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 |
|---|---|---|---|---|
| Atn1 gene detc abnor alleles CPT 81177 | not published | not published | $54.80 – $278.96 | 7 |
| Atomic absorption CPT 82190 | not published | not published | $7.36 – $32.38 | 7 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $122.48 | $122.48 | $0.08 – $27.03 | 9 |
| Attach bladder/urethra comp 51841 CPT 51841 | not published | not published | $766.23 – $1,632.83 | 8 |
| Attach bladder/urethra simple 51840 CPT 51840 | not published | not published | $661.67 – $1,414.57 | 8 |
| Attach ocular implant CPT 65140 | not published | not published | $885.51 – $1,858.53 | 8 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | $253.75 | $253.75 | $68.32 – $145.05 | 9 |
| Atxn10 gene detc abnor allel CPT 81183 | not published | not published | $54.80 – $278.96 | 7 |
| Atxn1 gene detc abnor allele CPT 81178 | not published | not published | $54.80 – $278.96 | 7 |
| Atxn2 gene detc abnor allele CPT 81179 | not published | not published | $54.80 – $278.96 | 7 |
| Atxn3 gene detc abnor allele CPT 81180 | not published | not published | $54.80 – $278.96 | 7 |
| Atxn7 gene detc abnor allele CPT 81181 | not published | not published | $54.80 – $278.96 | 7 |
| Atxn8os gen detc abnor allel CPT 81182 | not published | not published | $54.80 – $278.96 | 7 |
| Aud brainstem implt programg CPT 92640 | not published | not published | $90.19 – $208.16 | 9 |
| Audiometry air + bone CPT 92553 | not published | not published | $40.58 – $93.54 | 8 |
| Audit/dast 15-30 min CPT 99408 | not published | not published | $31.19 – $66.16 | 7 |
| Audit/dast over 30 min CPT 99409 | not published | not published | $62.37 – $127.42 | 7 |
| Auditor evoke potent limit CPT 92586 | not published | not published | $171.72 – $171.72 | 1 |
| Auditory function + 15 min CPT 92621 | not published | not published | $18.08 – $41.76 | 9 |
| Auditory function 60 min CPT 92620 | not published | not published | $76.54 – $169.62 | 9 |
| Aud rehab postling hear loss CPT 92633 | not published | not published | $147.12 – $147.12 | 1 |
| Aud rehab pre-ling hear loss CPT 92630 | not published | not published | $147.12 – $147.12 | 1 |
| Augmentation cheek bone CPT 21270 | not published | not published | $717.48 – $1,969.16 | 9 |
| Augmentation lower jaw bone CPT 21125 | not published | not published | $647.84 – $4,977.19 | 9 |
| Augmentation lower jaw bone CPT 21127 | not published | not published | $743.16 – $7,705.09 | 9 |
| Augmentation of facial bones CPT 21208 | not published | not published | $713.21 – $3,145.51 | 9 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $16,235.15 | $16,235.15 | $201.36 – $1,556.44 | 9 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $32,469.60 | $32,469.60 | $477.65 – $3,456.60 | 9 |
| Autgrft implnt knee w/scope CPT 29866 | not published | not published | $1,010.53 – $2,160.14 | 8 |
| Autochondrocyte implant knee CPT 27412 | not published | not published | $1,568.09 – $3,359.85 | 8 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | not published | not published | $300.47 – $1,711.73 | 7 |
| Autologous blood op salvage CPT 86891 | not published | not published | $59.33 – $814.35 | 7 |
| Autologous blood process CPT 86890 | not published | not published | $42.05 – $170.82 | 7 |
| Autolog prp diab wound ulcer HCPCS G0465 | not published | not published | $13.70 – $994.54 | 7 |
| Autolog prp not diab ulcer HCPCS G0460 | not published | not published | $223.83 – $1,823.51 | 7 |
| Automated diff wbc count CPT 85004 | not published | not published | $3.19 – $13.17 | 7 |
| Autonomic nrv adrenrg inervj CPT 95922 | not published | not published | $42.98 – $89.48 | 8 |
| Autonomic nrv parasym inervj CPT 95921 | not published | not published | $41.86 – $87.44 | 8 |
| Autonomic nrv syst funj test CPT 95923 | not published | not published | $42.07 – $88.78 | 8 |
| Autopsy (necropsy) complete CPT 88020 | not published | not published | $153.50 – $733.38 | 4 |
| Autopsy (necropsy) complete CPT 88025 | not published | not published | $148.61 – $709.66 | 4 |
| Autopsy (necropsy) complete CPT 88027 | not published | not published | $158.54 – $757.10 | 4 |
| Autopsy (necropsy) complete CPT 88028 | not published | not published | $89.14 – $425.67 | 4 |
| Autopsy (necropsy) complete CPT 88029 | not published | not published | $89.14 – $425.67 | 4 |
| Autopsy (necropsy) gross CPT 88000 | not published | not published | $89.14 – $425.67 | 4 |
| Autopsy (necropsy) gross CPT 88005 | not published | not published | $103.97 – $496.83 | 4 |
| Autopsy (necropsy) gross CPT 88007 | not published | not published | $109.01 – $520.55 | 4 |
| Autopsy (necropsy) gross CPT 88012 | not published | not published | $89.14 – $425.67 | 4 |
| Autopsy (necropsy) gross CPT 88014 | not published | not published | $81.79 – $390.42 | 4 |
