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 |
|---|---|---|---|---|
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $54.89 – $54.89 | 1 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $2,844.40 | $2,844.40 | $319.06 – $739.48 | 9 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $1,233.70 | $1,233.70 | $77.84 – $215.21 | 9 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $649.80 | $649.80 | $232.17 – $587.12 | 9 |
| Clsd tx pelvic ring fx CPT 27197 | not published | not published | $127.99 – $273.16 | 8 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $232.17 – $643.91 | 8 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $3,580.90 | $3,580.90 | $393.40 – $876.33 | 9 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | not published | not published | $185.16 – $407.96 | 9 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | not published | not published | $232.17 – $533.89 | 9 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,557.55 | $1,557.55 | $394.76 – $729.72 | 9 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | not published | not published | $232.17 – $516.48 | 9 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,159.50 | $1,159.50 | $210.85 – $582.94 | 9 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,287.00 | $1,287.00 | $59.19 – $163.65 | 9 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,764.75 | $2,764.75 | $192.63 – $532.56 | 9 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $329.61 – $755.54 | 9 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $473.05 | $473.05 | $29.36 – $186.94 | 9 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $422.75 | $422.75 | $74.73 – $185.07 | 9 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $2,368.45 | $2,368.45 | $232.17 – $458.20 | 9 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,726.45 | $1,726.45 | $220.18 – $608.74 | 9 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | not published | not published | $232.17 – $535.82 | 9 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $232.17 – $616.81 | 9 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $471.00 | $471.00 | $232.17 – $442.74 | 9 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $750.00 | $750.00 | $232.17 – $442.74 | 9 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | not published | not published | $232.17 – $1,109.57 | 8 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | not published | not published | $232.17 – $664.31 | 9 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $430.95 | $430.95 | $216.05 – $276.08 | 9 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $1,713.91 – $3,766.54 | 8 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $1,703.23 – $3,750.27 | 8 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $899.95 | $899.95 | $232.17 – $442.18 | 9 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $1,248.55 | $1,248.55 | $433.91 – $939.42 | 9 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $669.78 – $1,407.79 | 8 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | not published | not published | $347.54 – $774.82 | 9 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | not published | not published | $232.17 – $670.08 | 9 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $2,698.15 | $2,698.15 | $123.39 – $341.13 | 9 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | not published | not published | $232.17 – $710.57 | 9 |
| Cltx lunate dislc w/mnpj CPT 25690 | $3,226.90 | $3,226.90 | $477.68 – $2,299.79 | 9 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $9,442.45 | $9,442.45 | $890.11 – $2,108.58 | 9 |
| Cltx mndblr fx w/mnpj CPT 21451 | $1,664.60 | $1,664.60 | $617.54 – $1,398.26 | 9 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $5,193.75 | $5,193.75 | $528.26 – $1,466.11 | 9 |
| Cltx palatal/max fx wire fix CPT 21421 | $5,429.35 | $5,429.35 | $525.04 – $1,243.81 | 9 |
| Cltx post ankle fx CPT 27767 | not published | not published | $232.17 – $614.08 | 9 |
| Cltx post ankle fx w/mnpj CPT 27768 | $2,844.40 | $2,844.40 | $227.73 – $940.79 | 9 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | not published | not published | $370.00 – $822.99 | 9 |
| Cltx strnclav dislc w/mnpj CPT 23525 | not published | not published | $232.17 – $797.30 | 9 |
| Cltx thigh fx CPT 27267 | not published | not published | $427.30 – $921.81 | 8 |
| Cltx thigh fx w/mnpj CPT 27268 | not published | not published | $526.56 – $1,129.22 | 8 |
| Cltx tmprmand dislc comp CPT 21485 | not published | not published | $749.87 – $1,845.80 | 9 |
| Cmbn ant pst colprhy CPT 57260 | not published | not published | $737.63 – $1,588.76 | 8 |
| C motor evoked lwr limbs CPT 95929 | $325.70 | $325.70 | $73.80 – $273.59 | 9 |
| C motor evoked uppr limbs CPT 95928 | $325.70 | $325.70 | $74.34 – $273.59 | 9 |
| C motor evoked upr&lwr limbs CPT 95939 | $2,062.30 | $2,062.30 | $111.89 – $1,732.33 | 9 |
