Pen Bay Medical Center
6 Glen Cove Dr, Rockport, ME · MaineHealth · · NPI 1982645305
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 |
|---|---|---|---|---|
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $7.35 | $7.35 | $0.66 – $6.54 | 6 |
| Sodium chloride 3 % ivpb HCPCS J7131 | not published | not published | $0.12 – $0.27 | 3 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $310.36 | $310.36 | $2.14 – $291.74 | 6 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | not published | not published | $73.10 – $144.35 | 4 |
| Sodium serum/plasma/whole blood CPT 84295 | $99.25 | $99.25 | $4.81 – $93.30 | 9 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $790.54 | $790.54 | $1.95 – $743.11 | 6 |
| Soft interface below knee se HCPCS L2820 | not published | not published | $102.62 – $272.26 | 7 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $85.22 – $87.77 | 5 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,345.31 – $2,819.01 | 6 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $2,505.78 | 6 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $6,890.86 | 6 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $2,192.56 | 6 |
| Solid skin barrier HCPCS A4362 | not published | not published | $3.29 – $9.26 | 7 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $8.22 – $21.67 | 7 |
| Somatosensory testing CPT 95927 | not published | not published | $26.01 – $54.23 | 8 |
| Somatropin injection HCPCS J2941 | not published | not published | $48.92 – $154.84 | 8 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,989.55 – $6,264.41 | 6 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $1,879.33 | 6 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $22.41 – $47.84 | 7 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $148.36 – $393.56 | 7 |
| Spacer bag/reservoir HCPCS A4627 | $26.00 | $26.00 | $5.50 – $23.05 | 5 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $155.57 – $340.26 | 8 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $169.40 – $372.11 | 8 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $191.76 – $239.95 | 3 |
| Special casting material HCPCS A4590 | not published | not published | $52.87 – $52.87 | 1 |
| Special physics consult CPT 77370 | not published | not published | $128.50 – $305.01 | 8 |
| Special pump services CPT 99190 | not published | not published | $624.53 – $866.90 | 3 |
| Special pump services CPT 99191 | not published | not published | $436.83 – $607.99 | 3 |
| Special pump services CPT 99192 | not published | not published | $312.01 – $433.80 | 3 |
| Special radiation dosimetry CPT 77331 | not published | not published | $19.06 – $88.02 | 8 |
| Special radiation treatment CPT 77470 | not published | not published | $38.45 – $204.30 | 8 |
| Special teletx port plan CPT 77321 | not published | not published | $44.52 – $95.72 | 8 |
| Specific gravity body fluid CPT 84315 | $9.70 | $9.70 | $3.28 – $9.12 | 9 |
| Specimen fat stain CPT 89125 | not published | not published | $5.88 – $12.20 | 7 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $619.60 | $619.60 | $223.55 – $432.63 | 9 |
| Speech audiometry complete CPT 92556 | $121.45 | $121.45 | $39.64 – $95.82 | 9 |
| Speech evaluation complex CPT 70371 | not published | not published | $40.57 – $84.72 | 8 |
| Speech recep thresh CPT 92555 | $129.65 | $129.65 | $25.56 – $102.29 | 9 |
| Speech Therapy Session (one-on-one) CPT 92507 | $688.40 | $688.40 | $75.09 – $164.19 | 9 |
| Sperm antibody test CPT 89325 | not published | not published | $10.67 – $22.36 | 7 |
| Sperm evaluation test CPT 89329 | not published | not published | $19.59 – $41.05 | 7 |
| Sperm identification CPT 89257 | not published | not published | $51.71 – $53.26 | 5 |
| Sperm isolation complex CPT 89261 | not published | not published | $14.88 – $53.26 | 6 |
| Sperm isolation simple CPT 89260 | not published | not published | $14.88 – $53.26 | 6 |
| Sperm washing 58323 CPT 58323 | not published | not published | $11.34 – $28.91 | 9 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $672.09 – $1,408.47 | 8 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $717.64 – $1,528.43 | 8 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $102.40 – $225.70 | 8 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $196.13 – $255.54 | 3 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $2,519.55 | $2,519.55 | $81.10 – $426.60 | 9 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $12,453.02 – $12,826.61 | 5 |
