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 |
|---|---|---|---|---|
| Collagen imp urinary 2.5 ml HCPCS L8603 | $349.95 | $349.95 | $257.42 – $541.35 | 9 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | $278.90 | $278.90 | $7.68 – $210.13 | 9 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | not published | not published | $23.62 – $59.46 | 7 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | not published | not published | $73.64 – $185.40 | 7 |
| Collar cerv ascend 172 reg HCPCS L0172 | $158.40 | $158.40 | $88.60 – $147.32 | 9 |
| Collar cerv patriot adlt HCPCS L0150 | not published | not published | $109.71 – $276.17 | 7 |
| Collar extrication adult univ HCPCS L0200 | $1,735.15 | $1,735.15 | $456.04 – $651.53 | 9 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $228.40 | $228.40 | $24.28 – $56.26 | 9 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $231.15 | $231.15 | $27.04 – $112.85 | 9 |
| Coll-e-derm 1 sq cm HCPCS Q4193 | $2,200.00 | $2,200.00 | $1,471.20 – $1,880.00 | 6 |
| Collj & interpj data ea 30 d CPT 99091 | not published | not published | $51.14 – $108.44 | 8 |
| Colon motility 6 hr study CPT 91117 | not published | not published | $129.13 – $272.48 | 8 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $86.85 – $654.68 | 9 |
| Colonoscopy flex with decompression 45393 CPT 45393 | not published | not published | $234.17 – $502.25 | 8 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | not published | not published | $212.78 – $939.28 | 9 |
| Colonoscopy for bleeding 44391 CPT 44391 | not published | not published | $215.12 – $1,225.82 | 9 |
| Colonoscopy for foreign body CPT 44390 | not published | not published | $197.40 – $778.66 | 9 |
| Colonoscopy & polypectomy 44392 CPT 44392 | not published | not published | $186.16 – $750.40 | 9 |
| Colonoscopy stoma w/endo mucosal rescj 44403 CPT 44403 | not published | not published | $283.80 – $607.30 | 8 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | not published | not published | $210.56 – $843.56 | 9 |
| Colonoscopy submucous njx CPT 45381 | not published | not published | $188.30 – $851.92 | 9 |
| Colonoscopy thru stoma spx CPT 44388 | not published | not published | $73.33 – $609.06 | 9 |
| Colonoscopy w/ablation CPT 45388 | not published | not published | $252.40 – $4,657.88 | 9 |
| Colonoscopy w/balloon dilat CPT 45386 | not published | not published | $198.68 – $1,169.29 | 9 |
| Colonoscopy w/band ligation CPT 45398 | not published | not published | $219.28 – $1,575.32 | 9 |
| Colonoscopy w/control bleed CPT 45382 | not published | not published | $242.16 – $1,276.58 | 9 |
| Colonoscopy w/decompression CPT 44408 | not published | not published | $216.87 – $462.26 | 8 |
| Colonoscopy w/dilation CPT 44405 | not published | not published | $172.00 – $1,065.85 | 9 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | not published | not published | $241.09 – $514.45 | 8 |
| Colonoscopy w/endoscopic fnb CPT 45392 | not published | not published | $284.13 – $607.32 | 8 |
| Colonoscopy/w endoscopic stent 45389 CPT 45389 | not published | not published | $270.27 – $578.16 | 8 |
| Colonoscopy w/fb removal CPT 45379 | not published | not published | $223.13 – $835.84 | 9 |
| Colonoscopy w/injection CPT 44404 | not published | not published | $160.94 – $809.50 | 9 |
| Colonoscopy with ablation CPT 44401 | not published | not published | $226.50 – $4,508.82 | 9 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $188.30 – $834.57 | 9 |
| Colonoscopy with biopsy CPT 44389 | not published | not published | $160.94 – $792.17 | 9 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $237.61 – $873.75 | 9 |
| Colonoscopy w/ndl aspir/bx CPT 44407 | not published | not published | $257.41 – $549.02 | 8 |
| Colonoscopy w/resection CPT 45390 | not published | not published | $310.28 – $663.56 | 8 |
| Colonoscopy w/stent plcmt CPT 44402 | not published | not published | $244.23 – $521.90 | 8 |
| Colonoscopy w/ultrasound CPT 44406 | not published | not published | $214.92 – $458.19 | 8 |
| Colostomy skin level cecostomy 44320 CPT 44320 | not published | not published | $1,124.31 – $2,436.70 | 8 |
| Colostomy with biopsies CPT 44322 | not published | not published | $946.77 – $2,048.32 | 8 |
| Colotomy exploration/bx/foreign body removal 44025 CPT 44025 | not published | not published | $919.72 – $1,995.44 | 8 |
| Colpocentesis 57020 CPT 57020 | not published | not published | $74.12 – $242.20 | 9 |
| Colpocleisis (le forte type) 57120 CPT 57120 | not published | not published | $505.78 – $1,085.16 | 8 |
| Colpopexy abdominal approach 57280 CPT 57280 | not published | not published | $914.30 – $1,968.33 | 8 |
| Colpopexy extraperitoneal CPT 57282 | not published | not published | $658.59 – $1,415.93 | 8 |
| Colpopexy intraperitoneal CPT 57283 | not published | not published | $662.99 – $1,427.45 | 8 |
| Colpopexy, min/inv, ex-perit HCPCS C9778 | not published | not published | $4,777.69 – $4,921.02 | 5 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $5,166.90 | $5,166.90 | $318.53 – $4,176.19 | 9 |
