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 |
|---|---|---|---|---|
| Adv prim care mgmt lvl 3 HCPCS G0558 | not published | not published | $79.61 – $167.43 | 6 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $77.50 – $160.64 | 8 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $79.35 – $164.70 | 8 |
| Aep thrshld est mlt freq i&r CPT 92652 | $151.15 | $151.15 | $106.05 – $142.08 | 9 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,943.42 – $7,473.77 | 8 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $770,620.00 – $793,738.60 | 5 |
| _afb id by dna probe rflx ast CPT 87149 | $59.60 | $59.60 | $20.05 – $56.02 | 9 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $15.32 | 7 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $115.36 – $241.73 | 7 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $137.00 – $287.07 | 7 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $274.83 – $575.89 | 7 |
| Aflibercept injection HCPCS J0178 | not published | not published | $790.04 – $1,583.56 | 8 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $11.89 – $23.72 | 3 |
| Afo molded ankle gauntlet HCPCS L1904 | not published | not published | $557.95 – $1,480.11 | 7 |
| Afo molded plas rig ant tib HCPCS L1945 | not published | not published | $1,098.36 – $2,913.70 | 7 |
| Afo molded to patient plasti HCPCS L1940 | not published | not published | $586.80 – $1,556.64 | 7 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | not published | not published | $828.92 – $2,198.95 | 7 |
| Afo sing bar clasp attach sh HCPCS L1910 | not published | not published | $282.15 – $748.47 | 7 |
| Afo sing solid stirrup calf HCPCS L1980 | not published | not published | $422.47 – $1,120.74 | 7 |
| Afo sing upright with adjust s HCPCS L1920 | not published | not published | $413.49 – $1,096.88 | 7 |
| Afo spiral molded to pt plas HCPCS L1950 | not published | not published | $848.69 – $2,251.38 | 7 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | not published | not published | $282.64 – $749.81 | 7 |
| Afo supramalleolar custom HCPCS L1907 | not published | not published | $522.69 – $1,386.59 | 7 |
| Afo tib fx cast molded to pt HCPCS L2108 | not published | not published | $1,225.55 – $3,251.07 | 7 |
| Afo tib fx cast plaster mold HCPCS L2106 | not published | not published | $806.75 – $2,140.11 | 7 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $607.60 – $1,611.83 | 7 |
| Afo tibial fracture rigid HCPCS L2116 | not published | not published | $780.32 – $2,070.00 | 7 |
| Afo tibial fracture soft HCPCS L2112 | not published | not published | $503.05 – $1,334.50 | 7 |
| Afo, walk boot type, cus fab HCPCS L4631 | not published | not published | $1,534.63 – $4,042.07 | 7 |
| Afo w/ankle joint, prefab HCPCS L1971 | not published | not published | $435.40 – $1,155.02 | 7 |
| After cataract laser surgery CPT 66821 | not published | not published | $296.51 – $641.17 | 9 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $210.26 – $441.86 | 8 |
| Ag detect nos ia single CPT 87450 | not published | not published | $12.13 – $12.13 | 1 |
| Air conduction bilat CPT 92552 | $145.80 | $145.80 | $33.07 – $115.04 | 9 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $85.09 – $285.90 | 9 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $11.69 – $24.39 | 8 |
| Ak 4 bar ling w/hydraul swig HCPCS L5613 | not published | not published | $3,097.94 – $8,218.11 | 7 |
| Ak 4 bar link w/fric swing HCPCS L5611 | not published | not published | $2,036.70 – $5,402.87 | 7 |
| Ak/bk self-aligning unit ea HCPCS L5617 | not published | not published | $547.04 – $1,451.17 | 7 |
| Ak flex inner socket ext fra HCPCS L5651 | not published | not published | $1,518.09 – $4,027.11 | 7 |
| Ak/knee disartic acrylic soc HCPCS L5631 | not published | not published | $555.42 – $1,473.41 | 7 |
| Ak/knee disartic pelvic band HCPCS L5697 | not published | not published | $101.48 – $269.20 | 7 |
| Ak/knee disartic pelvic join HCPCS L5696 | not published | not published | $224.80 – $596.32 | 7 |
| Ak/knee disartic silesian ba HCPCS L5698 | not published | not published | $113.91 – $302.18 | 7 |
| Ak open end sach HCPCS L5321 | not published | not published | $3,280.87 – $8,703.37 | 7 |
| Ak pelvic control belt light HCPCS L5692 | not published | not published | $149.00 – $395.24 | 7 |
| Ak pelvic control belt pad/l HCPCS L5694 | not published | not published | $229.33 – $608.35 | 7 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | not published | not published | $174.08 – $461.79 | 7 |
