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 |
|---|---|---|---|---|
| Brach/thor cath addl CPT 36218 | $2,029.70 | $2,029.70 | $47.93 – $399.61 | 9 |
| Brachy linear, non-str,p-103 HCPCS C2636 | not published | not published | $52.91 – $54.50 | 5 |
| Brachy source i-125 injection HCPCS C2638 | $202.55 | $202.55 | $37.04 – $190.40 | 9 |
| Brachy source iodine-125 nonstranded HCPCS C2639 | $132.80 | $132.80 | $35.11 – $124.83 | 9 |
| Brachy source palladium HCPCS C2640 | not published | not published | $69.69 – $71.78 | 5 |
| Brachy source palladium-103 nonstranded HCPCS C2641 | not published | not published | $79.77 – $82.16 | 5 |
| Brachy source yttrium-90 HCPCS C2616 | $47,109.85 | $47,109.85 | $17,485.10 – $44,283.26 | 9 |
| Brachy src nonstrand c-131 HCPCS C2643 | not published | not published | $96.56 – $99.46 | 5 |
| Brachy src nonstrand hdr ir-192 HCPCS C1717 | $635.75 | $635.75 | $342.39 – $597.61 | 9 |
| Brachy src stranded c-131 HCPCS C2642 | $61,820.00 | $61,820.00 | $107.86 – $23,500.00 | 9 |
| Brachytx isodose complex CPT 77318 | $5,036.10 | $5,036.10 | $148.28 – $4,230.32 | 9 |
| Brachytx isodose intermed CPT 77317 | $5,036.10 | $5,036.10 | $93.74 – $4,230.32 | 9 |
| Brachytx isodose plan simple CPT 77316 | $2,970.15 | $2,970.15 | $71.55 – $2,494.93 | 9 |
| Brachytx, non-str, gold-198 HCPCS C1716 | not published | not published | $868.33 – $894.38 | 5 |
| Brachytx, non-str, ha, i-125 HCPCS C2634 | not published | not published | $162.84 – $167.73 | 5 |
| Brachytx, non-str, ha, p-103 HCPCS C2635 | not published | not published | $69.38 – $71.46 | 5 |
| Brachytx, ns, non-hdrir-192 HCPCS C1719 | not published | not published | $564.50 – $581.44 | 5 |
| Braf gene CPT 81210 | $670.25 | $670.25 | $70.16 – $541.16 | 9 |
| Brain aneurysm repr complx CPT 61697 | not published | not published | $3,873.55 – $8,666.35 | 8 |
| Brain aneurysm repr complx CPT 61698 | not published | not published | $4,240.22 – $9,483.09 | 8 |
| Brain aneurysm repr simple CPT 61700 | not published | not published | $3,139.16 – $7,011.17 | 8 |
| Brain biopsy w/ct/mr guide CPT 61751 | not published | not published | $1,300.17 – $2,876.58 | 8 |
| Brain cavity shunt w/scope CPT 62201 | not published | not published | $1,142.30 – $2,521.43 | 8 |
| Brain flow imaging only CPT 78610 | not published | not published | $13.19 – $27.79 | 8 |
| Brain image < 4 views CPT 78600 | not published | not published | $19.57 – $41.34 | 8 |
| Brain image 4+ views CPT 78605 | not published | not published | $24.00 – $50.84 | 8 |
| Brain image w/flow < 4 views CPT 78601 | not published | not published | $22.49 – $47.44 | 8 |
| Brain image w/flow 4 + views CPT 78606 | $2,280.35 | $2,280.35 | $28.54 – $976.33 | 9 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $4,469.80 | $4,469.80 | $66.71 – $2,519.33 | 9 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $3,380.85 | $3,380.85 | $53.95 – $2,085.05 | 9 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $3,932.90 | $3,932.90 | $53.95 – $1,552.82 | 9 |
| Brain MRI (with and without contrast) CPT 70553 | $5,592.10 | $5,592.10 | $103.67 – $2,519.33 | 9 |
| Brain MRI (with contrast) CPT 70552 | $4,713.95 | $4,713.95 | $80.55 – $2,085.05 | 9 |
| Brain MRI (without contrast) CPT 70551 | $3,932.90 | $3,932.90 | $66.71 – $1,552.82 | 9 |
