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 |
|---|---|---|---|---|
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $441.60 – $965.18 | 8 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | not published | not published | $1,151.86 – $2,513.28 | 8 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | not published | not published | $823.65 – $1,794.14 | 8 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | not published | not published | $794.72 – $1,741.28 | 8 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $592.57 – $1,295.96 | 8 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $529.92 – $1,159.05 | 8 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $391.47 – $856.06 | 8 |
| Rpr acq av fistula thrx&abd CPT 35189 | not published | not published | $1,353.76 – $2,997.92 | 8 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | $923.25 – $1,995.44 | 8 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | not published | not published | $836.96 – $1,843.62 | 8 |
| Rpr blvs gr ot/th vn ntrth w CPT 35271 | not published | not published | $1,259.86 – $2,768.13 | 8 |
| Rpr blvs gr ot/t vn ntrth wo CPT 35276 | not published | not published | $1,332.13 – $2,905.74 | 8 |
| Rpr blvsl gr ot/th vn ntr-ab CPT 35281 | not published | not published | $1,478.91 – $3,227.01 | 8 |
| Rpr blvsl vn grf intra-abdl CPT 35251 | not published | not published | $1,569.93 – $3,460.17 | 8 |
| Rpr blvsl vn grf ntrthrc w/b CPT 35241 | not published | not published | $1,310.12 – $2,859.64 | 8 |
| Rpr cgen av fistula thrx&abd CPT 35182 | not published | not published | $1,636.22 – $3,586.24 | 8 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $709.74 – $1,503.37 | 8 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $959.05 – $2,035.44 | 8 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | not published | not published | $1,052.58 – $2,297.75 | 8 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | not published | not published | $870.92 – $1,889.72 | 8 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | not published | not published | $795.35 – $1,731.79 | 8 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $597.75 – $1,294.60 | 8 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $752.01 – $1,633.50 | 8 |
| Rpr hypopl a-arch w/byp CPT 33853 | not published | not published | $1,674.10 – $3,670.96 | 8 |
| Rpr hypopl a-arch wo byp CPT 33852 | not published | not published | $1,282.89 – $2,808.12 | 8 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $959.18 – $2,040.17 | 8 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $545.25 – $1,158.35 | 8 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $582.92 – $1,262.75 | 8 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $387.93 – $839.12 | 8 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $574.11 – $1,243.77 | 8 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $397.19 – $856.73 | 8 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $901.12 – $1,960.88 | 8 |
| Rpr intst excl anrect fist HCPCS C9796 | not published | not published | $2,654.19 – $2,733.82 | 5 |
| Rpr nsl vlv collapse w/implt CPT 30468 | not published | not published | $160.93 – $4,817.85 | 9 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | $142.54 – $4,708.62 | 9 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | not published | not published | $699.41 – $1,504.04 | 8 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | not published | not published | $868.09 – $1,854.47 | 8 |
| Rpr pul art unifocal without cpb CPT 33925 | not published | not published | $1,557.65 – $3,423.56 | 8 |
| Rpr&refitg spect xcp aphakia CPT 92370 | not published | not published | $15.27 – $58.46 | 7 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $10.86 – $59.21 | 7 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $547.39 – $1,184.11 | 8 |
| Rpr tga aortic pulm art rcns CPT 33778 | not published | not published | $2,134.20 – $4,693.09 | 8 |
| Rpr tga atr bfl clsr vsd CPT 33776 | not published | not published | $1,790.30 – $3,925.14 | 8 |
| Rpr tga atr bfl rmvl plm bnd CPT 33775 | not published | not published | $1,692.17 – $3,709.59 | 8 |
| Rpr tga atrial baffle px CPT 33774 | not published | not published | $1,646.03 – $3,605.91 | 8 |
| Rpr tga bfl rpr sbpulm obstr CPT 33777 | not published | not published | $1,719.68 – $3,778.07 | 8 |
| Rpr tga rcnstj clsr vsd CPT 33780 | not published | not published | $2,140.89 – $4,714.11 | 8 |
| Rpr tga rcnstj rmvl plm bnd CPT 33779 | not published | not published | $2,099.24 – $4,625.31 | 8 |
