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 |
|---|---|---|---|---|
| Blood smear microscopic w manual differential wbc count CPT 85007 | not published | not published | $1.70 – $7.74 | 7 |
| Blood split unit HCPCS P9011 | not published | not published | $71.46 – $146.05 | 7 |
| Blood thymol turbidity HCPCS P2033 | not published | not published | $4.95 – $10.08 | 7 |
| Blood Transfusion CPT 36430 | $1,339.00 | $1,339.00 | $36.42 – $86.09 | 9 |
| Blood typing abo CPT 86900 | $61.65 | $61.65 | $1.48 – $34.55 | 9 |
| Blood typing ag donor ea ag CPT 86902 | $180.35 | $180.35 | $2.54 – $61.48 | 9 |
| Blood typing antigen system CPT 86911 | not published | not published | $9.36 – $35.45 | 4 |
| Blood typing paternity test CPT 86910 | not published | not published | $10.80 – $41.37 | 4 |
| Blood typing patient serum CPT 86904 | not published | not published | $6.54 – $59.21 | 7 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $208.00 | $208.00 | $1.89 – $73.55 | 9 |
| Blood typing rh (d) CPT 86901 | $57.10 | $57.10 | $1.48 – $34.87 | 9 |
| Blood typing rh phenotype complete reference CPT 86906 | $149.30 | $149.30 | $3.83 – $69.75 | 9 |
| Blood volume CPT 78122 | $1,149.10 | $1,149.10 | $19.56 – $965.24 | 9 |
| Bls-emergency HCPCS A0429 | not published | not published | $350.00 – $895.95 | 3 |
| Body jacket mold to patient HCPCS L1300 | not published | not published | $1,581.28 – $3,980.65 | 7 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $365.75 | $365.75 | $8.65 – $185.01 | 9 |
| Bone biopsy open superficial CPT 20240 | $687.90 | $687.90 | $133.13 – $283.32 | 9 |
| Bone Density Scan (DEXA) CPT 77080 | $1,000.90 | $1,000.90 | $8.97 – $560.66 | 9 |
| Bone filler cerament 10cc HCPCS C1602 | $4,122.00 | $4,122.00 | $3,032.14 – $3,874.68 | 6 |
| Bone imaging multiple areas CPT 78305 | $2,400.80 | $2,400.80 | $37.19 – $843.74 | 9 |
| Bone/joint imaging ltd area CPT 78300 | $1,961.20 | $1,961.20 | $27.89 – $575.74 | 9 |
| Bone marrow;aspiration only 38220 CPT 38220 | $1,187.70 | $1,187.70 | $64.18 – $303.25 | 9 |
| Bone marrow aspir bone grfg CPT 20939 | not published | not published | $64.38 – $140.99 | 8 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $3,348.30 | $3,348.30 | $66.11 – $313.53 | 9 |
| Bone marrow harvest allogen CPT 38230 | not published | not published | $188.84 – $409.40 | 8 |
| Bone marrow harvest autolog CPT 38232 | not published | not published | $175.91 – $377.53 | 8 |
| Bone marrow imaging body CPT 78104 | not published | not published | $34.70 – $73.19 | 8 |
| Bone marrow imaging ltd CPT 78102 | $788.40 | $788.40 | $23.78 – $643.10 | 9 |
| Bone marrow imaging mult CPT 78103 | $871.70 | $871.70 | $28.40 – $732.23 | 9 |
| Bone marrow interpretation CPT 85097 | $1,290.10 | $1,290.10 | $43.02 – $94.90 | 9 |
| Bone mineral dual photon CPT 78351 | not published | not published | $9.49 – $28.59 | 6 |
| Bone mineral single photon CPT 78350 | not published | not published | $10.65 – $21.69 | 6 |
| Bone/skin graft great toe CPT 20973 | not published | not published | $2,829.09 – $6,084.61 | 8 |
| Bone/skin graft iliac crest CPT 20970 | not published | not published | $2,689.26 – $5,778.25 | 8 |
| Bone/skin graft metatarsal CPT 20972 | not published | not published | $2,680.56 – $5,761.31 | 8 |
| Bone/skin graft microvasc CPT 20969 | not published | not published | $2,566.95 – $5,498.31 | 8 |
| Bone survey-lead poisoning CPT 77074 | $1,557.90 | $1,557.90 | $19.89 – $356.37 | 9 |
| Bone tendon board add on HCPCS C9356 | not published | not published | $108.77 – $108.77 | 1 |
| Boot cast sandal rocker med HCPCS L3265 | not published | not published | $23.64 – $51.65 | 3 |
| Boot heel care softcare one sz HCPCS E0191 | not published | not published | $3.02 – $18.11 | 3 |
| Boot j walker l HCPCS L4386 | not published | not published | $147.27 – $370.71 | 7 |
| Boot mlti podous univ xlg HCPCS L4396 | not published | not published | $162.85 – $409.95 | 7 |
| Boot softgait shrt m HCPCS L4387 | not published | not published | $147.27 – $370.71 | 7 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $774.05 | $774.05 | $328.54 – $727.61 | 9 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | $67.67 | $67.67 | $28.51 – $428.40 | 9 |
| Borrelia antibody CPT 86619 | not published | not published | $6.61 – $27.24 | 7 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $220.50 | $220.50 | $8.41 – $144.01 | 9 |
| Borrelia miyamotoi amp prb CPT 87478 | $140.35 | $140.35 | $14.04 – $68.95 | 9 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | $20,133.30 | $20,133.30 | $1.73 – $314.10 | 9 |
| (both sides) donor search management CPT 38204 | not published | not published | $97.72 – $213.95 | 6 |
| (both sides) smear without diff wbc count CPT 85008 | $103.80 | $103.80 | $1.70 – $37.04 | 9 |