| Bra surgical elizabeth pink sm HCPCS L8000 | not published | not published | $35.25 – $88.74 | 7 |
| Brca1&2 gene full seq alys CPT 81163 | not published | not published | $187.20 – $952.94 | 7 |
| Brca1&2 gen ful dup/del alys CPT 81164 | not published | not published | $233.69 – $1,189.61 | 7 |
| Brca1 dna gene analy known fam var CPT 81215 | not published | not published | $150.10 – $764.08 | 7 |
| Brca1 gene full dup/del alys CPT 81166 | not published | not published | $120.54 – $613.61 | 7 |
| Brca1 gene full seq alys CPT 81165 | not published | not published | $113.15 – $576.00 | 7 |
| Brca2 dna gene analy full seq analy CPT 81216 | not published | not published | $74.05 – $376.94 | 7 |
| Brca2 dna gene analy known fam var CPT 81217 | not published | not published | $150.10 – $764.08 | 7 |
| Brca2 gene full dup/del alys CPT 81167 | not published | not published | $113.15 – $576.00 | 7 |
| Brcassure ashkenazi panel-sendout CPT 81212 | not published | not published | $176.00 – $895.93 | 7 |
| Brcassure comprehensive panel-sendout CPT 81162 | not published | not published | $901.17 – $3,715.82 | 7 |
| Breast augmentation 19325 CPT 19325 | not published | not published | $590.50 – $1,258.01 | 8 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $3,792.90 | $3,792.90 | $143.63 – $950.85 | 9 |
| Breastbone (Sternum) X-ray CPT 71120 | $534.95 | $534.95 | $8.97 – $291.96 | 9 |
| Breast prosthesis bra & form HCPCS L8001 | not published | not published | $116.76 – $293.93 | 7 |
| Breast prosthesis w adhesive HCPCS L8031 | not published | not published | $398.80 – $1,003.93 | 7 |
| Breast prosthes without adhesive HCPCS L8030 | not published | not published | $398.80 – $1,003.93 | 7 |
| Breast punct aspir cyst, bil CPT 19000 | $862.15 | $862.15 | $39.87 – $193.38 | 9 |
| Breast reconstruction CPT 19366 | not published | not published | $2,860.86 – $2,860.86 | 1 |
| Breast reconstruction 19357 CPT 19357 | not published | not published | $1,110.59 – $2,366.21 | 8 |
| Breast reconstruction tram flap 19367 CPT 19367 | not published | not published | $1,683.71 – $3,591.65 | 8 |
| Breast reconstr w/lat flap 19361 CPT 19361 | not published | not published | $1,482.97 – $3,163.97 | 8 |
| Breast reduction CPT 19318 | not published | not published | $1,044.50 – $2,225.22 | 8 |
| Breath hydrogen test 91065 CPT 91065 | not published | not published | $8.97 – $18.98 | 8 |
| Breathing response hypoxia CPT 94450 | $227.75 | $227.75 | $18.93 – $191.31 | 9 |
| Breath recording infant CPT 94772 | not published | not published | $192.38 – $528.94 | 7 |
| Breath test analysis c-14 CPT 78268 | not published | not published | $37.76 – $192.24 | 7 |
| Breath tst attain/anal c-14 CPT 78267 | $533.40 | $533.40 | $4.42 – $501.40 | 9 |
| Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 | $16,263.40 | $16,263.40 | $218.08 – $15,287.60 | 9 |
| Brexucabtagene car pos t HCPCS Q2053 | not published | not published | $0.02 – $863,348.80 | 6 |
| Brief alcohol misuse counsel HCPCS G0443 | not published | not published | $22.40 – $48.19 | 8 |
| Brief chkin, 5-10, non-e/m HCPCS G2251 | not published | not published | $12.11 – $26.98 | 8 |
| Brief chkin by md/qhp, 11-20 HCPCS G2252 | not published | not published | $24.01 – $50.76 | 8 |
