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 |
|---|---|---|---|---|
| Biopsy of sacroiliac joint CPT 27050 | not published | not published | $391.99 – $845.90 | 8 |
| Biopsy of salivary gland 42400 CPT 42400 | $1,396.15 | $1,396.15 | $50.94 – $184.38 | 9 |
| Biopsy of salivary glnd;incisional 42405 CPT 42405 | not published | not published | $218.60 – $591.71 | 9 |
| Biopsy of stomach CPT 43605 | not published | not published | $791.84 – $1,703.99 | 8 |
| Biopsy of tear gland CPT 68510 | not published | not published | $272.64 – $864.12 | 9 |
| Biopsy of tear sac CPT 68525 | not published | not published | $243.35 – $515.14 | 8 |
| Biopsy of testis CPT 54500 | not published | not published | $70.97 – $150.48 | 8 |
| Biopsy of testis CPT 54505 | not published | not published | $201.23 – $425.67 | 8 |
| Biopsy of toe joint lining CPT 28054 | not published | not published | $226.76 – $706.07 | 9 |
| Biopsy of upper nose/throat CPT 42804 | not published | not published | $118.31 – $419.52 | 9 |
| Biopsy of urethra CPT 53200 | not published | not published | $134.41 – $307.10 | 9 |
| Biopsy of wrist joint CPT 25100 | not published | not published | $339.32 – $731.34 | 8 |
| Biopsy oocyte polar body CPT 89291 | not published | not published | $165.85 – $170.82 | 5 |
| Biopsy oocyte polar body <=5 CPT 89290 | not published | not published | $165.85 – $170.82 | 5 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | $418.82 – $904.19 | 8 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | not published | not published | $446.81 – $956.38 | 8 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,882.05 | $1,882.05 | $118.86 – $976.55 | 9 |
| Biopsy roof of mouth CPT 42100 | $2,790.80 | $2,790.80 | $106.11 – $283.33 | 9 |
| Biopsy skin incisional single lesion CPT 11106 | $655.15 | $655.15 | $53.43 – $285.59 | 9 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $797.45 | $797.45 | $149.91 – $516.54 | 9 |
| Biopsy thigh soft tissues CPT 27324 | not published | not published | $394.83 – $850.64 | 8 |
| Biopsy tongue anterior two-thirds CPT 41100 | not published | not published | $103.72 – $363.00 | 9 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | not published | not published | $140.79 – $345.01 | 9 |
| Biopsy vestibule of mouth 40808 CPT 40808 | not published | not published | $85.29 – $327.66 | 9 |
| Biopsy vrt bdy open lmbr/crv CPT 20251 | not published | not published | $401.20 – $858.10 | 8 |
| Biopsy vrt bdy open thoracic CPT 20250 | not published | not published | $370.02 – $802.51 | 8 |
| Biospy of bladder CPT 53899 | $3,827.05 | $3,827.05 | $235.39 – $444.67 | 9 |
| Biotinidase - quest CPT 82261 | not published | not published | $8.33 – $34.35 | 7 |
| Biovance 1 square cm HCPCS Q4154 | $2,158.00 | $2,158.00 | $140.88 – $747.30 | 7 |
| Biovance tri or 3l, sq cm HCPCS Q4283 | not published | not published | $1,059.21 – $2,532.39 | 4 |
| Bis xtracell fluid analysis CPT 93702 | $229.20 | $229.20 | $115.98 – $215.45 | 9 |
| Bivalirudin HCPCS J0583 | $916.15 | $916.15 | $0.19 – $861.18 | 7 |
| Bk/ak locking mechanism HCPCS L5671 | not published | not published | $471.59 – $1,187.17 | 7 |
| Bk back check HCPCS L5686 | not published | not published | $57.10 – $143.74 | 7 |
| Bk flex inner socket ext fra HCPCS L5645 | not published | not published | $842.50 – $2,120.84 | 7 |
| Bk fork strap HCPCS L5684 | not published | not published | $57.16 – $143.88 | 7 |
| Bk joint covers pair HCPCS L5678 | not published | not published | $37.64 – $94.76 | 7 |
| Bk knee joints polycentric p HCPCS L5677 | not published | not published | $623.28 – $1,568.99 | 7 |
| Bk knee joints single axis p HCPCS L5676 | not published | not published | $450.03 – $1,132.90 | 7 |
| Bk molded distal cushion HCPCS L5668 | not published | not published | $117.45 – $295.68 | 7 |
| Bk molded supracondylar susp HCPCS L5670 | not published | not published | $273.25 – $687.87 | 7 |
| Bk mold socket sach ft endo HCPCS L5301 | not published | not published | $2,325.68 – $5,854.54 | 7 |
| Bk removable medial brim sus HCPCS L5672 | not published | not published | $332.40 – $836.76 | 7 |
| Bk thigh lacer glut/ischia m HCPCS L5682 | not published | not published | $790.55 – $1,990.10 | 7 |
| Bk thigh lacer non-molded HCPCS L5680 | not published | not published | $327.60 – $824.66 | 7 |
| Bk waist belt padded and lin HCPCS L5690 | not published | not published | $123.70 – $311.40 | 7 |
| Bk waist belt webbing HCPCS L5688 | not published | not published | $67.33 – $169.47 | 7 |
| Bladder calculi irrig sol HCPCS Q2004 | not published | not published | $29.14 – $289.34 | 4 |
