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 |
|---|---|---|---|---|
| Preventive counseling group CPT 99411 | not published | not published | $7.28 – $38.54 | 8 |
| Preventive counseling group CPT 99412 | not published | not published | $12.22 – $48.19 | 8 |
| Prev med cnsl indiv apprx 15 CPT 99401 | $114.95 | $114.95 | $23.44 – $108.05 | 9 |
| Prev med cnsl indiv apprx 30 CPT 99402 | $165.90 | $165.90 | $47.11 – $155.95 | 9 |
| Prev med cnsl indiv apprx 45 CPT 99403 | $216.90 | $216.90 | $70.54 – $203.89 | 9 |
| Prev med cnsl indiv apprx 60 CPT 99404 | $267.80 | $267.80 | $93.87 – $251.73 | 9 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | not published | not published | $128.33 – $319.94 | 8 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | not published | not published | $79.06 – $245.43 | 9 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $157.45 – $434.94 | 9 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $767.45 | $767.45 | $65.19 – $158.79 | 9 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $1,296.52 – $2,781.69 | 8 |
| Prgrmg dev eval impltbl sys CPT 93260 | not published | not published | $41.23 – $77.74 | 8 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | not published | not published | $30.73 – $62.36 | 8 |
| Prgrmg dev eval scrms ip CPT 93285 | not published | not published | $24.99 – $50.16 | 8 |
| Prgrmg eval implantable dfb CPT 93282 | not published | not published | $40.91 – $77.28 | 8 |
| Prgrmg eval implantable dfb CPT 93283 | not published | not published | $55.04 – $104.72 | 8 |
| Prgrmg eval implantable dfb CPT 93284 | not published | not published | $59.75 – $113.71 | 8 |
| Prgr stim/pace a/iv drug CPT 93623 | not published | not published | $35.92 – $127.20 | 8 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $638.30 | $638.30 | $169.69 – $350.42 | 9 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $437.75 | $437.75 | $127.04 – $262.98 | 9 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $321.65 | $321.65 | $80.72 – $166.73 | 9 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $328.00 | $328.00 | $116.41 – $238.59 | 9 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $229.60 | $229.60 | $77.37 – $159.97 | 9 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $127.40 | $127.40 | $48.39 – $98.97 | 9 |
| Prim art mech thrmbc non-intracranial CPT 37184 | not published | not published | $406.24 – $3,228.39 | 9 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | not published | not published | $153.65 – $896.25 | 9 |
| Prin care mgmt staff 1st 30 CPT 99426 | not published | not published | $47.94 – $119.50 | 9 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $549.55 | $549.55 | $30.26 – $73.72 | 9 |
| Pr incision & drainage abscess simple/single CPT 10060 | $501.40 | $501.40 | $30.26 – $73.72 | 9 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $211.90 | $211.90 | $43.78 – $106.64 | 9 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $148.90 | $148.90 | $31.30 – $76.24 | 9 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | not published | not published | $186.36 – $539.68 | 9 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | not published | not published | $136.74 – $398.97 | 9 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $34.10 | $34.10 | $7.29 – $17.77 | 9 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $580.43 – $1,260.70 | 8 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $121.93 – $309.67 | 9 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $128.67 – $274.50 | 8 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $211.52 – $720.20 | 9 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $150.14 – $1,625.44 | 9 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $601.60 | $601.60 | $139.82 – $565.50 | 9 |
| Procalcitonin CPT 84145 | $151.05 | $151.05 | $27.22 – $141.99 | 9 |
| Procarbazine 50 mg caps 100 each bottle HCPCS S0182 | not published | not published | $77.95 – $131.85 | 2 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $117.92 | $117.92 | $2.91 – $110.84 | 9 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | not published | not published | $0.36 – $0.67 | 4 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $1,748.34 – $3,663.51 | 8 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $1,742.35 – $3,673.00 | 8 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $99.11 – $429.17 | 9 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $105.85 – $425.95 | 9 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $81.72 – $1,803.40 | 9 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $46.31 – $247.35 | 9 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $80.11 – $394.47 | 9 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $85.05 – $406.69 | 9 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $100.35 – $438.80 | 9 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $97.77 – $212.83 | 8 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $69.68 – $349.50 | 9 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $94.96 – $411.82 | 9 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $110.66 – $240.62 | 8 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $91.08 – $231.21 | 8 |
