MaineHealth - Memorial Hospital
3073 White Mountain Highway, North Conway, NH · MaineHealth · · NPI 1760436216
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | not published | not published | $14.46 – $59.62 | 7 |
| 17-hydroxypregnenolone CPT 84143 | $230.40 | $230.40 | $11.26 – $101.29 | 9 |
| 17-ketosteroids CPT 83586 | not published | not published | $6.32 – $26.06 | 7 |
| 1pc ost pch drain hgh output HCPCS A4435 | not published | not published | $6.41 – $16.00 | 7 |
| 1 pc ost pouch w filter HCPCS A5056 | not published | not published | $5.20 – $12.99 | 7 |
| 1 pc ost pou w built-in conv HCPCS A5057 | not published | not published | $10.68 – $26.67 | 7 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $448.05 | $448.05 | $87.45 – $185.72 | 9 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | $2,164.75 | $2,164.75 | $841.54 – $1,787.36 | 9 |
| 1st psyc collab care mgmt CPT 99492 | not published | not published | $89.53 – $295.53 | 9 |
| 1st/sbsq psyc collab care CPT 99494 | not published | not published | $38.50 – $114.36 | 9 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $21.67 – $73.14 | 7 |
| 24 hr ambulatory b/p monitor CPT 93786 | $353.05 | $353.05 | $20.87 – $296.56 | 9 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $2,103.05 | $2,103.05 | $764.65 – $1,746.76 | 9 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $2,028.05 | $2,028.05 | $764.65 – $1,906.37 | 9 |
| 2nd order venous cath CPT 36012 | $3,298.05 | $3,298.05 | $159.98 – $1,375.33 | 9 |
| 2vhpv vaccine 3 dose im CPT 90650 | not published | not published | $148.50 – $260.55 | 3 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $151.43 – $155.97 | 5 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $151.43 – $155.97 | 5 |
| 3d ech img cgen car anomal CPT 93319 | $769.90 | $769.90 | $21.93 – $106.65 | 9 |
| 3-d radiotherapy plan CPT 77295 | $5,744.60 | $5,744.60 | $219.30 – $4,825.46 | 9 |
| 3d recon without postprocess indpndt CPT 76376 | $1,221.00 | $1,221.00 | $8.97 – $879.23 | 9 |
| 4-bar link above knee w/swng HCPCS L5614 | not published | not published | $1,570.57 – $3,953.67 | 7 |
| 5% dextrose and 0.45% saline HCPCS S5010 | not published | not published | $8.06 – $9.83 | 2 |
| 5% dextrose with potassium HCPCS S5012 | not published | not published | $4.85 – $9.41 | 2 |
| 5' nucleotidase - sendout CPT 83915 | $127.30 | $127.30 | $5.51 – $57.34 | 9 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | not published | not published | $18.99 – $69.38 | 8 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $186.85 | $186.85 | $72.24 – $210.09 | 8 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $214.35 | $214.35 | $76.95 – $219.72 | 8 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $214.35 | $214.35 | $81.66 – $228.08 | 8 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $160.25 | $160.25 | $65.73 – $139.35 | 8 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $186.85 | $186.85 | $72.24 – $152.72 | 8 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $186.85 | $186.85 | $72.24 – $152.72 | 8 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $214.35 | $214.35 | $81.66 – $172.43 | 8 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $271.50 | $271.50 | $95.92 – $256.35 | 8 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $2,843.98 – $6,247.96 | 8 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | not published | not published | $43.16 – $82.30 | 8 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $105.40 | $105.40 | $5.93 – $37.98 | 9 |
| Abciximab injection HCPCS J0130 | not published | not published | $1,170.55 – $2,276.09 | 4 |
| Abd aorta w/runoff s&i CPT 75630 | $7,747.35 | $7,747.35 | $62.29 – $3,135.26 | 9 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $1,129.07 – $2,453.64 | 8 |
| Abd/low ext cath 1st CPT 36245 | $3,298.05 | $3,298.05 | $215.49 – $1,793.23 | 9 |
| Abd/low ext cath 2nd CPT 36246 | $2,432.05 | $2,432.05 | $227.89 – $1,393.90 | 9 |
| Abd/low ext cath 3rd CPT 36247 | $2,363.65 | $2,363.65 | $271.37 – $1,385.20 | 9 |
| Abd/low ext cath addl CPT 36248 | $1,930.20 | $1,930.20 | $44.59 – $220.36 | 9 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $2,483.65 | $2,483.65 | $51.66 – $392.78 | 9 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $1,222.50 | $1,222.50 | $35.89 – $559.52 | 9 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,125.30 | $3,125.30 | $62.93 – $1,620.11 | 9 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,400.80 | $2,400.80 | $57.41 – $1,462.48 | 9 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,987.35 | $1,987.35 | $53.63 – $854.32 | 9 |
| Abdominal MRI (with and without contrast) CPT 74183 | $8,602.30 | $8,602.30 | $99.57 – $2,519.33 | 9 |
