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 |
|---|---|---|---|---|
| Wrist X-ray (2 views, both wrists) CPT 73100 | $293.05 | $293.05 | $7.68 – $210.13 | 9 |
| Wrst mld sck flx hng tri pad HCPCS L6050 | not published | not published | $1,995.21 – $5,022.65 | 7 |
| Xcapsl ctrc rmvl cplx w/ecp CPT 66987 | not published | not published | $865.40 – $1,746.78 | 8 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $710.03 – $1,497.25 | 8 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $651.93 – $1,374.58 | 8 |
| Xcapsl ctrc rmvl w/ecp CPT 66988 | not published | not published | $706.20 – $1,420.75 | 8 |
| Xcellistem, 1 mg HCPCS A2004 | not published | not published | $13.26 – $300.95 | 3 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $814.52 – $1,718.22 | 8 |
| Xe133 xenon 10mci HCPCS A9558 | not published | not published | $236.01 – $563.97 | 9 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $598.54 – $1,472.54 | 9 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $541.84 – $1,364.60 | 9 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $846.27 – $1,861.09 | 7 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $846.27 – $1,861.09 | 7 |
| Xm archive tissue molec anal CPT 88363 | not published | not published | $17.96 – $44.33 | 9 |
| Xpos opn axillary/sbclvn art w/cndt crtn CPT 34716 | not published | not published | $334.87 – $736.78 | 8 |
| Xpos opn fmrl eprst aor uni add-on CPT 34812 | not published | not published | $183.39 – $407.35 | 8 |
| X-ray abdomen >=3 views CPT 74021 | $602.35 | $602.35 | $12.22 – $243.26 | 9 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $1,362.15 | $1,362.15 | $25.63 – $482.92 | 9 |
| X-ray assay calculus CPT 82370 | not published | not published | $6.18 – $25.49 | 7 |
| X-ray bone length studies CPT 77073 | $605.00 | $605.00 | $12.44 – $202.57 | 9 |
| X-ray bone survey infant CPT 77076 | $514.10 | $514.10 | $32.00 – $150.74 | 9 |
| X-ray consultation CPT 76140 | not published | not published | $36.63 – $36.63 | 1 |
| Xray endovasc thor ao repr CPT 75956 | $2,597.85 | $2,597.85 | $301.98 – $2,182.19 | 9 |
| Xray endovasc thor ao repr CPT 75957 | $2,597.85 | $2,597.85 | $258.96 – $2,182.19 | 9 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $944.35 | $944.35 | $16.44 – $229.36 | 9 |
| X-ray exam entire spi 6/> vw CPT 72084 | $944.35 | $944.35 | $19.25 – $793.25 | 9 |
| X-ray exam of arm infant CPT 73092 | $365.75 | $365.75 | $7.35 – $215.93 | 9 |
| X-ray exam of femur 1 CPT 73551 | $301.20 | $301.20 | $7.68 – $176.27 | 9 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $8.33 – $17.61 | 8 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $24.65 – $51.52 | 8 |
| X-ray exam of mastoids CPT 70120 | $1,170.60 | $1,170.60 | $8.33 – $983.30 | 9 |
| X-ray exam of middle ear CPT 70134 | $1,333.75 | $1,333.75 | $16.45 – $1,120.35 | 9 |
| X-ray exam of penis CPT 74445 | not published | not published | $49.59 – $101.51 | 8 |
| X-ray exam of perineum CPT 74775 | not published | not published | $28.22 – $58.97 | 8 |
| X-ray exam of salivary gland CPT 70380 | $534.95 | $534.95 | $7.68 – $449.36 | 9 |
| X-ray exam of tear duct CPT 70170 | $879.05 | $879.05 | $13.73 – $738.40 | 9 |
| X-ray exam of teeth CPT 70300 | not published | not published | $4.76 – $10.16 | 8 |
| X-ray exam of teeth CPT 70310 | not published | not published | $7.63 – $16.26 | 8 |
| X-ray exam si joints CPT 72200 | $522.30 | $522.30 | $7.98 – $226.92 | 9 |
| X-ray exam thorac spine4/>vw CPT 72074 | $607.60 | $607.60 | $11.24 – $388.25 | 9 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $351.60 | $351.60 | $8.33 – $118.73 | 9 |
