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 |
|---|---|---|---|---|
| Sirolimus, oral HCPCS J7520 | $27.21 | $27.21 | $1.34 – $25.58 | 7 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $84.53 – $209.93 | 8 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $255.24 – $642.54 | 7 |
| Skeletal muscle relaxant 1/2 CPT 80369 | not published | not published | $5.33 – $50.16 | 4 |
| Skel musc relaxant 3 or more CPT 80370 | not published | not published | $11.79 – $11.79 | 1 |
| Skin and muscle repair face CPT 15845 | not published | not published | $1,017.41 – $2,164.89 | 8 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $6.97 – $17.41 | 7 |
| Skin Biopsy CPT 11102 | $600.90 | $600.90 | $35.72 – $194.03 | 9 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $642.78 – $1,626.72 | 9 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $100.36 – $336.01 | 9 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $705.83 – $1,707.04 | 9 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $695.15 – $1,752.64 | 9 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $103.19 – $357.21 | 9 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $5.53 – $12.89 | 8 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $2,314.74 – $5,159.41 | 8 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $3,883.91 – $8,575.52 | 8 |
| Skull X-ray (1 to 3 views) CPT 70250 | $441.85 | $441.85 | $8.33 – $278.70 | 9 |
| Skull X-ray (complete) CPT 70260 | $562.75 | $562.75 | $12.87 – $400.96 | 9 |
| Skyla, 13.5 mg HCPCS J7301 | $4,710.04 | $4,710.04 | $935.70 – $3,604.57 | 6 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $355.95 | 7 |
| Sleep study attended CPT 95807 | $9,195.35 | $9,195.35 | $55.67 – $7,724.09 | 9 |
| Sleep Study (Polysomnography) CPT 95810 | $4,570.35 | $4,570.35 | $111.70 – $443.53 | 9 |
| Sleep study unattended CPT 95806 | not published | not published | $41.52 – $87.43 | 8 |
| Sleeve fing rolyan med HCPCS L3933 | $285.45 | $285.45 | $60.81 – $168.12 | 9 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $2,765.83 – $6,088.69 | 8 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $226.30 | $226.30 | $8.55 – $212.72 | 9 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $74.49 – $147.26 | 7 |
| Sling suprapubic suburetheral HCPCS C1771 | $7,555.00 | $7,555.00 | $584.80 – $754.23 | 9 |
| Slitting of prepuce CPT 54000 | not published | not published | $106.15 – $317.37 | 9 |
| Slitting of prepuce CPT 54001 | $3,644.50 | $3,644.50 | $135.12 – $385.48 | 9 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $30.39 – $63.71 | 8 |
| Slp eval non-spch gen comm dev CPT 92605 | $636.15 | $636.15 | $84.23 – $236.41 | 9 |
| Slp pure tone screening CPT 92551 | $259.60 | $259.60 | $11.17 – $38.12 | 9 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $38.61 – $81.34 | 8 |
| Slp ther svc non-spch gen CPT 92606 | $535.60 | $535.60 | $67.09 – $113.74 | 9 |
| Sm-153 lexidron ther HCPCS A9604 | $21,300.25 | $21,300.25 | $4,314.91 – $20,022.24 | 9 |
| Small animal inoculation CPT 87003 | not published | not published | $8.32 – $34.29 | 7 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $1,054.10 | $1,054.10 | $36.54 – $580.56 | 9 |
| Small bowel endoscopy CPT 44360 | not published | not published | $134.82 – $288.06 | 8 |
| Small bowel endoscopy CPT 44364 | not published | not published | $191.36 – $408.03 | 8 |
| Small bowel endoscopy CPT 44366 | not published | not published | $224.33 – $478.53 | 8 |
| Small bowel endoscopy CPT 44369 | not published | not published | $229.74 – $490.05 | 8 |
| Small bowel endoscopy CPT 44376 | not published | not published | $265.74 – $565.96 | 8 |
| Small bowel endoscopy CPT 44378 | not published | not published | $358.72 – $766.59 | 8 |
| Small bowel endoscopy CPT 44382 | not published | not published | $70.16 – $573.72 | 9 |
