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 |
|---|---|---|---|---|
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | $40.55 | $40.55 | $20.65 – $41.12 | 8 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $73.11 – $152.35 | 7 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $21.40 – $38.91 | 6 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $36.10 | $36.10 | $18.98 – $44.02 | 8 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $10.33 – $20.56 | 7 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $27.42 – $54.73 | 7 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $71.34 – $144.55 | 7 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $22.04 – $72.84 | 8 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | $27.45 | $27.45 | $5.99 – $25.80 | 9 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $326.55 | $326.55 | $228.10 – $455.60 | 6 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $213.09 – $387.41 | 4 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $1,750.58 | $1,750.58 | $170.20 – $340.00 | 6 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $1,697.40 | $1,697.40 | $141.35 – $180.62 | 6 |
| Vaccine mmr live subcutaneous CPT 90707 | $969.09 | $969.09 | $62.75 – $178.29 | 9 |
| Vaccine mmrv live subcutaneous CPT 90710 | $85.30 | $85.30 | $62.75 – $261.32 | 7 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $46.75 | $46.75 | $34.39 – $137.47 | 9 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $210.70 | $210.70 | $149.63 – $265.73 | 9 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $249.26 – $487.08 | 8 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $2,882.91 | $2,882.91 | $292.95 – $1,120.81 | 9 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $455.35 | $455.35 | $31.12 – $39.76 | 6 |
| Vaccine rabies im CPT 90675 | $4,213.36 | $4,213.36 | $244.44 – $321.39 | 9 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $330.40 – $600.68 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $0.05 | $0.05 | $0.02 – $0.05 | 9 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | $0.05 | $0.05 | $0.02 – $0.05 | 9 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $313.60 – $570.14 | 4 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $130.81 – $220.82 | 4 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $107.48 – $157.29 | 4 |
| Vaccine tdap >=7 years im CPT 90715 | $500.83 | $500.83 | $38.38 – $92.13 | 9 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $267.44 | $267.44 | $18.83 – $36.28 | 7 |
| Vaccine typhoid vicps im CPT 90691 | $1,492.00 | $1,492.00 | $63.30 – $80.89 | 6 |
| Vaccine varicella live subcutaneous CPT 90716 | $1,862.86 | $1,862.86 | $98.24 – $272.43 | 9 |
| Vaccine yellow fever live subcutaneous CPT 90717 | $4,275.71 | $4,275.71 | $147.77 – $2,631.91 | 6 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.02 | 6 |
| Vacuum drain bottle/tube kit HCPCS A7048 | not published | not published | $45.91 – $114.76 | 7 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | not published | not published | $438.84 – $1,096.86 | 7 |
| Vad cable power module dc input HCPCS Q0478 | not published | not published | $172.27 – $430.57 | 7 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | not published | not published | $3,915.54 – $9,786.75 | 7 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | not published | not published | $940.67 – $2,030.02 | 8 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $1,171.26 – $2,530.91 | 8 |
| Vag hyst including t/o CPT 58262 | not published | not published | $877.59 – $1,892.41 | 8 |
| Vag hyst t/o & repair compl CPT 58292 | not published | not published | $1,233.60 – $2,665.79 | 8 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | not published | not published | $1,146.52 – $2,477.35 | 8 |
| Vag hyst w/enterocele repair CPT 58270 | not published | not published | $846.37 – $1,824.64 | 8 |
| Vag hyst w/uro repair compl 58293 CPT 58293 | not published | not published | $2,722.91 – $2,722.91 | 1 |
| Vaginal bx CPT 58999 | $58.70 | $58.70 | $43.18 – $200.54 | 9 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | not published | not published | $827.50 – $1,842.94 | 8 |
| Vaginal Delivery (full care) CPT 59400 | not published | not published | $2,253.53 – $4,935.74 | 8 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $794.44 – $1,712.12 | 8 |
| Vaginectomy partial w/nodes CPT 57109 | not published | not published | $1,646.30 – $3,541.50 | 8 |
| Vag inser rectal control sys HCPCS A4563 | not published | not published | $120.61 – $3,197.75 | 7 |
| Vagnc compl rmvl paravag tis CPT 57111 | not published | not published | $1,646.30 – $3,541.50 | 8 |
