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 |
|---|---|---|---|---|
| Storage/year oocyte(s) CPT 89346 | not published | not published | $165.85 – $170.82 | 5 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $165.85 – $170.82 | 5 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $165.85 – $170.82 | 5 |
| Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 | not published | not published | $438.57 – $976.70 | 8 |
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $151.94 – $382.48 | 7 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $12.37 – $25.08 | 3 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $3.66 – $9.16 | 7 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $271.50 | $271.50 | $16.53 – $53.96 | 9 |
| Strapping of chest CPT 29200 | not published | not published | $17.08 – $61.68 | 9 |
| Strapping of elbow or wrist 29260 CPT 29260 | $356.20 | $356.20 | $17.83 – $48.55 | 9 |
| Strapping of hand or finger CPT 29280 | $116.50 | $116.50 | $18.70 – $31.44 | 9 |
| Strapping of hip CPT 29520 | $140.00 | $140.00 | $17.62 – $66.81 | 9 |
| Strapping of knee CPT 29530 | $335.80 | $335.80 | $17.30 – $56.54 | 9 |
| Strapping of toes 29550 CPT 29550 | $290.80 | $290.80 | $10.48 – $37.27 | 9 |
| Strep a ag ia CPT 87430 | $162.50 | $162.50 | $6.72 – $134.19 | 9 |
| Strep a dna dir probe CPT 87650 | not published | not published | $9.90 – $40.83 | 7 |
| Strep a dna quant CPT 87652 | not published | not published | $20.62 – $85.03 | 7 |
| Strep b assay w/optic CPT 87802 | not published | not published | $5.92 – $25.92 | 7 |
| Strep b dna amp probe CPT 87653 | not published | not published | $17.33 – $71.45 | 7 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $79.50 – $149.11 | 4 |
| Streptokinase antibody CPT 86590 | not published | not published | $5.46 – $25.78 | 7 |
| Streptomycin injection HCPCS J3000 | not published | not published | $31.98 – $44.31 | 6 |
| Streptozocin injection HCPCS J9320 | not published | not published | $355.85 – $729.03 | 6 |
| Stress test pulmonary CPT 94618 | $793.00 | $793.00 | $12.32 – $41.76 | 9 |
| Stress tte complete CPT 93351 | $1,668.05 | $1,668.05 | $77.96 – $164.03 | 9 |
| Str markers spec anal addl CPT 81266 | not published | not published | $121.92 – $620.65 | 7 |
| Str markers specimen anal CPT 81265 | not published | not published | $106.20 – $474.58 | 7 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $105.61 – $233.84 | 8 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | not published | not published | $364.18 – $773.36 | 8 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | $49.22 – $158.04 | 9 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $96.17 – $280.76 | 9 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | $393.95 | $393.95 | $113.72 – $241.29 | 9 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | $399.90 | $399.90 | $109.51 – $232.49 | 9 |
| Subsequent repair of nerve CPT 64872 | not published | not published | $107.56 – $231.80 | 8 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $623.03 – $1,341.37 | 8 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $499.90 – $1,051.94 | 8 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $615.92 – $1,319.68 | 8 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $843.38 – $1,803.63 | 8 |
| Subtemporal cranial dcmprn CPT 61340 | not published | not published | $1,344.16 – $2,980.28 | 8 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $19.72 | $19.72 | $0.82 – $17.62 | 6 |
| Suction lipectomy head&neck CPT 15876 | not published | not published | $864.75 – $3,649.53 | 6 |
| Suction lipectomy lwr extrem CPT 15879 | not published | not published | $3,543.23 – $3,649.53 | 5 |
| Suction lipectomy trunk CPT 15877 | not published | not published | $864.75 – $3,649.53 | 6 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $770.96 – $1,823.51 | 6 |
| Suction socket HCPCS L6686 | not published | not published | $746.28 – $1,878.66 | 7 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $510.74 – $1,285.72 | 7 |
| Sugars multiple quant CPT 84379 | not published | not published | $5.69 – $23.48 | 7 |
| Sugars single quant CPT 84378 | not published | not published | $5.69 – $23.48 | 7 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $24,339.44 | $24,339.44 | $286.12 – $1,142.80 | 9 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $127.65 | $127.65 | $33.90 – $78.22 | 9 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $3.17 – $50.16 | 4 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $122.16 | $122.16 | $29.73 – $82.20 | 9 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $2.64 – $6.68 | 7 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $3.14 – $32.13 | 9 |
