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 |
|---|---|---|---|---|
| Cytogenetics 25-99 CPT 88274 | $423.90 | $423.90 | $19.72 – $106.03 | 9 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $16.28 – $82.87 | 7 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $464.00 – $2,361.99 | 7 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $360.00 – $1,832.58 | 7 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,263.53 – $2,647.65 | 6 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $5.92 – $25.08 | 7 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $277.80 | $277.80 | $7.11 – $125.26 | 9 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $375.75 | $375.75 | $8.32 – $125.26 | 9 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $5.92 – $27.33 | 7 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,807.87 – $3,473.49 | 8 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $12.01 – $61.15 | 7 |
| Cyto/molecular report CPT 88291 | $232.20 | $232.20 | $27.03 – $34.55 | 9 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $12.10 – $51.66 | 7 |
| Cytopath c/v automated CPT 88147 | not published | not published | $20.22 – $102.95 | 7 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $11.06 – $56.28 | 7 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $8.61 – $36.16 | 7 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $5.86 – $30.51 | 7 |
| Cytopath c/v manual CPT 88150 | not published | not published | $5.99 – $36.16 | 7 |
| Cytopath c/v redo CPT 88153 | not published | not published | $9.61 – $48.93 | 7 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $11.48 – $46.91 | 7 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $17.75 – $37.28 | 8 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $338.80 | $338.80 | $25.86 – $166.38 | 9 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $73.90 | $73.90 | $15.01 – $61.90 | 9 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $261.65 | $261.65 | $11.48 – $182.69 | 9 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | not published | not published | $20.99 – $44.06 | 8 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | not published | not published | $26.18 – $54.22 | 8 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | not published | not published | $8.51 – $40.47 | 8 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $666.10 | $666.10 | $21.49 – $182.66 | 9 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $783.35 | $783.35 | $51.71 – $166.70 | 9 |
| Cytopath smear other source CPT 88160 | $339.10 | $339.10 | $23.70 – $247.84 | 9 |
| Cytopath smear other source CPT 88162 | not published | not published | $36.91 – $77.27 | 8 |
| Cytopath smear oth prep screen & interp CPT 88161 | not published | not published | $23.70 – $49.48 | 8 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $5.99 – $36.16 | 7 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $5.99 – $36.16 | 7 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $16.89 – $85.97 | 7 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $5.86 – $36.16 | 7 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $31.46 – $160.15 | 7 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $14.66 – $60.43 | 7 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $45.54 – $94.89 | 8 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $95.40 | $95.40 | $3.60 – $89.68 | 9 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $302.92 – $668.90 | 8 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $6,384.45 | $6,384.45 | $15.29 – $5,172.64 | 9 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $14.25 – $27.41 | 6 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $4,171.62 | $4,171.62 | $0.02 – $534.61 | 7 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.05 – $0.08 | 6 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $37,937.15 | $37,937.15 | $49.05 – $13,707.26 | 9 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $13,887.50 | $13,887.50 | $2.93 – $16.73 | 9 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.93 – $5.58 | 8 |
| Dark field exam spec collj CPT 87164 | not published | not published | $5.30 – $35.34 | 8 |
| Dark field exam without collj CPT 87166 | not published | not published | $5.58 – $23.01 | 7 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $14,784.21 | $14,784.21 | $223.52 – $13,897.16 | 9 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $19.76 – $46.50 | 8 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $57.66 – $452.39 | 4 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $192.31 – $548.33 | 8 |
| D&c after delivery 59160 CPT 59160 | $2,541.45 | $2,541.45 | $174.98 – $531.96 | 9 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $3,223.20 | $3,223.20 | $72.02 – $255.85 | 9 |
| Dch glucoscan CPT 82948 | $32.70 | $32.70 | $3.02 – $30.74 | 9 |
| Dch pulmonary stress test CPT 94621 | $1,011.15 | $1,011.15 | $64.00 – $666.12 | 9 |
| Dch validity tests CPT 81002 | $27.85 | $27.85 | $2.09 – $16.59 | 9 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | $1,131.35 | $1,131.35 | $546.96 – $1,063.47 | 9 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $1,669.29 – $3,708.92 | 8 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $262.81 – $551.06 | 8 |
| D&c of cervical stump CPT 57558 | not published | not published | $122.79 – $308.38 | 9 |
| Deamidated gliadin antibody iga CPT 86258 | $124.60 | $124.60 | $4.61 – $28.11 | 9 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $646.83 – $1,407.12 | 8 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $1,027.95 | $1,027.95 | $25.49 – $114.36 | 9 |
| Debridement (>20 cm) charge pt CPT 97598 | $640.30 | $640.30 | $18.65 – $86.73 | 9 |
| Debridement bone <= 20 sq cm CPT 11044 | $3,387.95 | $3,387.95 | $211.34 – $600.70 | 9 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $580.90 | $580.90 | $50.56 – $140.71 | 9 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,695.05 | $1,695.05 | $89.87 – $232.57 | 9 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $1,160.30 | $1,160.30 | $57.63 – $204.90 | 9 |
| Debride nail1-5 11720 CPT 11720 | $215.10 | $215.10 | $13.61 – $63.61 | 9 |
| Debride nail6 or more 11721 CPT 11721 | $225.55 | $225.55 | $22.57 – $86.09 | 9 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | not published | not published | $280.54 – $964.34 | 9 |
| Debride skin bone at fx site CPT 11012 | $2,226.70 | $2,226.70 | $323.53 – $762.76 | 9 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $525.63 – $1,141.41 | 8 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $709.10 – $1,555.55 | 8 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $606.75 | $606.75 | $23.22 – $77.10 | 9 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $49.25 – $151.62 | 9 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $908.05 | $908.05 | $192.63 – $508.84 | 9 |
| Debr inf skin add-on 11001 CPT 11001 | $26.35 | $26.35 | $13.94 – $52.69 | 9 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,161.05 | $1,161.05 | $145.35 – $449.09 | 9 |
| Decalcification CPT 88311 | $116.20 | $116.20 | $8.07 – $36.54 | 9 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $1,017.94 | $1,017.94 | $1.35 – $956.86 | 7 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $565.25 | $565.25 | $28.08 – $70.49 | 9 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $444.40 – $967.91 | 8 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $711.77 – $1,506.07 | 8 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $1,173.20 – $2,510.57 | 8 |
| Decompress fasciotomyhand 26037 CPT 26037 | not published | not published | $543.28 – $1,161.06 | 8 |
| Decompress fingers/hand CPT 26035 | not published | not published | $828.97 – $1,775.83 | 8 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $1,255.46 – $2,677.32 | 8 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $746.48 – $1,605.71 | 8 |
| Decompression fasct forearm CPT 24495 | not published | not published | $883.68 – $1,877.51 | 8 |
| Decompression of leg CPT 27892 | not published | not published | $514.66 – $1,098.71 | 8 |
| Decompression of leg CPT 27893 | not published | not published | $592.25 – $1,270.87 | 8 |
| Decompression of leg CPT 27894 | not published | not published | $778.30 – $1,661.29 | 8 |
| Decompression of lower leg CPT 27600 | not published | not published | $382.42 – $817.43 | 8 |
| Decompression of lower leg CPT 27601 | not published | not published | $422.40 – $906.90 | 8 |
| Decompression of thigh/knee CPT 27496 | not published | not published | $529.77 – $1,140.07 | 8 |
| Decompression of thigh/knee CPT 27497 | not published | not published | $560.56 – $1,201.05 | 8 |
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.