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 |
|---|---|---|---|---|
| Crnec stpl sctj cmprn/dcmprn CPT 61450 | not published | not published | $1,779.83 – $3,963.10 | 8 |
| Crnec treph exc brn abs sttl CPT 61514 | not published | not published | $1,781.66 – $3,952.94 | 8 |
| Crnec treph exc cyst sttl CPT 61516 | not published | not published | $1,738.84 – $3,872.95 | 8 |
| Crnop skull defect>5 cm diam CPT 62141 | not published | not published | $1,073.75 – $2,364.17 | 8 |
| Crnop w/autograft<5 cm diam CPT 62146 | not published | not published | $1,169.53 – $2,591.90 | 8 |
| Crnop w/autograft>5 cm diam CPT 62147 | not published | not published | $1,332.28 – $2,924.02 | 8 |
| Cromolyn sodium noncomp unit HCPCS J7631 | not published | not published | $0.42 – $1.54 | 6 |
| Cross-over vein graft CPT 34520 | not published | not published | $892.19 – $1,967.66 | 8 |
| Crotalidae poly immune fab HCPCS J0840 | $6,967.94 | $6,967.94 | $1,861.13 – $6,549.86 | 9 |
| Crtj pericardial window/prtl resecj w/drg/bx CPT 33025 | not published | not published | $709.32 – $1,546.07 | 8 |
| Crutches underarm other than wood adjustable or e0114 HCPCS E0114 | not published | not published | $21.31 – $72.68 | 3 |
| Cryoablate prostate CPT 55873 | not published | not published | $729.06 – $10,934.13 | 9 |
| Cryocautery of cervix 57511 CPT 57511 | not published | not published | $141.11 – $388.05 | 9 |
| Cryo fib comp path redu each HCPCS P9026 | not published | not published | $161.53 – $323.18 | 6 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $95.65 | $95.65 | $5.66 – $41.41 | 9 |
| Cryoprecipitate each unit HCPCS P9012 | $1,005.90 | $1,005.90 | $31.58 – $321.48 | 9 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $790.63 – $814.35 | 5 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $165.85 – $170.82 | 5 |
| Cryopreservation sperm CPT 89259 | not published | not published | $165.85 – $170.82 | 5 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $43.65 – $435.81 | 7 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $51.71 – $53.26 | 5 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $194.30 – $4,369.40 | 9 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | $309.95 | $309.95 | $106.87 – $281.40 | 9 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $47.23 – $101.51 | 9 |
| Cryptococcus abs qn - sendout CPT 86641 | not published | not published | $7.12 – $29.34 | 7 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $5.92 – $25.08 | 7 |
| Crystal identification light microscopy CPT 89060 | $90.20 | $90.20 | $3.53 – $40.95 | 9 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $2,490.33 – $5,482.73 | 8 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $1,231.60 – $2,731.53 | 8 |
| Csf leakage imaging CPT 78650 | $1,270.65 | $1,270.65 | $23.22 – $1,067.35 | 9 |
| Csf shunt reprogram 62252 CPT 62252 | not published | not published | $41.13 – $88.02 | 8 |
| Csf ventriculography CPT 78635 | not published | not published | $27.57 – $58.30 | 8 |
| Cstb gene detc abnor allele CPT 81188 | not published | not published | $54.80 – $278.96 | 7 |
| Cstb gene full gene sequence CPT 81189 | not published | not published | $109.93 – $559.61 | 7 |
| Cstb gene known famil vrnt CPT 81190 | not published | not published | $74.08 – $377.10 | 7 |
| CT 3d report other modality w/workstation CPT 76377 | $1,310.05 | $1,310.05 | $35.90 – $815.22 | 9 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $3,783.70 | $3,783.70 | $85.19 – $1,669.42 | 9 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $5,890.40 | $5,890.40 | $99.13 – $2,374.05 | 9 |
| CT Angiogram of the Abdomen CPT 74175 | $4,139.55 | $4,139.55 | $81.94 – $1,669.42 | 9 |
| CT Angiogram of the Abdomen and Both Legs CPT 75635 | $5,433.55 | $5,433.55 | $106.91 – $1,669.42 | 9 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $4,260.00 | $4,260.00 | $82.27 – $1,669.42 | 9 |
| CT Angiogram of the Head CPT 70496 | $3,727.40 | $3,727.40 | $78.93 – $1,669.42 | 9 |
| CT Angiogram of the Neck CPT 70498 | $3,727.40 | $3,727.40 | $78.93 – $1,669.42 | 9 |
| CT angio hrt w/3d image CPT 75574 | $1,566.00 | $1,566.00 | $108.00 – $1,315.44 | 9 |
| CT angio pelvis CPT 72191 | $2,948.65 | $2,948.65 | $80.96 – $1,669.42 | 9 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,783.70 | $3,783.70 | $80.96 – $1,669.42 | 9 |
| CT bone density axial CPT 77078 | $434.00 | $434.00 | $11.24 – $364.56 | 9 |
| CT colonography dx CPT 74261 | $1,017.05 | $1,017.05 | $102.92 – $854.32 | 9 |
| CT colonography dx w/dye CPT 74262 | $1,741.05 | $1,741.05 | $113.41 – $1,462.48 | 9 |