| Colposcopy/cervix/bx vagina/cervix 57421 CPT 57421 | $356.10 | $356.10 | $114.79 – $345.65 | 9 |
| Colposcopy/cervix/ conization 57461 CPT 57461 | $604.55 | $604.55 | $172.03 – $676.51 | 9 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $264.15 | $264.15 | $86.35 – $246.06 | 9 |
| Colposcopy vulva 56820 CPT 56820 | $2,117.05 | $2,117.05 | $79.47 – $243.50 | 9 |
| Colposcopy vulva w/biopsy 56821 CPT 56821 | $274.45 | $274.45 | $106.80 – $172.91 | 9 |
| Colposcopy w/biopsy of cervix 57455 CPT 57455 | $321.90 | $321.90 | $102.35 – $314.17 | 9 |
| Colpotomy drng of abscess 57010 CPT 57010 | $4,223.10 | $4,223.10 | $436.17 – $3,547.40 | 9 |
| Colpotomy w/exploration 57000 CPT 57000 | not published | not published | $192.42 – $412.78 | 8 |
| Combination bilateral ho HCPCS L1690 | not published | not published | $1,796.29 – $4,521.91 | 7 |
| Combo ankle/foot prosthesis HCPCS L5975 | not published | not published | $431.47 – $1,086.17 | 7 |
| Comm hlth intg svs sdoh 60mn HCPCS G0019 | not published | not published | $47.04 – $155.47 | 8 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $278.70 | $278.70 | $15.84 – $166.05 | 9 |
| Compatibility test each unit electronic CPT 86923 | $410.50 | $410.50 | $11.81 – $92.52 | 9 |
| Compatibility test each unit immediate spin technique CPT 86920 | $176.65 | $176.65 | $14.83 – $129.02 | 9 |
| Compatibility test incubate CPT 86921 | not published | not published | $13.39 – $170.82 | 7 |
| Comp cystometrogram/void presssure 51728 CPT 51728 | not published | not published | $97.28 – $206.74 | 8 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | not published | not published | $117.90 – $250.78 | 8 |
| Complement antigen each component c3 CPT 86160 | $158.60 | $158.60 | $5.92 – $53.44 | 9 |
| Complement fixation each CPT 86171 | not published | not published | $4.94 – $20.38 | 7 |
| Complete removal of vulva CPT 56625 | not published | not published | $638.60 – $1,369.16 | 8 |
| Completion pneumonectomy 32488 CPT 32488 | not published | not published | $2,176.84 – $4,779.84 | 8 |
| Complex body section x-ray CPT 76101 | not published | not published | $70.38 – $70.38 | 1 |
| Complex body section x-rays CPT 76102 | not published | not published | $66.85 – $66.85 | 1 |
| Complex cystometrogram 51726 CPT 51726 | not published | not published | $79.33 – $168.09 | 8 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $887.25 | $887.25 | $220.99 – $399.64 | 9 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $1,506.25 | $1,506.25 | $235.93 – $765.17 | 9 |
| Complex simulation w/pet-ct HCPCS G0562 | not published | not published | $1,887.77 – $1,944.41 | 5 |
| Complex uroflowmetry (electronic) 51741 CPT 51741 | not published | not published | $5.78 – $16.06 | 8 |
| Compl oph exam general anes CPT 92018 | not published | not published | $134.48 – $278.57 | 8 |
| Compl rpr tof w/pulm atresia CPT 33697 | not published | not published | $1,863.52 – $4,097.97 | 8 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $1,594.55 | $1,594.55 | $265.32 – $815.29 | 9 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $2,175.10 | $2,175.10 | $318.89 – $842.48 | 9 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $1,563.95 | $1,563.95 | $128.91 – $355.93 | 9 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $1,066.00 | $1,066.00 | $231.33 – $597.24 | 9 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $1,688.45 | $1,688.45 | $150.79 – $416.89 | 9 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $598.15 | $598.15 | $118.03 – $284.84 | 9 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $485.30 | $485.30 | $72.90 – $180.52 | 9 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | not published | not published | $192.06 – $657.25 | 9 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | not published | not published | $67.27 – $224.22 | 9 |
| Component ankle afo plastic jt mold to pt mdl foot cup HCPCS L1970 | not published | not published | $844.30 – $2,125.41 | 7 |
| Composite byp grft 2 veins CPT 35682 | not published | not published | $312.78 – $696.10 | 8 |
| Composite byp grft 3/> segmt CPT 35683 | not published | not published | $364.24 – $807.94 | 8 |
| Composite byp grft pros&vein CPT 35681 | not published | not published | $70.83 – $157.24 | 8 |
| Composite drsg >16<=48 sq in HCPCS A6204 | not published | not published | $6.92 – $17.29 | 7 |
| Composite drsg <= 16 sq in HCPCS A6203 | not published | not published | $3.74 – $9.37 | 7 |
| Composite graft/pri close/don area 15760 CPT 15760 | not published | not published | $671.75 – $1,637.00 | 9 |
| Comprehensive hearing test CPT 92557 | not published | not published | $30.63 – $70.03 | 9 |
| Compre oph exam est pt 1/> CPT 92014 | not published | not published | $58.43 – $242.20 | 9 |
| Compre oph exam new pt 1/> CPT 92004 | not published | not published | $72.58 – $286.53 | 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.