $9.49 | 8 |
| Pr biopsy skin punch single lesion CPT 11104 | $466.25 | $466.25 | $45.33 – $230.60 | 9 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $583.20 – $1,970.43 | 9 |
| Pr correction hammertoe CPT 28285 | not published | not published | $372.47 – $1,042.73 | 9 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $89.55 | $89.55 | $11.56 – $28.27 | 9 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | not published | not published | $271.43 – $576.81 | 8 |
| Prcrd drg 6+yr without anomly CPT 33017 | not published | not published | $231.80 – $491.40 | 8 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $148.51 – $770.32 | 9 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $230.90 | $230.90 | $78.72 – $164.03 | 9 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $338.05 | $338.05 | $111.61 – $231.82 | 9 |
| Prealbumin CPT 84134 | $380.60 | $380.60 | $14.59 – $357.76 | 9 |
| Pr ecg 12 lead report only CPT 93010 | not published | not published | $7.98 – $16.26 | 8 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | not published | not published | $18.08 – $36.61 | 8 |
| Prednisolone acetate inj HCPCS J2650 | not published | not published | $0.52 – $0.52 | 2 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | not published | not published | $0.24 – $1.13 | 8 |
| Prednisone 1 mg tablet HCPCS J7512 | not published | not published | $0.01 – $0.67 | 6 |
| Prefab glove for term device HCPCS L6890 | not published | not published | $178.32 – $473.04 | 3 |
| Pregabalin - sendout CPT 80366 | not published | not published | $8.25 – $50.16 | 3 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $191.20 – $402.62 | 8 |
| Pregnancy associated plasma protein-a CPT 84163 | $51.55 | $51.55 | $15.05 – $48.46 | 9 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,406.60 | $1,406.60 | $47.00 – $1,310.95 | 9 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $867.60 | $867.60 | $46.70 – $808.60 | 9 |
| Pregnancy Ultrasound (limited) CPT 76815 | $573.50 | $573.50 | $30.88 – $189.48 | 9 |
| Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 | not published | not published | $95.92 – $255.69 | 8 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $413.20 – $1,092.19 | 9 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $758.73 – $1,998.07 | 9 |
| Pre-op service lvrs 10-15dos HCPCS G0303 | not published | not published | $1,432.64 – $1,432.64 | 1 |
| Pre-op service lvrs 1-9 dos HCPCS G0304 | not published | not published | $2,441.13 – $2,441.13 | 1 |
| Pre-op service lvrs complete HCPCS G0302 | not published | not published | $2,441.13 – $2,441.13 | 1 |
| Prep ak ischial direct form HCPCS L5570 | not published | not published | $2,248.15 – $5,963.80 | 3 |
| Prep ak ischial laminated HCPCS L5590 | not published | not published | $2,629.24 – $6,974.74 | 3 |
| Prep ak ischial plast molded HCPCS L5560 | not published | not published | $1,864.11 – $4,945.02 | 3 |
| Prep ak ischial thermo mold HCPCS L5580 | not published | not published | $2,331.58 – $6,185.12 | 3 |
| Preparation for bladder xray CPT 51605 | not published | not published | $36.75 – $77.95 | 8 |
| Preparation palate mold CPT 42280 | not published | not published | $106.02 – $340.51 | 9 |
| Prepare donor heart CPT 33944 | not published | not published | $518.72 – $637.97 | 4 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $736.06 – $817.22 | 4 |
| Prepare donor intestine CPT 44715 | not published | not published | $700.92 – $811.29 | 4 |
| Prepare donor lung double CPT 32856 | not published | not published | $642.12 – $708.17 | 4 |
| Prepare donor lung single CPT 32855 | not published | not published | $532.19 – $586.93 | 4 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $245.82 – $245.82 | 1 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $70.11 – $216.52 | 8 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $1,642.94 – $3,496.09 | 8 |
| Prepare penis study CPT 54230 | not published | not published | $76.42 – $206.23 | 9 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $178.60 – $376.86 | 8 |
| Prep bk ptb laminated socket HCPCS L5540 | not published | not published | $1,957.26 – $5,192.11 | 3 |
| Prep bk ptb open end socket HCPCS L5535 | not published | not published | $2,058.46 – $5,460.60 | 3 |
| Prep bk ptb plaster molded HCPCS L5510 | not published | not published | $1,728.92 – $4,586.43 | 3 |
| Prep bk ptb thermopls molded HCPCS L5530 | not published | not published | $1,973.23 – $5,234.48 | 3 |
| Prep cadaver renal allograft CPT 50323 | not published | not published | $380.57 – $422.75 | 4 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $244.13 – $329.09 | 4 |
| Prep donor intestine/artery CPT 44721 | not published | not published | $362.13 – $774.05 | 8 |
| Prep donor intestine/venous CPT 44720 | not published | not published | $259.05 – $552.40 | 8 |
| Prep donor liver 3-segment CPT 47144 | not published | not published | $934.14 – $1,030.22 | 4 |
| Prep donor liver/arterial CPT 47147 | not published | not published | $361.45 – $772.69 | 8 |
| Prep donor liver lobe split CPT 47145 | not published | not published | $934.14 – $1,030.22 | 4 |
| Prep donor liver/venous CPT 47146 | not published | not published | $310.14 – $660.86 | 8 |
| Prep donor liver whole CPT 47143 | not published | not published | $622.78 – $700.92 | 4 |
| Prep donor pancreas CPT 48551 | not published | not published | $423.32 – $483.13 | 4 |
| Prep donor pancreas/venous CPT 48552 | not published | not published | $222.67 – $475.14 | 8 |
| Prep donor renal graft CPT 50325 | not published | not published | $380.57 – $419.72 | 4 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $155.69 – $333.47 | 8 |
| Pre-plan 3d model w/ccta HCPCS C9793 | not published | not published | $4,680.72 – $4,680.72 | 1 |
| Prep renal graft/arterial CPT 50328 | not published | not published | $179.47 – $382.96 | 8 |
| Prep renal graft/ureteral CPT 50329 | not published | not published | $170.93 – $363.98 | 8 |
| Prep renal graft/venous CPT 50327 | not published | not published | $205.31 – $435.83 | 8 |
| Prep skin to 100cm2 other CPT 15004 | not published | not published | $250.60 – $755.54 | 9 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $2,636.75 | $2,636.75 | $209.61 – $661.74 | 9 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | $2,636.75 | $2,636.75 | $42.96 – $133.63 | 9 |
| Pressure max expiratory/inspiratory CPT 94799 | $184.80 | $184.80 | $72.07 – $175.56 | 9 |
| Pressure treatment esophagus CPT 43460 | not published | not published | $203.46 – $427.01 | 8 |
| Pressure velocity wire add ves CPT 93572 | not published | not published | $49.48 – $103.70 | 8 |
| Pre-tibial shell molded to p HCPCS L2340 | not published | not published | $397.73 – $1,055.07 | 3 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | not published | not published | $41.70 – $51.51 | 3 |
| Pretreat rbc absorption reference CPT 86978 | $206.30 | $206.30 | $34.26 – $82.58 | 9 |
| Pretreat rbc density gradient separation reference CPT 86972 | not published | not published | $48.72 – $60.33 | 3 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $75.00 | $75.00 | $29.25 – $70.50 | 9 |
| Pretreat rbc w enzyme reference CPT 86971 | $78.50 | $78.50 | $27.66 – $73.79 | 9 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $207.15 | $207.15 | $170.99 – $373.92 | 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.