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 |
|---|---|---|---|---|
| Chest 2 vws w oblique CPT 71048 | $764.10 | $764.10 | $14.17 – $348.17 | 9 |
| Chest apical lordotic proj CPT 71047 | $663.10 | $663.10 | $12.55 – $330.44 | 9 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,104.70 | $3,104.70 | $56.44 – $1,620.11 | 9 |
| Chest CT scan (with contrast) CPT 71260 | $2,481.90 | $2,481.90 | $52.66 – $1,462.48 | 9 |
| Chest CT scan (without contrast) CPT 71250 | $2,107.70 | $2,107.70 | $48.76 – $854.32 | 9 |
| Chest Physiotherapy (first session) CPT 94667 | $282.85 | $282.85 | $21.73 – $81.61 | 9 |
| Chest Physiotherapy (follow-up session) CPT 94668 | $207.65 | $207.65 | $33.93 – $139.31 | 9 |
| Chest Ultrasound CPT 76604 | $764.05 | $764.05 | $25.94 – $509.12 | 9 |
| Chest X-ray CPT 71046 | $577.75 | $577.75 | $9.95 – $278.70 | 9 |
| Chest X-ray (single view) CPT 71045 | $440.40 | $440.40 | $8.33 – $207.13 | 9 |
| Chg pr pul rehab for copd patients CPT 94626 | $360.25 | $360.25 | $24.53 – $117.88 | 9 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $876.85 | $876.85 | $31.67 – $457.93 | 9 |
| Chikungunya vaccine live im CPT 90589 | not published | not published | $279.98 – $279.98 | 1 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $102.45 – $422.43 | 7 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $128.78 – $531.02 | 7 |
| Chiropractic manj 5 regions CPT 98942 | not published | not published | $24.49 – $97.65 | 9 |
| Chiropract manj 1-2 regions CPT 98940 | not published | not published | $21.31 – $52.69 | 9 |
| Chiropract manj 3-4 regions CPT 98941 | not published | not published | $24.49 – $75.81 | 9 |
| Chiropract manj xtrspinl 1/> CPT 98943 | not published | not published | $22.43 – $49.46 | 7 |
| Chlamydia culture CPT 87110 | $217.70 | $217.70 | $9.68 – $115.90 | 9 |
| Chlamydia trachomatis ag if CPT 87270 | not published | not published | $5.92 – $25.08 | 7 |
| Chlamydia type CPT 87140 | $12.20 | $12.20 | $2.75 – $11.47 | 9 |
| Chlmyd pneum dna dir probe CPT 87485 | not published | not published | $9.90 – $40.83 | 7 |
| Chlmyd pneum dna quant CPT 87487 | not published | not published | $21.15 – $87.23 | 7 |
| Chlnggrphy intraop addl s&i CPT 74301 | not published | not published | $9.62 – $19.65 | 8 |
| Chloramphenicol sodium injec HCPCS J0720 | not published | not published | $41.08 – $82.38 | 5 |
| Chlordiazepoxide injection HCPCS J1990 | not published | not published | $21.05 – $42.01 | 4 |
| Chloride CPT 82435 | $81.60 | $81.60 | $2.27 – $44.74 | 9 |
| Chloride 24 hour urine CPT 82436 | $103.80 | $103.80 | $2.48 – $60.25 | 9 |
| Chloroprocaine (clorotekal) HCPCS J2402 | not published | not published | $0.31 – $0.63 | 4 |
| Chloroprocaine hcl injection HCPCS J2401 | $247.36 | $247.36 | $0.03 – $62.91 | 9 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $0.60 – $1.19 | 8 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $610.77 | $610.77 | $63.79 – $347.49 | 7 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $294.08 | $294.08 | $29.79 – $51.62 | 7 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | not published | not published | $0.36 – $0.71 | 4 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $128.98 – $1,437.84 | 9 |
| Cholangiogram percutaneous compl CPT 47532 | $10,704.30 | $10,704.30 | $195.99 – $1,590.74 | 9 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $1,408.35 | $1,408.35 | $12.43 – $596.90 | 9 |
| Cholecystectomy expl duct 47612 CPT 47612 | not published | not published | $1,185.61 – $2,589.19 | 8 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | not published | not published | $1,055.13 – $2,295.71 | 8 |
| Cholecystoenterostomy direct 47720 CPT 47720 | not published | not published | $1,081.66 – $2,353.99 | 8 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $7,237.55 | $7,237.55 | $315.60 – $5,237.36 | 9 |
| Cholera vaccine live oral CPT 90625 | not published | not published | $308.00 – $559.96 | 4 |
| Cholesterol CPT 82465 | $135.80 | $135.80 | $3.22 – $40.89 | 9 |
| Cholesterol body fluid CPT 84999 | $174.10 | $174.10 | $31.74 – $87.75 | 9 |
| Cholesterol (Lipid) Test CPT 80061 | $276.55 | $276.55 | $9.92 – $159.94 | 9 |
| Choline c-11 HCPCS A9515 | not published | not published | $2,062.94 – $12,217.20 | 8 |
| Cholinesterase CPT 82480 | not published | not published | $3.89 – $16.02 | 7 |
| Cholinesterase challenge CPT 95857 | $269.35 | $269.35 | $26.83 – $122.70 | 9 |
