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 |
|---|---|---|---|---|
| Revision of knee joint CPT 27446 | not published | not published | $1,094.85 – $2,344.50 | 8 |
| Revision of knee joint CPT 27445 | not published | not published | $1,195.75 – $2,561.40 | 8 |
| Revision of larynx CPT 31400 | not published | not published | $978.49 – $2,066.62 | 8 |
| Revision of leg vein 37780 CPT 37780 | not published | not published | $217.76 – $475.15 | 8 |
| Revision of lung CPT 32940 | not published | not published | $1,131.66 – $2,473.96 | 8 |
| Revision of mitral valve CPT 33420 | not published | not published | $1,324.73 – $2,889.47 | 8 |
| Revision of mitral valve CPT 33422 | not published | not published | $1,518.41 – $3,311.04 | 8 |
| Revision of neck muscle CPT 21700 | not published | not published | $328.87 – $720.51 | 8 |
| Revision of neck muscle CPT 21720 | not published | not published | $502.98 – $1,108.20 | 8 |
| Revision of neck muscle CPT 21725 | not published | not published | $522.95 – $1,121.09 | 8 |
| Revision of neck muscle/rib CPT 21705 | not published | not published | $488.86 – $1,074.32 | 8 |
| Revision of nose CPT 30120 | not published | not published | $404.68 – $990.68 | 9 |
| Revision of nose CPT 30430 | not published | not published | $1,031.83 – $2,179.13 | 8 |
| Revision of nose CPT 30435 | not published | not published | $1,282.85 – $2,722.05 | 8 |
| Revision of nose CPT 30450 | not published | not published | $1,671.12 – $3,561.84 | 8 |
| Revision of nose CPT 30460 | not published | not published | $792.81 – $1,691.10 | 8 |
| Revision of nose CPT 30462 | not published | not published | $1,519.57 – $3,247.33 | 8 |
| Revision of pelvis CPT 27158 | not published | not published | $1,331.13 – $2,853.53 | 8 |
| Revision of penis CPT 54300 | not published | not published | $616.57 – $1,309.50 | 8 |
| Revision of penis CPT 54304 | not published | not published | $712.30 – $1,514.20 | 8 |
| Revision of penis CPT 54420 | not published | not published | $670.26 – $1,424.73 | 8 |
| Revision of penis CPT 54430 | not published | not published | $611.29 – $1,297.30 | 8 |
| Revision of penis CPT 54435 | $6,243.20 | $6,243.20 | $399.06 – $5,045.63 | 9 |
| Revision of pharyngeal walls CPT 42892 | not published | not published | $1,769.59 – $3,774.68 | 8 |
| Revision of pharyngeal walls CPT 42894 | not published | not published | $2,242.65 – $4,788.66 | 8 |
| Revision of pulmonary artery CPT 33788 | not published | not published | $1,396.61 – $3,065.01 | 8 |
| Revision of pulmonary valve CPT 33474 | not published | not published | $1,982.14 – $4,352.83 | 8 |
| Revision of radius CPT 25350 | not published | not published | $653.15 – $1,393.55 | 8 |
| Revision of radius CPT 25355 | not published | not published | $737.49 – $1,577.91 | 8 |
| Revision of sciatic nerve CPT 64712 | not published | not published | $571.50 – $1,224.10 | 8 |
| Revision of scrotum CPT 55175 | not published | not published | $352.27 – $745.57 | 8 |
| Revision of scrotum CPT 55180 | not published | not published | $658.40 – $1,398.97 | 8 |
| Revision of spinal shunt CPT 63744 | not published | not published | $645.95 – $1,421.35 | 8 |
| Revision of testis CPT 54660 | not published | not published | $345.48 – $732.71 | 8 |
| Revision of thigh muscles CPT 27430 | not published | not published | $715.61 – $1,531.14 | 8 |
| Revision of toe CPT 28312 | not published | not published | $326.56 – $1,051.72 | 9 |
| Revision of tricuspid valve CPT 33468 | not published | not published | $2,219.24 – $4,884.90 | 8 |
| Revision of tricuspid valve w/bypass 33460 CPT 33460 | not published | not published | $2,170.91 – $4,756.12 | 8 |
| Revision of ulna CPT 25360 | not published | not published | $634.43 – $1,357.64 | 8 |
| Revision of unstable kneecap CPT 27420 | not published | not published | $719.61 – $1,546.74 | 8 |
| Revision of unstable kneecap CPT 27422 | not published | not published | $715.64 – $1,529.13 | 8 |
| Revision of upper arm CPT 24940 | not published | not published | $1,363.69 – $2,238.09 | 4 |
| Revision of ureter CPT 50700 | not published | not published | $879.96 – $1,871.41 | 8 |
| Revision of urethra CPT 53450 | not published | not published | $394.17 – $833.70 | 8 |
| Revision of urethra CPT 53460 | not published | not published | $439.12 – $932.66 | 8 |
| Revision of urethra CPT 57220 | not published | not published | $331.96 – $710.33 | 8 |
| Revision of urinary tract CPT 51820 | not published | not published | $1,029.96 – $2,189.97 | 8 |
| Revision open av fistula without thromb CPT 36832 | $9,440.15 | $9,440.15 | $685.22 – $7,929.73 | 9 |