| Ak univ multiplex sys frict HCPCS L5616 | not published | not published | $1,453.66 – $3,856.19 | 7 |
| Albumin body fluid quantitative each specimen CPT 82042 | $96.75 | $96.75 | $7.78 – $90.95 | 9 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $564.61 | $564.61 | $45.90 – $530.73 | 7 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $41.97 | 8 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $878.38 | $878.38 | $47.49 – $825.68 | 9 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.83 – $33.45 | 5 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $71.12 | 7 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $62.85 | $62.85 | $5.78 – $59.08 | 9 |
| Albumin serum plasma or whole blood CPT 82040 | $50.90 | $50.90 | $4.60 – $47.85 | 9 |
| Albuterol comp con HCPCS J7610 | not published | not published | $0.49 – $1.23 | 2 |
| Albuterol comp unit HCPCS J7609 | not published | not published | $0.49 – $2.79 | 3 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.13 – $0.38 | 4 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.14 – $0.31 | 4 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.03 – $0.15 | 4 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $8.31 – $35.92 | 7 |
| Alcohols biomarkers 3/more CPT 80322 | not published | not published | $11.40 – $11.40 | 1 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $16.05 – $33.88 | 8 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | not published | not published | $28.83 – $66.18 | 8 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $59.84 – $128.49 | 8 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $1,246.98 – $5,662.50 | 8 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $125.50 – $262.98 | 7 |
| Alefacept HCPCS J0215 | not published | not published | $41.64 – $52.87 | 3 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,280.09 – $4,770.78 | 8 |
| Alginate dressing <=16 sq in HCPCS A6196 | not published | not published | $8.18 – $21.54 | 7 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | not published | not published | $18.27 – $48.15 | 7 |
| Alginate drsg wound filler HCPCS A6199 | not published | not published | $5.88 – $15.44 | 7 |
| Alglucerase injection HCPCS J0205 | not published | not published | $42.03 – $63.03 | 3 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $206.70 – $451.42 | 4 |
| Alkaline phosphatase CPT 84075 | $36.75 | $36.75 | $5.18 – $34.55 | 9 |
| Allergen alpha lactalbumin ige CPT 86008 | $46.65 | $46.65 | $17.93 – $43.85 | 9 |
| Allergen egg white ige CPT 86003 | $23.65 | $23.65 | $5.22 – $22.23 | 9 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $23.70 | $23.70 | $7.97 – $22.28 | 9 |
| Allergy injections; 2 or more 95117 CPT 95117 | $85.00 | $85.00 | $10.86 – $67.07 | 9 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $9.29 – $21.69 | 8 |
| Allergy Skin Testing CPT 95004 | not published | not published | $3.51 – $7.46 | 8 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $4.60 – $10.16 | 8 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $1,226.28 – $2,640.04 | 8 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | not published | not published | $17.05 – $33.72 | 3 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $77.66 – $171.39 | 4 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $97.32 – $230.67 | 4 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $8,800.00 | $8,800.00 | $390.56 – $465.30 | 6 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $1,411.85 | $1,411.85 | $30.73 – $1,327.14 | 6 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $1,294.00 | $1,294.00 | $151.60 – $257.89 | 6 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $85.96 – $147.77 | 3 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $129.93 – $252.06 | 3 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $440.93 | $440.93 | $244.49 – $414.47 | 6 |
| Alloskin HCPCS Q4115 | not published | not published | $12.13 – $29.94 | 4 |
| Alloskin ac, 1 cm HCPCS Q4141 | not published | not published | $39.45 – $75.08 | 3 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $6.77 – $38.54 | 9 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $3.49 – $16.71 | 9 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $1,408.80 | $1,408.80 | $4.83 – $1,324.27 | 9 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $134.88 | 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.