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 |
|---|---|---|---|---|
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $25.88 – $58.97 | 8 |
| Disability dlco CPT 94727 | $558.70 | $558.70 | $11.24 – $23.72 | 9 |
| Disaccharidases CPT 82657 | $897.25 | $897.25 | $8.92 – $429.11 | 9 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $455.15 – $980.78 | 8 |
| Disarticulation shoulder CPT 23920 | not published | not published | $1,075.76 – $2,300.46 | 8 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $1,385.85 – $2,976.21 | 8 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $187.33 – $420.92 | 8 |
| Discography cerv/thor spine CPT 72285 | $5,936.70 | $5,936.70 | $53.43 – $4,986.83 | 9 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $68.07 – $171.33 | 7 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $164.70 – $414.61 | 7 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $92.44 – $197.25 | 8 |
| Dissect brain w/scope CPT 62161 | not published | not published | $1,421.82 – $3,157.86 | 8 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $93.87 – $197.91 | 7 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $338.94 – $744.23 | 8 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,026.93 – $2,263.85 | 8 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $1,051.58 – $2,305.20 | 8 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $753.22 – $1,620.61 | 8 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $320.73 – $689.31 | 8 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $4.75 – $50.16 | 4 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $262.70 – $581.56 | 8 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $111.60 – $568.10 | 7 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $109.93 – $559.61 | 7 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $54.80 – $278.96 | 7 |
| Dna antibody native/double stranded CPT 86225 | $247.05 | $247.05 | $6.79 – $66.46 | 9 |
| Dna gardnerella CPT 87510 | not published | not published | $9.90 – $40.83 | 7 |
| Dna probe chlamydia CPT 87490 | not published | not published | $9.90 – $46.32 | 7 |
| Dna probe gc CPT 87590 | not published | not published | $10.75 – $54.73 | 7 |
| Dna trichomonas CPT 87660 | not published | not published | $9.90 – $40.83 | 7 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $1,043.39 | $1,043.39 | $6.66 – $63.24 | 9 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $4,739.59 | $4,739.59 | $0.47 – $249.48 | 7 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $49.08 – $103.22 | 6 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $6.17 – $20.00 | 4 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $61.52 – $115.90 | 4 |
| Domicil/r-home visit est pat CPT 99334 | not published | not published | $119.64 – $119.64 | 1 |
| Domicil/r-home visit est pat CPT 99335 | not published | not published | $188.61 – $188.61 | 1 |
| Domicil/r-home visit est pat CPT 99336 | not published | not published | $268.15 – $268.15 | 1 |
| Domicil/r-home visit est pat CPT 99337 | not published | not published | $383.55 – $383.55 | 1 |
| Domicil/r-home visit new pat CPT 99324 | not published | not published | $109.80 – $109.80 | 1 |
| Domicil/r-home visit new pat CPT 99325 | not published | not published | $159.76 – $159.76 | 1 |
| Domicil/r-home visit new pat CPT 99326 | not published | not published | $277.29 – $277.29 | 1 |
| Domicil/r-home visit new pat CPT 99327 | not published | not published | $369.49 – $369.49 | 1 |
| Domicil/r-home visit new pat CPT 99328 | not published | not published | $432.83 – $432.83 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $201.05 | $201.05 | $0.68 – $12.71 | 9 |
| Doppler echo complete CPT 93320 | $915.55 | $915.55 | $16.76 – $35.25 | 9 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $2,317.60 | $2,317.60 | $65.66 – $1,946.78 | 9 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,099.20 | $1,099.20 | $19.87 – $146.53 | 9 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $1,012.70 | $1,012.70 | $11.01 – $112.03 | 9 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.81 – $1.36 | 4 |
| Dornase alfa non-comp unit HCPCS J7639 | $1,361.75 | $1,361.75 | $51.08 – $715.17 | 7 |
| Dornhoffer fixed part w/window HCPCS L8614 | $28,350.00 | $28,350.00 | $8.47 – $23,669.37 | 9 |
| Dorsi & plantar flex ass/res HCPCS L2220 | not published | not published | $72.87 – $183.46 | 7 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $228.40 – $446.72 | 8 |
