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 |
|---|---|---|---|---|
| Dextrose 5 % IV bolus HCPCS J7070 | not published | not published | $3.36 – $7.10 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $21.90 | $21.90 | $17.28 – $22.90 | 9 |
| Diabetes (HbA1c) Test CPT 83036 | $30.25 | $30.25 | $9.71 – $28.44 | 9 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $8.74 – $36.63 | 8 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $211.99 – $558.37 | 7 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $34.00 – $94.84 | 7 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $34.00 – $94.84 | 7 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $34.00 – $94.84 | 7 |
| Diab manage trn ind/group HCPCS G0109 | $74.20 | $74.20 | $15.13 – $58.54 | 9 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $70.68 – $186.18 | 7 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $34.00 – $94.84 | 7 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $160.02 – $337.55 | 8 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $314.32 – $679.84 | 8 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $89.66 – $289.12 | 9 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $118.42 – $400.26 | 9 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $290.15 | $290.15 | $39.40 – $117.30 | 9 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $143.00 | $143.00 | $15.39 – $79.67 | 9 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $143.00 | $143.00 | $15.39 – $79.67 | 9 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $781.50 | $781.50 | $47.29 – $153.48 | 9 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $430.50 | $430.50 | $65.36 – $249.28 | 9 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $855.70 | $855.70 | $45.43 – $312.29 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $692.45 | $692.45 | $36.91 – $220.56 | 9 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $85.22 – $87.77 | 5 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $184.46 – $3,568.26 | 9 |
| Dialysis one evaluation CPT 90945 | not published | not published | $83.07 – $174.19 | 8 |
| Dialysis repeated eval CPT 90947 | not published | not published | $117.05 – $246.05 | 8 |
| Dialysis training complete CPT 90989 | not published | not published | $542.58 – $854.04 | 3 |
| Dialysis training incompl CPT 90993 | not published | not published | $117.76 – $185.05 | 3 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.99 – $14.92 | 8 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $55.20 | $55.20 | $0.07 – $51.89 | 6 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $328.54 | $328.54 | $5.45 – $308.83 | 6 |
| Dicyclomine injection HCPCS J0500 | not published | not published | $20.33 – $29.46 | 4 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.08 – $0.48 | 8 |
| Diffusing capacity CPT 94729 | $410.95 | $410.95 | $8.40 – $153.38 | 9 |
| Digital analysis of eeg CPT 95957 | not published | not published | $96.93 – $201.98 | 8 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $169.33 – $364.65 | 8 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $63.82 | $63.82 | $7.17 – $59.99 | 6 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,876.92 | $11,876.92 | $4,685.44 – $11,164.30 | 9 |
| Digoxin total therapeutic drug level CPT 80162 | $237.95 | $237.95 | $13.28 – $223.67 | 9 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $42.34 – $81.11 | 4 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $126.43 – $941.21 | 9 |
| Dilate esophagus CPT 43453 | not published | not published | $82.73 – $1,524.57 | 9 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $76.33 – $361.07 | 9 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $325.88 – $700.48 | 4 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $162.94 – $349.96 | 4 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $463.87 – $997.18 | 4 |
| Dilate tear duct opening CPT 68801 | not published | not published | $75.22 – $185.68 | 9 |
| Dilate urethra stricture CPT 53600 | $684.25 | $684.25 | $60.81 – $170.89 | 9 |
| Dilate urethra stricture CPT 53601 | not published | not published | $51.01 – $165.76 | 9 |
| Dilate urethra stricture CPT 53605 | not published | not published | $60.46 – $128.79 | 8 |
| Dilate urethra stricture CPT 53621 | not published | not published | $68.37 – $314.17 | 9 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $39.78 – $147.12 | 9 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $163.57 – $351.09 | 8 |
| Dilation of cervical canal 57800 CPT 57800 | $4,957.90 | $4,957.90 | $45.89 – $150.98 | 9 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $185.55 – $397.86 | 8 |
| Dilation of salivary duct CPT 42660 | not published | not published | $76.71 – $216.52 | 9 |
| Dilation of urethra CPT 53661 | not published | not published | $38.46 – $144.55 | 9 |
| Dilation of urethra CPT 53665 | not published | not published | $35.47 – $75.23 | 8 |
| Dilation of vagina CPT 57400 | not published | not published | $124.18 – $265.70 | 8 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $56.62 – $144.55 | 9 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $83.00 – $327.66 | 9 |
| Dilator fascial 10fx20cm HCPCS C2627 | $74.75 | $74.75 | $6.50 – $69.61 | 6 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $142.97 – $304.34 | 8 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $238.69 – $505.63 | 8 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $54.55 – $181.37 | 4 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.38 – $17.14 | 4 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,742.50 | $1,742.50 | $651.47 – $1,637.95 | 9 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $14.97 | $14.97 | $0.02 – $14.07 | 6 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $13.60 | $13.60 | $0.80 – $12.66 | 6 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $35.25 – $104.50 | 3 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.72 – $7.65 | 4 |
| Direct advanced life support CPT 99288 | not published | not published | $403.47 – $403.47 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $25.88 – $59.64 | 8 |
| Disability dlco CPT 94727 | $248.10 | $248.10 | $11.35 – $127.78 | 9 |
| Disaccharidases CPT 82657 | $590.30 | $590.30 | $22.17 – $554.88 | 9 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $455.15 – $988.23 | 8 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,077.52 – $2,319.44 | 8 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,399.71 – $2,999.26 | 8 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $189.20 – $422.94 | 8 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $53.96 – $112.52 | 8 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $68.07 – $180.54 | 7 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $164.70 – $436.90 | 7 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $92.72 – $197.91 | 8 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,433.84 – $3,168.05 | 8 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $93.87 – $96.69 | 5 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $342.33 – $745.58 | 8 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,037.20 – $2,270.63 | 8 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,062.10 – $2,311.98 | 8 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $760.75 – $1,623.33 | 8 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $323.94 – $689.31 | 8 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $11.80 – $50.16 | 3 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $265.33 – $583.58 | 8 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $163.22 – $584.63 | 7 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $575.89 | 7 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $287.07 | 7 |
| Dna antibody native/double stranded CPT 86225 | $71.70 | $71.70 | $13.74 – $67.40 | 9 |
| Dna gardnerella CPT 87510 | not published | not published | $20.05 – $42.01 | 7 |
| Dna probe chlamydia CPT 87490 | not published | not published | $22.75 – $47.44 | 7 |
| Dna probe gc CPT 87590 | not published | not published | $26.88 – $56.26 | 7 |
| Dna trichomonas CPT 87660 | not published | not published | $20.05 – $42.01 | 7 |
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.