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 |
|---|---|---|---|---|
| Ultrasound hips infant dynamic CPT 76885 | $606.10 | $606.10 | $33.62 – $509.12 | 9 |
| Ultrasound infant hips ltd without stress CPT 76886 | $518.50 | $518.50 | $28.22 – $435.54 | 9 |
| Ultrasound joint complete left CPT 76881 | $696.05 | $696.05 | $10.36 – $395.14 | 9 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $14.62 – $109.87 | 8 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $635.80 | $635.80 | $39.49 – $156.41 | 9 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $584.80 | $584.80 | $20.30 – $165.61 | 9 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $1,183.80 | $1,183.80 | $86.20 – $422.48 | 9 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $785.00 | $785.00 | $38.72 – $65.99 | 9 |
| Ultrasound prostate/transrectal CPT 76872 | $687.70 | $687.70 | $30.93 – $577.67 | 9 |
| Ultrasound spinal canal and contents CPT 76800 | $797.45 | $797.45 | $58.44 – $175.73 | 9 |
| Ultrasound transabd ea addl gest CPT 76812 | $1,906.25 | $1,906.25 | $81.01 – $496.73 | 9 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $73.20 – $154.54 | 8 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $38.49 – $80.65 | 8 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.00 – $16.94 | 8 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $64.10 – $136.24 | 8 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $294.41 – $1,058.05 | 8 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $530.04 – $1,000.43 | 4 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $11,206.70 – $28,010.74 | 7 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $23.70 – $24.41 | 5 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $23.70 – $24.41 | 5 |
| Unlisted chemotherapy px CPT 96549 | $149.15 | $149.15 | $0.67 – $92.21 | 9 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | $336.70 | $336.70 | $224.75 – $316.50 | 9 |
| Unlisted CT procedure CPT 76497 | $2,810.00 | $2,810.00 | $44.07 – $2,641.40 | 9 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $388.91 – $400.57 | 5 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $51.71 – $53.26 | 5 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $51.71 – $53.26 | 5 |
| Unlisted dx gi procedure CPT 91299 | $1,711.55 | $1,711.55 | $151.43 – $1,608.86 | 9 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $388.91 – $400.57 | 5 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $194.70 – $200.54 | 5 |
| Unlisted fluoroscopic px CPT 76496 | $685.40 | $685.40 | $48.12 – $644.28 | 9 |
| Unlisted gi px dx nuc med CPT 78299 | $1,792.95 | $1,792.95 | $388.91 – $1,685.37 | 9 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $388.91 – $400.57 | 5 |
| Unlisted hystsc px uterus CPT 58579 | $775.95 | $775.95 | $146.24 – $200.54 | 9 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px esoph CPT 43289 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px lymphtc sys CPT 38589 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px ovidct ovry CPT 58679 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px renal CPT 50549 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px spleen CPT 38129 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px testis CPT 54699 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px ureter CPT 50949 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted laps px uterus CPT 58578 | not published | not published | $5,646.73 – $5,816.13 | 5 |
| Unlisted maxlfcl prosth px CPT 21089 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted misc path test CPT 89240 | not published | not published | $51.71 – $53.26 | 5 |
| Unlisted mr procedure CPT 76498 | $2,447.25 | $2,447.25 | $38.64 – $1,332.54 | 9 |
| Unlisted muscskel px dx nuc CPT 78399 | not published | not published | $388.91 – $400.57 | 5 |
| Unlisted muscskel px head CPT 21499 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted neurological dx px CPT 95999 | $207.05 | $207.05 | $92.72 – $155.97 | 9 |
| Unlisted nrvs sys px dx nuc CPT 78699 | not published | not published | $388.91 – $400.57 | 5 |