| Progesterone CPT 84144 | $267.45 | $267.45 | $20.86 – $251.40 | 9 |
| Prolactin CPT 84146 | $102.60 | $102.60 | $19.38 – $96.44 | 9 |
| Prolng clin staff svc 1st hr CPT 99415 | not published | not published | $12.61 – $42.01 | 8 |
| Prolng clin staff svc ea add CPT 99416 | not published | not published | $1.23 – $19.66 | 8 |
| Prolng ip/obs e/m ea 15 min CPT 99418 | $65.55 | $65.55 | $27.97 – $61.69 | 9 |
| Prolng off/op e/m ea 15 min 99417 CPT 99417 | not published | not published | $29.49 – $60.33 | 8 |
| Prolng svc o/p 1st hour CPT 99354 | not published | not published | $184.06 – $184.06 | 1 |
| Prolng svc o/p ea addl 30 CPT 99355 | not published | not published | $179.93 – $179.93 | 1 |
| Prolonged IV inf, req pump HCPCS C8957 | $806.70 | $806.70 | $314.61 – $766.37 | 9 |
| Prolong home eval add 15m HCPCS G0318 | not published | not published | $29.18 – $60.33 | 8 |
| Prolong service without contact CPT 99358 | not published | not published | $88.47 – $178.26 | 8 |
| Prolong serv without contact add CPT 99359 | not published | not published | $41.58 – $73.19 | 7 |
| Promethazine 25 mg tablet HCPCS Q0169 | not published | not published | $0.04 – $1.36 | 3 |
| Promethazine hcl injection HCPCS J2550 | not published | not published | $3.17 – $7.06 | 8 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $205.90 – $518.47 | 9 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $205.90 – $467.08 | 9 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $834.45 – $1,788.71 | 8 |
| Prophylactic tx radius CPT 25490 | not published | not published | $693.86 – $1,497.25 | 8 |
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $872.54 – $1,879.54 | 8 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $712.99 – $1,539.29 | 8 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $76.49 | $76.49 | $0.09 – $64.71 | 9 |
| _propoxygc/msur CPT 80367 | $150.00 | $150.00 | $12.51 – $141.00 | 9 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | not published | not published | $3.32 – $18.29 | 3 |
| Pros sheath/sock w gel cushn HCPCS L8417 | not published | not published | $69.89 – $185.40 | 3 |
| Pros soc insert gasket/seal HCPCS L7700 | not published | not published | $137.70 – $365.30 | 3 |
| Pros sock multi ply upper lm HCPCS L8435 | not published | not published | $25.74 – $68.25 | 3 |
| Pros sock single ply ak HCPCS L8480 | not published | not published | $11.06 – $29.34 | 3 |
| Pros sock single ply upper l HCPCS L8485 | not published | not published | $11.08 – $29.40 | 3 |
| Prostate biopsy, any mthd HCPCS G0416 | not published | not published | $172.71 – $349.75 | 8 |
| Prostate ca screening; dre HCPCS G0102 | not published | not published | $8.64 – $44.97 | 8 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $700.81 – $1,481.66 | 8 |
| Prostate laser enucleation CPT 52649 | not published | not published | $794.32 – $1,680.27 | 8 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $341.49 – $2,710.57 | 9 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $366.31 – $2,646.32 | 9 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | not published | not published | $101.64 – $269.62 | 3 |
| Prosthesis voc lopres 20f 22mm HCPCS L8507 | not published | not published | $38.98 – $103.41 | 3 |
| Prosthetic sock multi ply bk HCPCS L8420 | not published | not published | $19.71 – $52.28 | 3 |
| Prosthetic type socket molde HCPCS L2350 | not published | not published | $792.95 – $2,103.50 | 3 |
| Prost sock sgl ply blw knee ea HCPCS L8470 | not published | not published | $6.33 – $16.78 | 3 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $191.07 | $191.07 | $0.81 – $179.61 | 9 |
| Protect body sock ea pre ots HCPCS L0984 | not published | not published | $60.87 – $161.47 | 3 |
| Protector nerve neurawrap 4cm HCPCS C9353 | not published | not published | $1,096.25 – $1,096.25 | 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.