| Brief comunicaj tech-bsd svc CPT 98016 | not published | not published | $14.38 – $16.54 | 5 |
| Brompheniramine maleate inj HCPCS J0945 | not published | not published | $0.67 – $1.31 | 4 |
| Bronch/asp/tracheobronch tree/subs 31646 CPT 31646 | not published | not published | $133.30 – $282.64 | 8 |
| Bronch ebus ivntj perph les 31654 CPT 31654 | not published | not published | $62.12 – $231.28 | 9 |
| Bronch ebus samplng 1/2 node CPT 31652 | not published | not published | $205.44 – $2,383.55 | 9 |
| Bronch ebus samplng 3/> node CPT 31653 | not published | not published | $227.47 – $2,474.14 | 9 |
| Bronchial allergy tests CPT 95070 | not published | not published | $32.05 – $71.17 | 8 |
| Bronchial brush biopsy CPT 31717 | not published | not published | $99.14 – $549.31 | 9 |
| Bronchial challenge CPT 94070 | $698.75 | $698.75 | $26.05 – $524.62 | 9 |
| Bronchial valve addl insert CPT 31651 | not published | not published | $70.33 – $150.47 | 8 |
| Bronchial valve init insert CPT 31647 | not published | not published | $191.40 – $407.36 | 8 |
| Bronchial valve remov addl CPT 31649 | not published | not published | $64.40 – $132.17 | 8 |
| Bronchial valve remov init CPT 31648 | not published | not published | $183.64 – $391.76 | 8 |
| Bronchoscopy bronch stents CPT 31636 | not published | not published | $202.31 – $429.72 | 8 |
| Bronchoscopy clear airways 31645 CPT 31645 | not published | not published | $137.40 – $527.46 | 9 |
| Bronchoscopy dilate/fx repr CPT 31630 | not published | not published | $184.61 – $394.47 | 8 |
| Bronchoscopy dilate w/stent CPT 31631 | not published | not published | $210.77 – $449.39 | 8 |
| Bronchoscopy/lung bx addl 31632 CPT 31632 | not published | not published | $45.16 – $124.00 | 9 |
| Bronchoscopy/lung bx each 31628 CPT 31628 | not published | not published | $163.87 – $713.78 | 9 |
| Bronchoscopy/needle bx addl 31633 CPT 31633 | not published | not published | $58.55 – $154.20 | 9 |
| Bronchoscopy/needle bx each 31629 CPT 31629 | not published | not published | $174.11 – $868.61 | 9 |
| Bronchoscopy revise stent CPT 31638 | not published | not published | $229.35 – $488.02 | 8 |
| Bronchoscopy stent add-on CPT 31637 | not published | not published | $70.54 – $150.48 | 8 |
| Bronchoscopy treat blockage CPT 31641 | not published | not published | $235.18 – $502.93 | 8 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | not published | not published | $145.38 – $670.08 | 9 |
| Bronchoscopy w/fb removal 31635 CPT 31635 | $4,377.85 | $4,377.85 | $163.44 – $563.44 | 9 |
| Bronchoscopy w/markers CPT 31626 | not published | not published | $184.13 – $1,505.94 | 9 |
| Bronchoscopy w/tumor excise CPT 31640 | not published | not published | $229.56 – $490.72 | 8 |
| Bronch thermoplsty 1 lobe CPT 31660 | not published | not published | $176.02 – $374.83 | 8 |
| Bronch thermoplsty 2/> lobes CPT 31661 | not published | not published | $186.26 – $397.18 | 8 |
| Bronch w/balloon occlusion CPT 31634 | not published | not published | $175.85 – $2,815.29 | 9 |
| Bronch w/debrdmt subgltc & uppr trach CPT 31899 | $97.90 | $97.90 | $72.02 – $193.53 | 9 |
| Br punct aspir ea add, l CPT 19001 | $797.45 | $797.45 | $19.34 – $50.76 | 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.