| Botulism ig IV CPT 90288 | not published | not published | $48,705.00 – $116,674.26 | 4 |
| Bowel imaging CPT 78290 | $2,000.45 | $2,000.45 | $30.16 – $703.50 | 9 |
| Bpg axillary-pop/-tibial CPT 35623 | not published | not published | $1,180.78 – $2,610.20 | 8 |
| Bpg carotid-vertebral CPT 35642 | not published | not published | $892.87 – $1,966.97 | 8 |
| Bpg ilio-celiac CPT 35632 | not published | not published | $1,617.89 – $3,584.20 | 8 |
| Bpg ilio-mesenteric CPT 35633 | not published | not published | $1,770.40 – $3,925.15 | 8 |
| Bpg iliorenal CPT 35634 | not published | not published | $1,583.51 – $3,507.62 | 8 |
| Bpg pop-tibl/-prnl artery CPT 35671 | not published | not published | $1,014.88 – $2,239.45 | 8 |
| Bpg splenorenal CPT 35636 | not published | not published | $1,429.94 – $3,165.33 | 8 |
| Bpg subclavian-axillary CPT 35616 | not published | not published | $989.41 – $2,187.94 | 8 |
| Bpg subclavian-vertebral CPT 35645 | not published | not published | $853.00 – $1,884.28 | 8 |
| Brace adj motion lerman type HCPCS L2186 | not published | not published | $137.74 – $346.74 | 7 |
| Brace afo dbl upright cust HCPCS L1990 | not published | not published | $502.60 – $1,265.23 | 7 |
| Brace afo lg left 6607 HCPCS L1930 | $910.90 | $910.90 | $50.09 – $316.80 | 9 |
| Brace afopos solid ankle cust HCPCS L1960 | not published | not published | $657.69 – $1,655.63 | 7 |
| Brace afo spiral prefab HCPCS L1951 | not published | not published | $780.13 – $1,963.85 | 7 |
| Brace ank aftr bioskn med lg HCPCS L1906 | not published | not published | $119.84 – $301.68 | 7 |
| Brace ank air stirrup univ HCPCS L4350 | not published | not published | $92.42 – $232.64 | 7 |
| Brace ankle joint dflxn assist HCPCS L2210 | not published | not published | $59.82 – $150.58 | 7 |
| Brace ankle stablizing lg HCPCS L1902 | not published | not published | $81.83 – $205.98 | 7 |
| Brace back epic lo 627 HCPCS L0642 | not published | not published | $310.94 – $614.69 | 7 |
| Brace back epic lso 637 HCPCS L0650 | $654.20 | $654.20 | $220.18 – $608.74 | 9 |
| Brace back epic tslo 456 HCPCS L0457 | $1,373.75 | $1,373.75 | $467.08 – $1,291.33 | 9 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | not published | not published | $381.85 – $961.25 | 7 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $1,872.25 | $1,872.25 | $400.37 – $1,106.90 | 9 |
| Brace back t-lso custom HCPCS L0486 | not published | not published | $2,237.15 – $5,631.68 | 7 |
| Brace back vista 464 tlso HCPCS L0648 | not published | not published | $776.53 – $1,535.11 | 7 |
| Brace cust back lso HCPCS L0631 | $3,313.00 | $3,313.00 | $953.60 – $3,114.22 | 9 |
| Brace fx hum ovr shldr lg HCPCS L3981 | not published | not published | $850.95 – $2,142.14 | 7 |
| Brace fx hum ovr shldr sm HCPCS L3980 | not published | not published | $358.95 – $903.60 | 7 |
| Brace halo bremer l2830 HCPCS L2830 | not published | not published | $111.47 – $280.61 | 7 |
| Brace kafo dbl upright cust HCPCS L2036 | not published | not published | $2,201.41 – $5,541.72 | 7 |
| Brace knee 32in univ t-scope short lt/rt HCPCS L1852 | not published | not published | $660.54 – $1,305.82 | 7 |
| Brace knee extender plus 22-30in HCPCS L1832 | $3,077.10 | $3,077.10 | $29.84 – $82.50 | 9 |
| Brace knee hing pat open med HCPCS L1820 | $262.60 | $262.60 | $135.46 – $246.84 | 9 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | not published | not published | $524.58 – $1,037.04 | 7 |
| Brace knee postop tscope xl HCPCS L1845 | not published | not published | $775.02 – $1,950.99 | 7 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | not published | not published | $92.00 – $231.58 | 7 |
| Brace m arm board HCPCS L3809 | $109.40 | $109.40 | $80.47 – $275.65 | 9 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $155.00 | $155.00 | $39.59 – $98.05 | 9 |
| Brace ortho exos 28-50in sm HCPCS L0637 | not published | not published | $1,087.69 – $2,738.12 | 7 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | not published | not published | $923.88 – $2,325.73 | 7 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $304.05 | $304.05 | $74.19 – $103.30 | 9 |
| Brace tlso flex cust HCPCS L0450 | not published | not published | $141.29 – $279.31 | 7 |
| Brace wrist classic lft sm HCPCS L3908 | not published | not published | $69.56 – $175.11 | 7 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $764.66 – $1,626.72 | 8 |
| Brach/thor cath 1st CPT 36215 | $1,930.20 | $1,930.20 | $196.70 – $1,572.44 | 9 |
| Brach/thor cath 2nd CPT 36216 | $1,930.20 | $1,930.20 | $248.05 – $1,572.44 | 9 |
| Brach/thor cath 3rd CPT 36217 | $1,930.20 | $1,930.20 | $306.65 – $553.47 | 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.