| Unlisted oph svc/procedure CPT 92499 | not published | not published | $23.70 – $24.41 | 5 |
| Unlisted orl service/px CPT 92700 | not published | not published | $23.70 – $24.41 | 5 |
| Unlisted procedure colon CPT 45399 | $3,909.30 | $3,909.30 | $882.39 – $3,674.74 | 9 |
| Unlisted procedure esophagus CPT 43499 | $1,929.50 | $1,929.50 | $907.41 – $1,813.73 | 9 |
| Unlisted procedure eyelids CPT 67999 | not published | not published | $289.32 – $298.00 | 5 |
| Unlisted procedure larynx CPT 31599 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted procedure liver CPT 47399 | $7,912.85 | $7,912.85 | $680.96 – $7,438.08 | 9 |
| Unlisted procedure orbit CPT 67599 | not published | not published | $289.32 – $298.00 | 5 |
| Unlisted procedure pancreas CPT 48999 | not published | not published | $680.96 – $701.39 | 5 |
| Unlisted procedure rectum CPT 45999 | $1,220.35 | $1,220.35 | $207.75 – $908.86 | 9 |
| Unlisted procedure spine CPT 22899 | $5,541.30 | $5,541.30 | $232.17 – $5,208.82 | 9 |
| Unlisted procedure urinary 58750 CPT 58750 | not published | not published | $859.59 – $1,855.13 | 8 |
| Unlisted psychiatric service/proc 90899 CPT 90899 | not published | not published | $28.83 – $29.70 | 5 |
| Unlisted px abdomen muscskel CPT 22999 | not published | not published | $232.17 – $239.13 | 5 |
| Unlisted px accessory sinus CPT 31299 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px ant segment eye CPT 66999 | not published | not published | $2,207.38 – $2,273.60 | 5 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | $232.17 – $239.13 | 5 |
| Unlisted px biliary tract CPT 47999 | not published | not published | $907.41 – $934.63 | 5 |
| Unlisted px casting/strpg CPT 29799 | not published | not published | $152.72 – $157.30 | 5 |
| Unlisted px conjunctiva CPT 68399 | not published | not published | $289.32 – $298.00 | 5 |
| Unlisted px exc pressure ulc CPT 15999 | not published | not published | $680.96 – $701.39 | 5 |
| Unlisted px external ear CPT 69399 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px extraocular musc CPT 67399 | not published | not published | $289.32 – $298.00 | 5 |
| Unlisted px foot/toes CPT 28899 | not published | not published | $232.17 – $239.13 | 5 |
| Unlisted px forearm/wrist CPT 25999 | not published | not published | $232.17 – $239.13 | 5 |
| Unlisted px hands/fingers CPT 26989 | $417.70 | $417.70 | $119.54 – $239.13 | 9 |
| Unlisted px inner ear CPT 69949 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px lacrimal system CPT 68899 | not published | not published | $289.32 – $565.17 | 6 |
| Unlisted px leg/ankle CPT 27899 | not published | not published | $232.17 – $239.13 | 5 |
| Unlisted px male genital sys CPT 55899 | $3,849.20 | $3,849.20 | $235.39 – $3,618.25 | 9 |
| Unlisted px med radj physics CPT 77399 | not published | not published | $128.50 – $132.36 | 5 |
| Unlisted px middle ear CPT 69799 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px neck/thorax CPT 21899 | $8,585.60 | $8,585.60 | $224.75 – $8,070.46 | 9 |
| Unlisted px palate uvula CPT 42299 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px pelvis/hip joint CPT 27299 | $13,363.70 | $13,363.70 | $232.17 – $12,561.88 | 9 |
| Unlisted px posterior segmnt CPT 67299 | not published | not published | $2,207.38 – $2,273.60 | 5 |
| Unlisted px salivry glnd/dux CPT 42699 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px small intestine CPT 44799 | $1,918.15 | $1,918.15 | $81.35 – $934.63 | 9 |
| Unlisted px temporal bone CPT 69979 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px ther rad tx plng CPT 77299 | not published | not published | $128.50 – $132.36 | 5 |
| Unlisted px tongue flr mouth CPT 41599 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted px vestibule mouth CPT 40899 | not published | not published | $224.75 – $231.49 | 5 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $51.71 – $53.26 | 5 |
| Unlisted resp px dx nuc med CPT 78599 | $744.70 | $744.70 | $388.91 – $700.02 | 9 |
| Unlisted spec derm svc/px CPT 96999 | not published | not published | $192.31 – $388.41 | 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.