| Revision orbitofacial bones CPT 21275 | not published | not published | $807.49 – $1,719.57 | 8 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $722.10 – $1,544.03 | 8 |
| Revision tips CPT 37183 | $24,565.60 | $24,565.60 | $345.13 – $2,480.23 | 9 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $1,525.78 – $3,273.09 | 8 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $1,645.76 – $3,532.68 | 8 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $178.13 – $391.70 | 4 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $169.96 – $762.63 | 6 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $1,110.88 – $2,459.73 | 8 |
| Revj fem anast nonautog grf CPT 35883 | not published | not published | $1,070.20 – $2,370.94 | 8 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $971.39 – $2,068.66 | 8 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $1,061.16 – $2,257.75 | 8 |
| Revj open gstr rstcv px CPT 43848 | not published | not published | $1,802.27 – $3,935.99 | 8 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,336.41 – $2,847.44 | 8 |
| Revj/rmvl nea pn w/int nstim CPT 64598 | not published | not published | $472.44 – $3,428.26 | 6 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $1,038.68 – $2,208.95 | 8 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $7,429.25 | $7,429.25 | $284.91 – $6,240.57 | 9 |
| Rev/rmvl gstr nstim eltrd CPT 43882 | not published | not published | $1,125.48 – $1,633.50 | 3 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $137.64 – $467.71 | 9 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | $6,219.35 | $6,219.35 | $122.21 – $702.85 | 9 |
| Rev rplcm arthrp 1ntrspc crv CPT 22861 | not published | not published | $2,147.21 – $4,777.82 | 8 |
| Rev rplcm rthrp 1ntrspc lmbr CPT 22862 | not published | not published | $2,152.16 – $4,781.20 | 8 |
| Rev/rplcmt sk-mnt crnl nstm CPT 61891 | not published | not published | $566.96 – $1,213.26 | 8 |
| Rev rplc/rmv thrc vrt tethrg CPT 22838 | not published | not published | $1,825.58 – $3,885.15 | 8 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | not published | not published | $822.81 – $1,758.22 | 8 |
| Revsc opn/prq tib/pero stent CPT 37234 | not published | not published | $253.26 – $6,853.83 | 9 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | $5,781.14 | $5,781.14 | $9.95 – $5,434.27 | 9 |
| Rf abltj nrv nrvtg si jt CPT 64625 | not published | not published | $188.02 – $911.67 | 9 |
| Rheumatoid factor qualitative CPT 86430 | not published | not published | $2.80 – $12.50 | 7 |
| Rheumatoid factor quantitative CPT 86431 | $133.30 | $133.30 | $2.80 – $51.09 | 9 |
| Rh ig IV CPT 90386 | not published | not published | $10.89 – $217.57 | 4 |
| Rh ig minidose im CPT 90385 | not published | not published | $33.42 – $92.85 | 4 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $1,178.27 – $2,495.66 | 8 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $967.70 | $967.70 | $4.76 – $909.64 | 7 |
| Rho d immune globulin 50 mcg HCPCS J2788 | not published | not published | $23.80 – $42.03 | 6 |
| Rho(d) immune globulin h, sd HCPCS J2792 | not published | not published | $30.77 – $58.87 | 8 |
| Rho d immune globulin inj HCPCS J2790 | $1,732.03 | $1,732.03 | $76.03 – $486.78 | 9 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $92.77 – $203.33 | 4 |
| R hrt cath chd abnl nt cnj CPT 93594 | $5,505.20 | $5,505.20 | $273.67 – $4,624.37 | 9 |
| R hrt cath chd nml nt cnj CPT 93593 | $5,505.20 | $5,505.20 | $177.96 – $4,239.82 | 9 |
| Rhythm ecg with report CPT 93040 | not published | not published | $12.20 – $26.43 | 8 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $475.85 | $475.85 | $12.22 – $299.67 | 9 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $924.40 | $924.40 | $14.70 – $400.96 | 9 |
| Rib cartilage graft CPT 21230 | not published | not published | $714.09 – $1,524.38 | 8 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $102.36 – $257.68 | 7 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $2,116.50 – $4,225.12 | 4 |
| Rib X-ray (3 views, both sides) CPT 71110 | $920.35 | $920.35 | $13.19 – $348.17 | 9 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $1,557.45 | $1,557.45 | $640.09 – $817.95 | 6 |
| Right heart cath congenital CPT 93530 | not published | not published | $422.97 – $422.97 | 1 |
| Right ventric recording CPT 93603 | $1,704.60 | $1,704.60 | $74.29 – $1,431.86 | 9 |
| Rilonacept injection HCPCS J2793 | not published | not published | $24.84 – $43.37 | 4 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $5.67 – $14.15 | 7 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $268.22 – $675.20 | 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.