| Supply of digital device HCPCS G0552 | not published | not published | $124.73 – $128.47 | 5 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $19.71 – $49.81 | 7 |
| Support clav 29.6-40.5in med HCPCS L3650 | not published | not published | $64.01 – $161.12 | 7 |
| Supprelin la implant HCPCS J9226 | $55,483.23 | $55,483.23 | $40,813.46 – $52,154.24 | 9 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $72.24 – $150.64 | 6 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $62.37 – $131.38 | 6 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $100.25 – $214.19 | 8 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $758.75 – $1,672.81 | 8 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $758.82 – $1,673.50 | 8 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $408.43 – $866.22 | 8 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $1,076.18 – $2,342.49 | 8 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $640.17 – $1,370.51 | 8 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $707.33 – $1,512.16 | 8 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $881.91 – $1,884.97 | 8 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $648.75 – $1,386.77 | 8 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $830.81 – $1,767.03 | 8 |
| Surgical opening esophagus CPT 43351 | not published | not published | $1,220.31 – $2,661.72 | 8 |
| Surgical opening esophagus CPT 43352 | not published | not published | $988.42 – $2,154.06 | 8 |
| Surgical opening of stomach CPT 43510 | not published | not published | $892.87 – $1,939.87 | 8 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $739.81 – $1,605.03 | 8 |
| Surgical opening of throat CPT 42955 | $5,035.40 | $5,035.40 | $728.25 – $4,229.74 | 9 |
| Surgical pathology level 1 gross examination only CPT 88300 | $147.85 | $147.85 | $4.11 – $51.45 | 9 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $338.90 | $338.90 | $6.38 – $155.74 | 9 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $427.80 | $427.80 | $10.60 – $275.18 | 9 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $550.80 | $550.80 | $34.91 – $304.84 | 9 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $860.85 | $860.85 | $76.62 – $573.26 | 9 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,184.05 | $1,184.05 | $135.28 – $447.59 | 9 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | not published | not published | $1,256.25 – $2,750.52 | 8 |
| Surgical repair stomach gastric lac 43502 CPT 43502 | not published | not published | $1,420.51 – $3,102.29 | 8 |
| Surgical revision intestine CPT 44680 | not published | not published | $1,004.49 – $2,189.97 | 8 |
| Surgical trays HCPCS A4550 | not published | not published | $34.86 – $39.98 | 2 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $85.00 – $263.76 | 4 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | not published | not published | $406.14 – $1,092.19 | 9 |
| Susceptibility agar dilution per agent CPT 87181 | $224.15 | $224.15 | $2.34 – $30.74 | 9 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $36.95 | $36.95 | $2.34 – $11.56 | 9 |
| Susceptibility mic per plate CPT 87186 | $227.30 | $227.30 | $4.27 – $103.35 | 9 |
| Suscept studies macrobroth dilution ea CPT 87188 | not published | not published | $3.28 – $13.52 | 7 |
| Suspend bowel w/prosthesis CPT 44700 | not published | not published | $938.76 – $2,027.97 | 8 |
| Suspension of testis CPT 54620 | not published | not published | $285.01 – $605.28 | 8 |
| Suspension of uterus CPT 58410 | not published | not published | $771.35 – $1,663.31 | 8 |
| Suspension of uterus 58400 CPT 58400 | not published | not published | $440.80 – $943.49 | 8 |
| Suspension sleeve lower ext HCPCS L2397 | not published | not published | $109.73 – $276.21 | 7 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | not published | not published | $981.75 – $2,137.09 | 8 |
| Suture bile duct injury 47900 CPT 47900 | not published | not published | $1,287.07 – $2,806.09 | 8 |
| Svc venogram s&i CPT 75827 | $2,449.45 | $2,449.45 | $49.78 – $575.48 | 9 |
| Swallowing Evaluation (Bedside) CPT 92610 | $788.40 | $788.40 | $68.76 – $164.47 | 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.