| Small bowel endoscopy CPT 44384 | not published | not published | $143.48 – $305.00 | 8 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $179.36 – $382.95 | 8 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $170.70 – $364.66 | 8 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $148.98 – $317.22 | 8 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $278.71 – $596.47 | 8 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $54.45 – $379.69 | 9 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $79.67 – $1,871.51 | 9 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $249.80 – $533.42 | 8 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.01 – $302.40 | 8 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $123.50 | $123.50 | $2.66 – $54.76 | 9 |
| Smear gram stain CPT 87205 | $106.05 | $106.05 | $2.11 – $50.43 | 9 |
| Smear nasal eosinophil CPT 89190 | $87.50 | $87.50 | $2.34 – $42.30 | 9 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $175.50 | $175.50 | $2.96 – $55.07 | 9 |
| Smear wet mount CPT 87210 | $83.50 | $83.50 | $3.49 – $47.94 | 9 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $120.54 – $613.61 | 7 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $74.08 – $377.10 | 7 |
| Smpd1 gene common variants CPT 81330 | $379.05 | $379.05 | $18.80 – $48.41 | 9 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $20.43 – $103.99 | 7 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $999.30 – $2,515.56 | 7 |
| So cap design without jnts cf HCPCS L3671 | not published | not published | $761.78 – $1,917.67 | 7 |
| Socket insert above knee HCPCS L5658 | not published | not published | $400.85 – $1,009.08 | 7 |
| Socket insert below knee HCPCS L5655 | not published | not published | $299.29 – $753.41 | 7 |
| Socket insert knee articulat HCPCS L5656 | not published | not published | $355.09 – $893.89 | 7 |
| Socket insert symes HCPCS L5654 | not published | not published | $419.24 – $1,055.36 | 7 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $623.27 – $1,568.99 | 7 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $747.96 – $1,882.85 | 7 |
| Sock fracture or equal each HCPCS L3995 | not published | not published | $37.96 – $95.58 | 7 |
| Sock wool above knee HCPCS L8430 | not published | not published | $23.09 – $58.11 | 7 |
| Sodium 24 hour urine CPT 84300 | $87.50 | $87.50 | $2.40 – $59.03 | 9 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $217.57 | $217.57 | $2.63 – $49.12 | 9 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $21.48 | $21.48 | $1.32 – $20.19 | 7 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $170.02 | $170.02 | $0.66 – $3.89 | 9 |
| Sodium chloride 3 % ivpb HCPCS J7131 | not published | not published | $0.12 – $0.20 | 4 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $323.71 | $323.71 | $2.14 – $304.29 | 7 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | not published | not published | $73.10 – $140.46 | 6 |
| Sodium serum/plasma/whole blood CPT 84295 | $87.50 | $87.50 | $2.38 – $46.01 | 9 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $824.54 | $824.54 | $1.95 – $443.07 | 9 |
| Soft interface below knee se HCPCS L2820 | not published | not published | $102.62 – $258.35 | 7 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $85.22 – $87.77 | 5 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,345.31 – $2,819.01 | 6 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $2,505.78 | 6 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $6,890.86 | 6 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $2,192.56 | 6 |
| Solid skin barrier HCPCS A4362 | not published | not published | $3.29 – $8.80 | 7 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $8.22 – $20.57 | 7 |
| Somatosensory testing CPT 95927 | not published | not published | $25.75 – $54.22 | 8 |
| Somatropin injection HCPCS J2941 | not published | not published | $48.92 – $154.84 | 8 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,989.55 – $6,264.41 | 6 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $1,879.33 | 6 |
| Sotalol hydrochloride IV HCPCS C9482 | $7,406.79 | $7,406.79 | $22.41 – $6,962.38 | 9 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $148.36 – $373.48 | 7 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $15.59 – $23.05 | 3 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $154.03 – $337.54 | 8 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $167.72 – $372.11 | 8 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $153.24 – $237.24 | 4 |
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.