| Chorion biopsy CPT 59015 | not published | not published | $120.52 – $307.10 | 9 |
| Chorionic gonadotropin/1000u HCPCS J0725 | not published | not published | $21.82 – $38.89 | 6 |
| Chrnc care mgmt phys 1st 30 CPT 99491 | not published | not published | $71.59 – $163.19 | 9 |
| Chrom analysis CPT 88273 | not published | not published | $18.20 – $70.88 | 7 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $15.60 – $79.41 | 7 |
| Chromatography CPT 83021 | $64.30 | $64.30 | $8.92 – $37.13 | 9 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $5.87 – $24.21 | 7 |
| Chromo high res and frag x - sendout CPT 81243 | $591.70 | $591.70 | $22.82 – $432.12 | 9 |
| Chromosome analys amniotic CPT 88269 | $380.20 | $380.20 | $94.23 – $339.53 | 9 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $98.11 – $352.61 | 7 |
| Chromosome analysis 15-20 cell count CPT 88262 | $593.95 | $593.95 | $70.62 – $315.37 | 9 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $85.52 – $352.61 | 7 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $85.14 – $306.02 | 7 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $105.74 – $538.25 | 7 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $98.11 – $352.61 | 7 |
| Chromosome analys placenta CPT 88267 | $596.75 | $596.75 | $101.85 – $368.72 | 9 |
| Chromosome banding study CPT 88283 | not published | not published | $38.86 – $139.68 | 7 |
| Chromosome count additional CPT 88285 | not published | not published | $10.76 – $54.79 | 7 |
| Chromosome karyotype study CPT 88280 | $293.80 | $293.80 | $14.22 – $113.88 | 9 |
| Chromosome study additional CPT 88289 | not published | not published | $19.51 – $70.11 | 7 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $6.15 – $25.37 | 7 |
| Chylomicron screen, bf - sendout CPT 82664 | not published | not published | $24.60 – $125.23 | 7 |
| Cid ext controller repl HCPCS L8628 | not published | not published | $1,151.40 – $2,898.47 | 7 |
| Cid ext speech process repl HCPCS L8627 | not published | not published | $6,641.17 – $16,718.16 | 7 |
| Cidofovir injection HCPCS J0740 | not published | not published | $529.38 – $595.23 | 8 |
| Cid transmit coil and cable HCPCS L8629 | not published | not published | $166.65 – $419.50 | 7 |
| Cilastatin sodium injection HCPCS J0743 | $332.37 | $332.37 | $6.91 – $312.43 | 7 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $373.28 – $848.70 | 9 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $0.02 – $974,870.23 | 6 |
| Cinacalcet 30 mg tablet HCPCS J0604 | not published | not published | $0.02 – $0.07 | 4 |
| Cine/video x-rays CPT 76120 | $312.70 | $312.70 | $17.95 – $262.67 | 9 |
| Cine/video x-rays add-on CPT 76125 | $293.05 | $293.05 | $12.69 – $246.16 | 9 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $55.65 | $55.65 | $1.37 – $38.28 | 9 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $28.88 – $59.12 | 6 |
| Circum 28 days or older CPT 54161 | not published | not published | $189.53 – $401.25 | 8 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $247.30 | $247.30 | $84.08 – $168.26 | 9 |
| Circumcision (newborn) CPT 54150 | $666.10 | $666.10 | $84.08 – $168.26 | 9 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $419.40 | $419.40 | $1.72 – $128.48 | 9 |
| C-kit mutation liquid tumor - sendout CPT 81272 | not published | not published | $131.80 – $670.95 | 7 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $1,473.50 | $1,473.50 | $9.73 – $1,385.09 | 9 |
| C-laminoplasty w/graft/plate CPT 63051 | not published | not published | $1,587.31 – $3,467.63 | 8 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $11,000.00 | $11,000.00 | $496.53 – $634.50 | 6 |
| Clamp neck artery CPT 61703 | not published | not published | $1,271.88 – $2,817.61 | 8 |
| Claviculectomy partial CPT 23120 | not published | not published | $567.46 – $1,220.05 | 8 |
| Claviculectomy total CPT 23125 | not published | not published | $684.98 – $1,466.08 | 8 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $131.57 – $419.52 | 9 |
| Clearance of airways CPT 31720 | $577.75 | $577.75 | $47.51 – $125.87 | 9 |
| Clearance of airways CPT 31725 | not published | not published | $73.88 – $157.26 | 8 |
| Clearance of tear duct CPT 68530 | not published | not published | $242.37 – $832.64 | 9 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $41.10 – $188.88 | 9 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $20.01 – $157.40 | 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.