| Bladder Catheter Insertion (simple) CPT 51702 | $233.80 | $233.80 | $23.45 – $68.29 | 9 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $573.45 | $573.45 | $28.09 – $147.77 | 9 |
| Bladder irrigation tubing HCPCS A4355 | not published | not published | $8.43 – $21.05 | 7 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $113.59 – $250.11 | 8 |
| Bld prd mix CPT 86965 | $120.15 | $120.15 | $13.82 – $170.82 | 9 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $46.70 – $98.97 | 8 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $902.37 | $902.37 | $21.02 – $267.95 | 9 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $494.75 – $1,120.46 | 9 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $382.62 – $893.66 | 9 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $529.03 – $1,201.41 | 9 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $527.80 – $1,199.48 | 9 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $9,403.61 | $9,403.61 | $138.79 – $8,839.39 | 9 |
| Blind cor sinus reducer impl HCPCS C9783 | not published | not published | $10,975.86 – $11,305.13 | 5 |
| Blinded conv. tx mdd clin tr HCPCS G2000 | not published | not published | $134.13 – $528.94 | 5 |
| Blind interatrial shunt ide HCPCS C9758 | not published | not published | $16,937.68 – $17,445.81 | 5 |
| Blind myocar trpl bon marrow HCPCS C9782 | not published | not published | $16,937.68 – $17,445.81 | 5 |
| Blind/nonblind trans atrial HCPCS C9792 | not published | not published | $9,436.92 – $9,720.03 | 5 |
| Blink reflex test CPT 95933 | not published | not published | $29.54 – $62.35 | 8 |
| Blm gene CPT 81209 | $316.85 | $316.85 | $15.72 – $40.49 | 9 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $16,319.60 | $16,319.60 | $8.46 – $10.81 | 6 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $9,458.30 | $9,458.30 | $13.20 – $61.88 | 9 |
| Bln dil 900ml preperitnl HCPCS C1727 | $5,217.20 | $5,217.20 | $94.97 – $213.20 | 9 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $14,800.30 | $14,800.30 | $864.33 – $1,104.50 | 6 |
| Bln press regulation 71-80cm HCPCS C1815 | $6,695.00 | $6,695.00 | $1,040.40 – $2,735.40 | 9 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $11,068.50 | $11,068.50 | $135.35 – $172.96 | 6 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | not published | not published | $13.63 – $34.09 | 7 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | $1,562.80 | $1,562.80 | $72.75 – $1,312.75 | 9 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | not published | not published | $68.00 – $144.37 | 8 |
| Block paracervical nrv CPT 64435 | $437.65 | $437.65 | $41.09 – $155.47 | 9 |
| Block plantar digital nerve CPT 64455 | $496.05 | $496.05 | $31.54 – $96.38 | 9 |
| Block tap inj(s) w/wo img bi CPT 64488 | $4,450.15 | $4,450.15 | $56.88 – $226.92 | 9 |
| Block tap inj(s) w/wo img uni CPT 64486 | $3,702.00 | $3,702.00 | $49.12 – $152.11 | 9 |
| Blood clot lysis time CPT 85175 | not published | not published | $8.00 – $41.48 | 7 |
| Blood clot retraction CPT 85170 | not published | not published | $6.52 – $33.19 | 7 |
| Blood Clotting (PT/INR) Test CPT 85610 | $117.50 | $117.50 | $2.91 – $47.38 | 9 |
| Blood Clotting (PTT) Test CPT 85730 | $178.15 | $178.15 | $2.97 – $71.35 | 9 |
| Blood component/product noc HCPCS P9099 | not published | not published | $48.93 – $50.40 | 5 |
| Blood Count (CBC) Test CPT 85025 | $143.70 | $143.70 | $5.75 – $89.77 | 9 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $129.10 | $129.10 | $4.79 – $76.23 | 9 |
| Blood count spun microhematocrit CPT 85013 | not published | not published | $4.20 – $14.25 | 7 |
| Blood Culture Test CPT 87040 | $215.10 | $215.10 | $5.10 – $124.22 | 9 |
| Blood draw capillary 36416 CPT 36416 | $31.85 | $31.85 | $2.34 – $12.95 | 9 |
| Blood Draw (Venipuncture) CPT 36415 | $51.00 | $51.00 | $3.00 – $25.85 | 9 |
| Blood gases o2 saturation direct measurement CPT 82805 | $445.90 | $445.90 | $31.51 – $206.94 | 9 |
| Blood gases ph venous CPT 82800 | $88.90 | $88.90 | $4.40 – $46.01 | 9 |
| Blood, l/r, irradiated HCPCS P9056 | not published | not published | $84.17 – $86.70 | 5 |
| Blood mucoprotein HCPCS P2038 | not published | not published | $2.44 – $10.08 | 7 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $149.90 | $149.90 | $7.86 – $60.40 | 9 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $59.40 | $59.40 | $2.54 – $26.09 | 9 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $13.35 | $13.35 | $2.63 – $12.55 | 9 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $119.50 | $119.50 | $3.19 – $12.50 | 9 |
| Blood smear interpretation CPT 85060 | $91.85 | $91.85 | $21.82 – $77.15 | 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.