| X-ray fallopian tube CPT 74742 | not published | not published | $27.57 – $58.30 | 8 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $8.29 – $16.94 | 8 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $497.05 | $497.05 | $12.76 – $200.97 | 9 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $944.35 | $944.35 | $14.38 – $358.55 | 9 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $15.68 – $33.21 | 8 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $318.95 | $318.95 | $7.35 – $122.43 | 9 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $623.10 | $623.10 | $10.27 – $400.96 | 9 |
| X-ray male genital tract CPT 74440 | not published | not published | $17.09 – $35.25 | 8 |
| X-ray mandible ltd <4 views CPT 70100 | $465.15 | $465.15 | $8.33 – $114.53 | 9 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $15.95 – $31.19 | 4 |
| X-ray nose to rectum for foreign body child CPT 76010 | $455.45 | $455.45 | $8.33 – $226.92 | 9 |
| X-ray of mammary ducts CPT 77054 | $1,632.65 | $1,632.65 | $20.22 – $704.13 | 9 |
| X-ray optic foramina CPT 70190 | $1,005.95 | $1,005.95 | $10.28 – $278.70 | 9 |
| Xray place dist ext thor ao CPT 75959 | $7,254.90 | $7,254.90 | $150.34 – $6,094.12 | 9 |
| Xray place prox ext thor ao CPT 75958 | $1,077.05 | $1,077.05 | $171.57 – $904.72 | 9 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,231.15 | $1,231.15 | $23.46 – $596.90 | 9 |
| X-ray ribs 2 views left CPT 71100 | $402.40 | $402.40 | $10.27 – $256.73 | 9 |
| X-ray sella turcica CPT 70240 | $431.85 | $431.85 | $8.65 – $362.75 | 9 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $800.45 | $800.45 | $23.55 – $461.33 | 9 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $1,054.10 | $1,054.10 | $26.27 – $885.44 | 9 |
| X-ray small intestine follow-through study CPT 74248 | $1,342.00 | $1,342.00 | $31.67 – $586.15 | 9 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $460.70 | $460.70 | $9.95 – $317.27 | 9 |
| X-ray surgical specimen CPT 76098 | $802.05 | $802.05 | $13.31 – $225.82 | 9 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $471.80 | $471.80 | $11.90 – $190.54 | 9 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $26.60 – $55.59 | 8 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $128.60 – $525.30 | 8 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $158.05 | $158.05 | $68.57 – $137.80 | 9 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $1,266.20 – $3,542.99 | 4 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $5.85 – $26.29 | 7 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.29 – $2.65 | 8 |
| Yersinia antibody CPT 86793 | not published | not published | $6.51 – $26.86 | 7 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $107,718.30 | $107,718.30 | $56,824.55 – $101,255.20 | 9 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $236.09 – $499.25 | 6 |
| Ziconotide injection HCPCS J2278 | not published | not published | $9.04 – $17.37 | 8 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $193.75 | $193.75 | $1.51 – $145.37 | 9 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.55 – $2.70 | 3 |
| Zika virus dna/rna amp probe CPT 87662 | not published | not published | $51.31 – $104.48 | 7 |
| Zika virus igm antibody CPT 86794 | not published | not published | $14.96 – $34.31 | 7 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.40 – $3.48 | 7 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $655.86 | $655.86 | $8.08 – $320.78 | 9 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $11,483.20 | $11,483.20 | $7.09 – $10,794.21 | 9 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $33.56 – $34.56 | 5 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $1,824.66 | $1,824.66 | $5.73 – $219.07 | 9 |
| Zoster vaccine-live inj CPT 90736 | $329.40 | $329.40 | $238.19 – $309.64 | 6 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $77.30 – $393.50 | 7 |
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.