| Cmp rpr tof wo plm atrs ptch CPT 33694 | not published | not published | $1,769.68 – $3,890.57 | 8 |
| Cmptr ophth dx img ant segmt CPT 92132 | not published | not published | $13.96 – $30.84 | 8 |
| Cmptr ophth img optic nerve CPT 92133 | not published | not published | $13.96 – $40.47 | 8 |
| #cms hgb-carboxyhemoglobin CPT 82376 | not published | not published | $5.63 – $28.65 | 7 |
| #cms hgb-sulfhemoglobin CPT 83060 | not published | not published | $4.08 – $17.92 | 7 |
| #cmvcul-virus inoculation shell CPT 87254 | $339.10 | $339.10 | $9.66 – $153.31 | 9 |
| Cmv ig IV CPT 90291 | not published | not published | $1,967.67 – $3,577.30 | 4 |
| Cmv pcr-sendout CPT 87496 | $175.70 | $175.70 | $17.33 – $128.97 | 9 |
| Cnbp gene detc abnor allele CPT 81187 | not published | not published | $54.80 – $278.96 | 7 |
| Cntct lens hydrophil photoch HCPCS V2524 | not published | not published | $152.29 – $332.12 | 7 |
| Co2 monitor per day CPT 94681 | not published | not published | $8.97 – $18.98 | 8 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $6,567.29 | $6,567.29 | $2.03 – $6,173.25 | 9 |
| Coagulation time activated teg CPT 85347 | $114.30 | $114.30 | $2.10 – $107.44 | 9 |
| Coagulation time lee & white CPT 85345 | not published | not published | $2.13 – $9.49 | 7 |
| Coagulation time otr method CPT 85348 | not published | not published | $1.84 – $9.14 | 7 |
| Cocaine 4 % nasal solution HCPCS C9046 | not published | not published | $1.56 – $3.12 | 2 |
| Cocaine hcl nasal (numbrino) HCPCS C9143 | not published | not published | $1.84 – $3.69 | 2 |
| Coccidioidomycosis skin test CPT 86490 | not published | not published | $72.80 – $159.74 | 7 |
| Coch imp ext proc/contr rplc HCPCS L8619 | not published | not published | $7,792.57 – $19,616.65 | 7 |
| Coch implant headset replace HCPCS L8615 | not published | not published | $419.78 – $1,056.71 | 7 |
| Coch implant microphone repl HCPCS L8616 | not published | not published | $97.77 – $246.14 | 7 |
| Coch implant tran cable repl HCPCS L8618 | not published | not published | $24.41 – $61.41 | 7 |
| Coch implant trans coil repl HCPCS L8617 | not published | not published | $85.40 – $214.98 | 7 |
| Cochlear implt f/up exam <7 CPT 92601 | not published | not published | $117.69 – $304.52 | 9 |
| Cochlear implt f/up exam 7/> CPT 92603 | not published | not published | $114.43 – $285.90 | 9 |
| Cocm by rhc/fqhc 60 min mo HCPCS G0512 | not published | not published | $94.01 – $282.69 | 7 |
| Codeine 15 mg/ml inj 2 ml HCPCS J0745 | not published | not published | $1.34 – $2.49 | 3 |
| Cogenex amnio memb per sq cm HCPCS Q4229 | not published | not published | $106.02 – $896.43 | 6 |
| Cold agglutinin screen (arc) CPT 86156 | not published | not published | $3.31 – $16.43 | 7 |
| Cold agglutinin titer CPT 86157 | not published | not published | $3.98 – $16.41 | 7 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | not published | not published | $1,534.96 – $3,344.28 | 8 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | not published | not published | $1,728.77 – $3,746.87 | 8 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | not published | not published | $1,928.15 – $4,175.92 | 8 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | not published | not published | $1,252.37 – $2,723.40 | 8 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | not published | not published | $1,797.31 – $3,906.84 | 8 |
| Colectomy prtl w/coloproctostomy 44145 CPT 44145 | not published | not published | $1,536.91 – $3,336.13 | 8 |
| Colectomy prtl w/coloproctostomy + colostomy 44146 CPT 44146 | not published | not published | $1,953.15 – $4,241.00 | 8 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | not published | not published | $1,160.03 – $2,519.39 | 8 |
| Colectomy prtl w/skin level cecost/colostomy 44141 CPT 44141 | not published | not published | $1,685.10 – $3,671.64 | 8 |
| Colectomy/w colostomy or ileostomy 44144 CPT 44144 | not published | not published | $1,640.19 – $3,569.30 | 8 |
| Colectomy w/ileoanal anast CPT 44157 | not published | not published | $2,028.42 – $4,429.43 | 8 |
| Colectomy w/neo-rectum pouch CPT 44158 | not published | not published | $2,078.30 – $4,539.91 | 8 |
| Colistimethate sodium inj HCPCS J0770 | $285.03 | $285.03 | $10.90 – $267.93 | 7 |
| Collagenase, clost hist inj HCPCS J0775 | $11,005.43 | $11,005.43 | $66.27 – $10,345.10 | 9 |
| Collagen based wound filler HCPCS A6010 | not published | not published | $25.32 – $86.05 | 7 |
| Collagen dressing <=16 sq in HCPCS A6021 | not published | not published | $23.37 – $58.42 | 7 |
| Collagen drsg>16<=48 sq in HCPCS A6022 | not published | not published | $23.37 – $58.42 | 7 |
| Collagen dsg wound filler HCPCS A6024 | not published | not published | $6.87 – $17.19 | 7 |
| Collagen gel/paste wound fil HCPCS A6011 | not published | not published | $2.54 – $6.35 | 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.