| CT colonography screening CPT 74263 | $1,017.05 | $1,017.05 | $107.23 – $956.03 | 9 |
| CT guidance for needle placement CPT 77012 | $3,621.45 | $3,621.45 | $56.19 – $944.41 | 9 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,905.70 | $1,905.70 | $52.42 – $803.88 | 9 |
| CT guid cryo ablat intramuscular CPT 20999 | $19,324.80 | $19,324.80 | $150.79 – $416.89 | 9 |
| CT guid parench tis ablat CPT 77013 | $3,824.70 | $3,824.70 | $172.99 – $3,212.75 | 9 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $291.55 | $291.55 | $26.27 – $189.53 | 9 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $1,566.00 | $1,566.00 | $115.03 – $1,315.44 | 9 |
| CT hrt w/3d image CPT 75572 | $1,566.00 | $1,566.00 | $78.39 – $1,315.44 | 9 |
| CT limited or localized follow-up study CPT 76380 | $1,279.55 | $1,279.55 | $42.91 – $239.90 | 9 |
| Ctlso a-p-l control molded HCPCS L0700 | not published | not published | $1,998.85 – $5,031.80 | 7 |
| Ctlso a-p-l control with inter HCPCS L0710 | not published | not published | $2,156.60 – $5,428.94 | 7 |
| Ctlso axilla sling HCPCS L1010 | not published | not published | $65.91 – $165.95 | 7 |
| Ctlso milwauke initial model HCPCS L1000 | not published | not published | $2,279.70 – $5,738.81 | 7 |
| CT lwr extremity w/o&w/dye CPT 73702 | $3,410.90 | $3,410.90 | $54.60 – $1,446.77 | 9 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $388.85 | $388.85 | $123.73 – $282.83 | 9 |
| CT scan for localization CPT 77011 | $2,854.45 | $2,854.45 | $58.63 – $2,397.74 | 9 |
| CT scan for therapy guide CPT 77014 | $1,162.50 | $1,162.50 | $43.73 – $976.50 | 9 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $5,977.35 | $5,977.35 | $90.71 – $2,374.05 | 9 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $5,089.70 | $5,089.70 | $82.60 – $1,916.98 | 9 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $4,240.00 | $4,240.00 | $78.60 – $1,017.89 | 9 |
| CT t-spine w /wo contrast CPT 72130 | $2,858.85 | $2,858.85 | $57.41 – $1,620.11 | 9 |
| CT uppr extremity w/o&w/dye CPT 73202 | $3,410.90 | $3,410.90 | $54.60 – $1,213.88 | 9 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $1,240.90 – $3,123.80 | 7 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $165.85 – $2,271.98 | 7 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $165.85 – $2,362.81 | 7 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $697.85 – $1,533.56 | 9 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $602.90 – $1,363.96 | 9 |
| Culture aerobic additional method definitive id each CPT 87077 | $101.95 | $101.95 | $5.98 – $85.12 | 9 |
| Culture afb any source CPT 87116 | $245.30 | $245.30 | $5.34 – $104.72 | 9 |
| Culture anaerobic additional method definitive id each CPT 87076 | $199.15 | $199.15 | $3.99 – $63.22 | 9 |
| Culture anaerobic except blood CPT 87075 | $337.90 | $337.90 | $4.68 – $84.32 | 9 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $4.66 – $19.67 | 7 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $21.09 – $36.61 | 4 |
| Culture bact stool aero addl path ea CPT 87046 | $130.85 | $130.85 | $4.66 – $55.18 | 9 |
| Culture body fluid CPT 87070 | $171.50 | $171.50 | $4.26 – $83.00 | 9 |
| Culture fungi definitive id mold CPT 87107 | $64.40 | $64.40 | $5.10 – $21.20 | 9 |
| Culture fungi definitive id yeast CPT 87106 | $130.85 | $130.85 | $5.10 – $80.28 | 9 |
| Culture fungi other (except blood) CPT 87102 | $304.10 | $304.10 | $4.15 – $92.21 | 9 |
| Culture fungi skin/hair/nail CPT 87101 | $304.10 | $304.10 | $3.80 – $75.44 | 9 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $5.84 – $29.75 | 7 |
| Culture mycoplasma any source CPT 87109 | not published | not published | $7.60 – $31.34 | 7 |
| Culture of specimen by kit CPT 87084 | not published | not published | $10.83 – $55.12 | 7 |
| Culture quantitative aerobic other source CPT 87071 | not published | not published | $4.66 – $20.14 | 7 |
| Culture screening strep group a CPT 87081 | $100.85 | $100.85 | $3.27 – $61.34 | 9 |
| Culture type pulse field gel CPT 87152 | not published | not published | $3.10 – $15.76 | 7 |
| Culture typing added method CPT 87158 | not published | not published | $3.10 – $15.76 | 7 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $6.18 – $25.49 | 7 |
| Culture typing immunologic CPT 87147 | not published | not published | $2.56 – $10.55 | 7 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $87.22 – $444.01 | 7 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $73.35 | $73.35 | $17.33 – $68.95 | 9 |
| Culture urine each isolate CPT 87088 | not published | not published | $4.00 – $16.47 | 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.