| Autopsy (necropsy) gross CPT 88016 | not published | not published | $113.90 – $544.27 | 4 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $5,744.80 | $5,744.80 | $90.96 – $5,400.11 | 9 |
| Av fistula revision CPT 36833 | $9,478.35 | $9,478.35 | $730.73 – $7,961.81 | 9 |
| Av fuse uppr arm basilic CPT 36819 | not published | not published | $658.92 – $1,452.53 | 8 |
| Av fuse uppr arm cephalic CPT 36818 | not published | not published | $624.06 – $1,373.21 | 8 |
| Av fusion direct any site CPT 36821 | not published | not published | $597.37 – $1,314.24 | 8 |
| Av fusion/forearm vein 36820 CPT 36820 | not published | not published | $660.89 – $1,446.44 | 8 |
| Avul nail plate addl CPT 11732 | $149.85 | $149.85 | $15.87 – $63.61 | 9 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $347.95 | $347.95 | $44.93 – $111.27 | 9 |
| Axatilimab-csfr 22 mg/0.44ml soln 0.44 ml vial HCPCS J9038 | $15,592.21 | $15,592.21 | $54.08 – $8,032.04 | 9 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | not published | not published | $0.02 – $882,445.75 | 6 |
| Axillary crutch extension HCPCS L0978 | not published | not published | $184.21 – $463.74 | 7 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | not published | not published | $663.56 – $1,436.95 | 8 |
| Azacitidine injection HCPCS J9025 | $4,270.00 | $4,270.00 | $0.35 – $2,316.07 | 9 |
| Azathioprine 50 mg tablet HCPCS J7500 | $151.15 | $151.15 | $1.83 – $142.08 | 7 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $130.13 – $255.00 | 8 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $66.41 | $66.41 | $2.10 – $28.71 | 9 |
| Azithromycin dihydrate, oral HCPCS Q0144 | not published | not published | $24.76 – $39.78 | 4 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $746.26 | $746.26 | $2.13 – $125.49 | 9 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | $4,809.89 | $4,809.89 | $175.82 – $1,472.04 | 9 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $37.44 – $80.51 | 6 |
| Baclofen eval charges CPT 97750 | $213.45 | $213.45 | $32.99 – $67.27 | 9 |
| Bacterial meningitis antigen CPT 86403 | $119.45 | $119.45 | $5.03 – $39.34 | 9 |
| Bacterial vaginosis pcr CPT 87801 | $1,200.50 | $1,200.50 | $34.66 – $297.65 | 9 |
| Bactericidal level serum CPT 87197 | not published | not published | $7.42 – $30.58 | 7 |
| #bac vag cand-c. albicans naa CPT 87481 | $328.40 | $328.40 | $19.88 – $76.66 | 9 |
| Bag urine leg fbrc strap 32oz flipflo anti-reflux valve HCPCS A4358 | not published | not published | $7.36 – $16.43 | 7 |
| Balance and Coordination Retraining (each 15 minutes) CPT 97112 | $184.90 | $184.90 | $32.10 – $89.25 | 9 |
| Balloon dilate urtrl strix CPT 50706 | $2,935.00 | $2,935.00 | $167.20 – $1,552.67 | 9 |
| Banding pulmonary artery CPT 33690 | not published | not published | $1,107.09 – $2,417.03 | 8 |
| Barium Enema (Colon X-ray, barium and air) CPT 74280 | $1,741.05 | $1,741.05 | $56.76 – $653.14 | 9 |
| Barium Enema (Colon X-ray, barium only) CPT 74270 | $1,029.60 | $1,029.60 | $46.60 – $447.59 | 9 |
| Barium Swallow (Esophagus X-ray) CPT 74220 | $876.85 | $876.85 | $27.25 – $457.93 | 9 |
| Barrier film 1.0ml wipe HCPCS A5120 | not published | not published | $0.30 – $0.67 | 3 |
| Barrier film 28ml spray no stng cavilon HCPCS A4369 | not published | not published | $2.69 – $6.74 | 7 |
| Barrier skin flat ctf 2.75in HCPCS A4408 | not published | not published | $10.97 – $27.43 | 7 |
| Barrier skin flextend 2.25in floating flang new image HCPCS A4409 | not published | not published | $6.91 – $17.25 | 7 |
| Barrier skin flxtnd ctf 3.5in flt flang 4in w/tape cut to ft HCPCS A4414 | not published | not published | $5.47 – $13.66 | 7 |
| Barrier skn ft cx ff red 2.25 ctf new image w/tape HCPCS A4407 | not published | not published | $9.74 – $24.33 | 7 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | not published | not published | $173.16 – $372.12 | 8 |
| Bartonella dna pcr-sendout CPT 87471 | not published | not published | $17.33 – $71.45 | 7 |
| Bartonella dna quant CPT 87472 | not published | not published | $21.15 – $87.23 | 7 |
| Basic vestibular evaluation CPT 92540 | not published | not published | $28.36 – $145.84 | 8 |
| Basiliximab HCPCS J0480 | $8,373.48 | $8,373.48 | $4,397.19 – $7,871.07 | 9 |
| Battery chrgr 12 volt utah/e HCPCS L7366 | not published | not published | $649.85 – $1,635.90 | 7 |
| Battery chrgr six volt otto HCPCS L7362 | not published | not published | $263.81 – $664.09 | 7 |
| Battery elec/combo vad, rep HCPCS Q0496 | not published | not published | $1,405.35 – $3,512.63 | 7 |
| Battery pneum vad replacemnt HCPCS Q0503 | not published | not published | $1,218.96 – $3,046.75 | 7 |
| B cells total count CPT 86355 | $271.70 | $271.70 | $18.63 – $84.93 | 9 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $743.80 | $743.80 | $2.87 – $699.17 | 9 |
| Bcg vaccine intravesical CPT 90586 | not published | not published | $146.59 – $277.53 | 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.