| Spine X-ray (single view, one level) CPT 72020 | $296.95 | $296.95 | $7.42 – $227.71 | 9 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $131.45 – $276.53 | 8 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $80.79 – $170.13 | 8 |
| Spleen imaging CPT 78185 | not published | not published | $15.59 – $32.54 | 8 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $1,083.41 – $2,347.89 | 8 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $2,167.25 – $4,718.17 | 8 |
| Splicing of ureters CPT 50770 | not published | not published | $1,102.21 – $2,337.73 | 8 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $930.40 | $930.40 | $121.39 – $598.23 | 9 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $53.40 | $53.40 | $24.42 – $74.74 | 9 |
| Splint finger 4 prong foam sm HCPCS A4570 | not published | not published | $12.69 – $23.72 | 2 |
| Splint finger fold over sm HCPCS L3924 | $57.75 | $57.75 | $45.56 – $131.70 | 9 |
| Splint finger frog med HCPCS L3927 | not published | not published | $29.54 – $78.37 | 7 |
| Splint fing stax assort 1-7in HCPCS Q4049 | not published | not published | $2.09 – $5.51 | 7 |
| Splint func pos polyflex ii med HCPCS L3999 | $101.80 | $101.80 | $80.32 – $95.69 | 6 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $148.45 | $148.45 | $100.99 – $134.42 | 9 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $662.16 – $1,635.71 | 9 |
| Split blood or products CPT 86985 | not published | not published | $30.55 – $170.82 | 7 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $68.29 – $181.13 | 7 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | not published | not published | $124.26 – $398.33 | 9 |
| Spontaneous nystagmus study CPT 92531 | not published | not published | $20.08 – $31.85 | 3 |
| Sprchoroidal spc njx rx agt CPT 67516 | not published | not published | $93.44 – $230.01 | 8 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $668.75 – $1,774.04 | 7 |
| Sputum specimen collection CPT 89220 | not published | not published | $16.80 – $38.64 | 8 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $949.83 – $3,825.00 | 9 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $1,298.06 – $2,866.41 | 8 |
| Srs cranial lesion simple CPT 61796 | not published | not published | $960.98 – $2,125.59 | 8 |
| Srs cran les complex addl CPT 61799 | not published | not published | $276.84 – $618.15 | 8 |
| Srs cran les simple addl CPT 61797 | not published | not published | $200.55 – $448.03 | 8 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $84.40 – $367.37 | 7 |
| Srs linear based CPT 77372 | not published | not published | $903.61 – $1,894.44 | 8 |
| Srs multisource CPT 77371 | not published | not published | $1,154.61 – $2,184.47 | 8 |
| Srs spinal lesion CPT 63620 | not published | not published | $1,061.80 – $2,346.55 | 8 |
| Srs spinal lesion addl CPT 63621 | not published | not published | $230.63 – $515.12 | 8 |
| Staggered spondaic word test CPT 92572 | $267.80 | $267.80 | $44.02 – $211.29 | 9 |
| Staging lapro hodgkins disease/lymphoma 49220 CPT 49220 | not published | not published | $1,370.59 – $1,370.59 | 1 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $272.44 – $722.72 | 7 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $643.75 | $643.75 | $106.70 – $207.54 | 9 |
| Stance phase only HCPCS L5858 | not published | not published | $17,297.78 – $45,886.89 | 7 |
| Standard control cable extra HCPCS L6655 | not published | not published | $77.94 – $206.74 | 7 |
| Staph a dna amp probe CPT 87640 | not published | not published | $35.09 – $73.19 | 7 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $162.85 – $431.99 | 7 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $74.87 – $135.01 | 6 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $74.87 – $135.01 | 6 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $704.55 | $704.55 | $99.59 – $224.59 | 9 |
| Stem cells total count CPT 86367 | not published | not published | $18.17 – $162.67 | 7 |
| Stenger test pure tone CPT 92565 | $106.70 | $106.70 | $18.68 – $84.19 | 9 |
| Stenger test speech CPT 92577 | $940.10 | $940.10 | $18.99 – $741.74 | 9 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | not published | not published | $648.73 – $21,060.65 | 9 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $7,084.00 | $7,084.00 | $1,144.05 – $1,363.00 | 6 |
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.