| Rpr tga rcnstj rpr sbpl obst CPT 33781 | not published | not published | $2,085.50 – $4,597.52 | 8 |
| Rpr tga without surg enlgmnt vsd CPT 33770 | not published | not published | $1,915.00 – $4,215.24 | 8 |
| Rpr tga w/surg enlgmnt vsd CPT 33771 | not published | not published | $1,965.32 – $4,331.81 | 8 |
| Rpr umbil hern block < 5 yr CPT 49582 | not published | not published | $938.85 – $938.85 | 1 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | $12,440.55 | $12,440.55 | $337.08 – $742.87 | 9 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $216.92 – $482.66 | 6 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $897.24 – $1,908.69 | 8 |
| Rsect hip tum incl femur CPT 27078 | not published | not published | $1,940.72 – $4,169.83 | 8 |
| Rsv assay w/optic CPT 87807 | not published | not published | $8.88 – $26.67 | 7 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $607.68 – $607.68 | 1 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $17.66 – $40.66 | 8 |
| Rtm dev sply cbt 16-30 d CPT 98978 | not published | not published | $36.09 – $96.25 | 6 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $36.09 – $91.23 | 8 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $36.09 – $91.23 | 8 |
| Rtm tx mgmt 1st 20 min CPT 98980 | not published | not published | $29.09 – $97.65 | 9 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | not published | not published | $28.44 – $77.10 | 9 |
| Rubella antibody igg CPT 86762 | $181.85 | $181.85 | $7.11 – $75.29 | 9 |
| Rubeola ag if CPT 87283 | not published | not published | $23.64 – $123.80 | 7 |
| Rubeola antibody igg CPT 86765 | $160.90 | $160.90 | $6.36 – $63.31 | 9 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $329.51 – $670.95 | 7 |
| Russell viper venom diluted CPT 85613 | $120.45 | $120.45 | $4.73 – $39.06 | 9 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $699.20 – $1,867.36 | 7 |
| Sach foot, replacement HCPCS L5971 | not published | not published | $256.73 – $646.29 | 7 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $9,018.80 | $9,018.80 | $33.20 – $8,477.67 | 9 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $607.60 | $607.60 | $10.27 – $278.70 | 9 |
| Safety plan interven HCPCS G0560 | not published | not published | $40.80 – $86.08 | 6 |
| Salivary gland function exam CPT 78232 | not published | not published | $18.03 – $37.28 | 8 |
| Salivary gland imaging CPT 78230 | not published | not published | $20.22 – $42.70 | 8 |
| Salivary glnd img serial img CPT 78231 | $871.70 | $871.70 | $19.98 – $732.23 | 9 |
| Salmonella antibody CPT 86768 | not published | not published | $6.51 – $26.86 | 7 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $814.09 – $1,756.18 | 8 |
| Same day nb discharge 99463 CPT 99463 | $724.00 | $724.00 | $102.41 – $217.57 | 9 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $1.24 – $8.57 | 3 |
| Sargramostim injection HCPCS J2820 | not published | not published | $56.09 – $114.21 | 8 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $9.05 – $104.72 | 7 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $145.60 – $284.68 | 8 |
| Sarscov coronavirus ag ia CPT 87426 | not published | not published | $21.31 – $71.94 | 7 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $29.83 – $143.12 | 7 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $382.02 – $817.43 | 8 |
| Sbrt management CPT 77435 | not published | not published | $621.81 – $1,298.67 | 8 |
| Sbrt w/positron emission del HCPCS G0563 | not published | not published | $3,629.88 – $3,738.78 | 5 |
| Sbsq ic vlbw inf<1,500 gm CPT 99478 | not published | not published | $125.18 – $265.70 | 8 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $353.60 | $353.60 | $146.86 – $310.44 | 9 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $146.55 | $146.55 | $71.25 – $150.47 | 9 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $193.65 | $193.65 | $96.83 – $217.57 | 9 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $96.80 | $96.80 | $38.22 – $80.65 | 9 |
| Sbsq psyc collab care mgmt CPT 99493 | not published | not published | $89.53 – $269.84 | 9 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $2,755.05 | $2,755.05 | $35.63 – $2,314.24 | 9 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,506.65 | $1,506.65 | $21.82 – $1,265.59 | 9 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,012.70 | $1,012.70 | $21.82 – $577.67 | 9 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,348.50 | $1,348.50 | $19.78 – $42.01 | 9 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,222.50 | $1,222.50 | $21.28 – $276.36 | 9 |
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.