| Vagnc compl rmvl vag wall CPT 57110 | not published | not published | $854.51 – $1,840.90 | 8 |
| Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 | not published | not published | $103.20 – $226.38 | 8 |
| Vagotomy & pylorus repair CPT 43641 | not published | not published | $1,126.68 – $2,454.99 | 8 |
| Vagotomy & pylorus repair 43640 CPT 43640 | not published | not published | $1,114.26 – $2,427.21 | 8 |
| Valproic acid total therapeutic drug level CPT 80164 | $171.45 | $171.45 | $6.69 – $105.28 | 9 |
| Valrubicin injection HCPCS J9357 | not published | not published | $1,363.85 – $2,588.82 | 8 |
| Valvuloplasty aortic CPT 92986 | $4,159.40 | $4,159.40 | $1,212.10 – $3,493.90 | 9 |
| Valvuloplasty aortic valve CPT 33390 | not published | not published | $1,752.76 – $3,828.22 | 8 |
| Valvuloplasty aortic valve CPT 33391 | not published | not published | $2,076.41 – $4,537.20 | 8 |
| Valvuloplasty mitral CPT 92987 | $9,194.55 | $9,194.55 | $1,249.68 – $7,723.42 | 9 |
| Valvuloplasty pulmonary CPT 92990 | $13,662.00 | $13,662.00 | $1,001.56 – $11,476.08 | 9 |
| Valvuloplasty/tv without ring insert 33463 CPT 33463 | not published | not published | $2,790.90 – $6,119.86 | 8 |
| Valvuloplasty/tv w/ring insertion 33464 CPT 33464 | not published | not published | $2,217.08 – $4,855.07 | 8 |
| Vancomycin hcl injection HCPCS J3370 | $918.80 | $918.80 | $2.00 – $50.90 | 9 |
| Vancomycin peak therapeutic drug level CPT 80202 | $244.05 | $244.05 | $6.69 – $161.16 | 9 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $17.33 – $71.45 | 7 |
| Vantas implant HCPCS J9225 | not published | not published | $3,087.96 – $9,556.99 | 6 |
| Variable concentration mask HCPCS A4620 | not published | not published | $0.67 – $1.67 | 7 |
| Varicella zoster antibody igg CPT 86787 | $168.95 | $168.95 | $6.36 – $57.29 | 9 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $208.77 – $3,463.96 | 8 |
| Varus/valgus strap padded/li HCPCS L2270 | not published | not published | $55.88 – $140.68 | 7 |
| Vasc emb/occ w/prs cath HCPCS C9797 | $26,068.85 | $26,068.85 | $17,379.23 – $24,504.72 | 9 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $705.99 – $1,512.86 | 8 |
| Vasectomy CPT 55250 | not published | not published | $220.27 – $648.25 | 9 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $1,017.94 | $1,017.94 | $1.82 – $56.22 | 9 |
| Vbac delivery 59610 CPT 59610 | not published | not published | $2,346.78 – $5,170.26 | 8 |
| Vbac/include postpartum care 59614 CPT 59614 | not published | not published | $1,070.61 – $2,381.80 | 8 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $33,588.05 | $33,588.05 | $22.06 – $12,530.89 | 9 |
| Veeg cont 2-12 hrs CPT 95713 | $967.10 | $967.10 | $513.54 – $805.11 | 9 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $1,808.65 | $1,808.65 | $984.67 – $1,517.40 | 9 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $503.65 | $503.65 | $301.39 – $436.54 | 9 |
| Veeg unmon 12-26 hrs CPT 95714 | $967.10 | $967.10 | $220.50 – $719.46 | 9 |
| Veeg unmon 2-12 hrs CPT 95711 | $503.65 | $503.65 | $150.29 – $390.10 | 9 |
| Vein bypass grft fem-popliteal 35583 CPT 35583 | not published | not published | $1,293.08 – $2,858.97 | 8 |
| Vein byp fem-tibial peroneal 35585 CPT 35585 | not published | not published | $1,495.95 – $3,310.37 | 8 |
| Vein byp pop-tibl peroneal CPT 35587 | not published | not published | $1,196.67 – $2,646.82 | 8 |
| Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 | not published | not published | $1,487.24 – $3,294.10 | 8 |
| Vein x-ray adrenal gland CPT 75840 | $9,131.70 | $9,131.70 | $51.68 – $7,670.63 | 9 |
| Vein x-ray adrenal glands CPT 75842 | $10,953.50 | $10,953.50 | $67.69 – $9,200.94 | 9 |
| Vein x-ray eye socket CPT 75880 | $5,754.15 | $5,754.15 | $32.00 – $4,833.49 | 9 |
| Vein x-ray kidney CPT 75831 | $7,747.35 | $7,747.35 | $48.39 – $3,087.76 | 9 |
| Vein x-ray liver CPT 75891 | $7,747.35 | $7,747.35 | $49.28 – $3,180.28 | 9 |
| Vein x-ray liver w/hemodynam CPT 75885 | $7,747.35 | $7,747.35 | $61.79 – $6,507.77 | 9 |
| Vein x-ray liver w/hemodynam CPT 75889 | $7,747.35 | $7,747.35 | $48.84 – $3,180.28 | 9 |
| Vein x-ray liver without hemodyn CPT 75887 | $5,243.85 | $5,243.85 | $62.45 – $1,914.99 | 9 |
| Vein x-ray skull CPT 75870 | $3,849.20 | $3,849.20 | $55.73 – $3,233.33 | 9 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $51.68 – $108.45 | 8 |
| Vein x-ray spleen/liver CPT 75810 | $7,747.35 | $7,747.35 | $45.54 – $6,507.77 | 9 |
| Velaglucerase alfa 400 unit intravenous solution HCPCS J3385 | not published | not published | $364.50 – $706.60 | 8 |
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.