| Abdominal MRI (with contrast) CPT 74182 | $4,655.10 | $4,655.10 | $77.95 – $2,085.05 | 9 |
| Abdominal MRI (without contrast) CPT 74181 | $3,883.20 | $3,883.20 | $65.73 – $1,552.82 | 9 |
| Abdominal pad HCPCS L1270 | not published | not published | $75.12 – $189.08 | 7 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,137.20 | $2,137.20 | $100.03 – $559.59 | 9 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,040.15 | $1,040.15 | $36.54 – $641.80 | 9 |
| Abdominal Ultrasound (limited) CPT 76705 | $795.25 | $795.25 | $26.60 – $509.12 | 9 |
| Abdominal X-ray (2 views) CPT 74019 | $602.35 | $602.35 | $10.60 – $243.26 | 9 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $710.60 | $710.60 | $14.70 – $330.44 | 9 |
| Abdominal X-ray (single view) CPT 74018 | $411.70 | $411.70 | $8.33 – $226.92 | 9 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $1,119.81 – $2,385.18 | 8 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,129.05 | $1,129.05 | $68.81 – $350.40 | 9 |
| Abduct control hip semi-flex HCPCS L1630 | not published | not published | $201.06 – $506.14 | 7 |
| Abduction bar jointed adjust HCPCS L2300 | not published | not published | $239.60 – $603.16 | 7 |
| Abduction bar-straight HCPCS L2310 | not published | not published | $109.48 – $275.60 | 7 |
| Abduction rotation bar shoe HCPCS L3140 | not published | not published | $82.72 – $208.22 | 7 |
| Abduct rotation bar without shoe HCPCS L3150 | not published | not published | $75.61 – $190.34 | 7 |
| Abl1 gene CPT 81170 | not published | not published | $120.00 – $610.86 | 7 |
| Ablat 1/+thyr ndul addl prq rf CPT 60661 | not published | not published | $205.01 – $445.32 | 6 |
| Ablate arrhythmia add on CPT 93655 | $7,417.15 | $7,417.15 | $277.43 – $6,230.41 | 9 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $1,247.35 – $2,723.40 | 8 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $1,753.66 – $3,830.26 | 8 |
| Ablate atria without bypass ext CPT 33255 | not published | not published | $1,483.30 – $3,235.13 | 8 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $597.74 – $1,298.67 | 8 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $1,678.74 – $3,673.67 | 8 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $19,324.80 | $19,324.80 | $321.68 – $9,622.20 | 9 |
| Ablate bone tumor(s) perq CPT 20982 | $24,909.10 | $24,909.10 | $342.30 – $6,611.61 | 9 |
| Ablate heart dysrhythm focus CPT 93650 | $12,646.75 | $12,646.75 | $527.55 – $10,623.27 | 9 |
| Ablate heart dysrhythm focus CPT 33250 | not published | not published | $1,329.58 – $2,899.63 | 8 |
| Ablate heart dysrhythm focus CPT 33251 | not published | not published | $1,485.07 – $3,258.18 | 8 |
| Ablate heart dysrhythm focus CPT 33261 | not published | not published | $1,469.29 – $3,205.32 | 8 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $193.57 – $538.39 | 9 |
| Ablate inf turbinate superf 30801 CPT 30801 | not published | not published | $145.35 – $423.38 | 9 |
| Ablate pulm tumor perq crybl CPT 32994 | not published | not published | $407.62 – $9,146.78 | 9 |
| Ablate pulm tumor perq rf CPT 32998 | $6,289.75 | $6,289.75 | $407.29 – $5,283.39 | 9 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $20,493.60 | $20,493.60 | $106.29 – $155.97 | 9 |
| Ablation cryo abd perit om CPT 49999 | $2,137.20 | $2,137.20 | $763.96 – $976.24 | 9 |
| Ablation cryo adrenal tumor CPT 60699 | $1,812.30 | $1,812.30 | $1,333.13 – $5,816.13 | 9 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | not published | not published | $232.17 – $239.13 | 5 |
| Ablation cryo pq liver tumor(s) CPT 47383 | not published | not published | $423.47 – $11,106.01 | 9 |
| Ablation cryo retro lymph node CPT 38999 | $1,874.60 | $1,874.60 | $423.12 – $1,762.12 | 9 |
| Ablation cryo thigh/knee CPT 27599 | $807.60 | $807.60 | $232.17 – $331.96 | 9 |
| Ablation of upper extremity nerves rf CPT 64999 | $3,298.05 | $3,298.05 | $101.35 – $210.09 | 9 |
| Abltj 1/+thyr ndul 1lobe prq CPT 60660 | not published | not published | $296.67 – $643.24 | 6 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $931.20 – $1,979.86 | 8 |
| Ablt trurl prst8 tis thrm Ultrasound CPT 55881 | not published | not published | $459.34 – $986.89 | 6 |
| Ablt trurl prst8 tis trnsdcr CPT 55882 | not published | not published | $564.20 – $1,213.95 | 6 |
| Abobotulinumtoxina HCPCS J0586 | not published | not published | $8.73 – $16.68 | 8 |
| Abortion CPT 59850 | not published | not published | $366.52 – $806.57 | 8 |
| Abortion (mpr) CPT 59866 | not published | not published | $218.99 – $485.31 | 8 |
| Above elbow prosth tiss shap HCPCS L6500 | not published | not published | $3,299.66 – $8,306.43 | 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.