| Double transfer toe-hand CPT 26554 | not published | not published | $3,596.09 – $7,742.51 | 8 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $2,677.49 | $2,677.49 | $2.51 – $2,516.84 | 7 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $4,485.65 | $4,485.65 | $79.62 – $1,780.83 | 9 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $880.52 | $880.52 | $47.41 – $108.05 | 9 |
| Dpyd gene common variants CPT 81232 | $1,096.20 | $1,096.20 | $174.81 – $1,030.43 | 9 |
| Drainable plastic pch w fcpl HCPCS A4375 | not published | not published | $19.08 – $47.71 | 7 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,138.25 | $1,138.25 | $113.72 – $371.83 | 9 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $1,214.35 | $1,214.35 | $139.17 – $450.36 | 9 |
| Drainage external ear complex 69005 CPT 69005 | $2,809.25 | $2,809.25 | $154.92 – $425.95 | 9 |
| Drainage external ear simple 69000 CPT 69000 | $837.95 | $837.95 | $105.91 – $140.86 | 9 |
| Drainage lymph node lesion 38300 CPT 38300 | $4,263.10 | $4,263.10 | $199.01 – $654.68 | 9 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $471.48 – $1,016.70 | 8 |
| Drainage mouth roof lesion CPT 42000 | $659.55 | $659.55 | $73.87 – $204.22 | 9 |
| Drainage of abdomen CPT 48000 | not published | not published | $1,747.30 – $3,819.40 | 8 |
| Drainage of arm bursa 23931 CPT 23931 | $2,419.30 | $2,419.30 | $155.00 – $588.50 | 9 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $394.23 – $834.37 | 8 |
| Drainage of bone lesion CPT 26992 | not published | not published | $963.05 – $2,070.00 | 8 |
| Drainage of bone lesion CPT 27303 | not published | not published | $614.43 – $1,323.73 | 8 |
| Drainage of eye CPT 65800 | not published | not published | $84.66 – $228.71 | 9 |
| Drainage of eye CPT 65810 | not published | not published | $442.24 – $935.36 | 8 |
| Drainage of eye CPT 65815 | not published | not published | $454.09 – $1,231.61 | 9 |
| Drainage of forearm bursa CPT 25031 | not published | not published | $356.88 – $769.30 | 8 |
| Drainage of kidney lesion CPT 50390 | $1,820.40 | $1,820.40 | $87.94 – $1,174.99 | 9 |
| Drainage of mouth lesion CPT 41005 | $358.55 | $358.55 | $114.95 – $301.18 | 9 |
| Drainage of mouth lesion CPT 41006 | not published | not published | $223.51 – $654.03 | 9 |
| Drainage of mouth lesion CPT 41007 | not published | not published | $213.39 – $634.11 | 9 |
| Drainage of mouth lesion CPT 41008 | $4,602.25 | $4,602.25 | $247.78 – $759.40 | 9 |
| Drainage of mouth lesion CPT 41009 | $913.60 | $913.60 | $274.47 – $738.44 | 9 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $288.55 – $770.32 | 9 |
| Drainage of mouth lesion CPT 41016 | $8,529.90 | $8,529.90 | $332.71 – $898.16 | 9 |
| Drainage of mouth lesion CPT 41017 | not published | not published | $331.47 – $897.52 | 9 |
| Drainage of mouth lesion CPT 41018 | not published | not published | $386.35 – $1,011.89 | 9 |
| Drainage of nose lesion int 30000 CPT 30000 | $624.55 | $624.55 | $117.11 – $360.86 | 9 |
| Drainage of nose lesion sept 30020 CPT 30020 | not published | not published | $118.04 – $522.97 | 9 |
| Drainage of pelvis bursa CPT 26991 | $2,291.55 | $2,291.55 | $506.30 – $1,378.09 | 9 |
| Drainage of pelvis lesion 26990 CPT 26990 | $1,641.65 | $1,641.65 | $654.76 – $1,401.70 | 9 |
| Drainage of prostate abscess CPT 52700 | not published | not published | $424.83 – $900.79 | 8 |
| Drainage of prostate abscess CPT 55720 | not published | not published | $433.23 – $920.44 | 8 |
| Drainage of prostate abscess CPT 55725 | not published | not published | $571.81 – $1,212.58 | 8 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $158.88 – $609.06 | 9 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $548.24 – $1,161.06 | 8 |
| Drainage of salivary gland CPT 42305 | not published | not published | $411.15 – $889.94 | 8 |
| Drainage of salivary gland CPT 42320 | not published | not published | $173.44 – $506.91 | 9 |
| Drainage of spinal cyst CPT 63172 | not published | not published | $1,320.70 – $2,926.73 | 8 |
| Drainage of spinal cyst CPT 63173 | not published | not published | $1,608.17 – $3,572.68 | 8 |
| Drainage of throat abscess CPT 42725 | not published | not published | $765.37 – $1,632.14 | 8 |
| Drainage of urethra abscess CPT 53040 | not published | not published | $377.46 – $799.13 | 8 |
| Drainage of urethra abscess 53060 CPT 53060 | not published | not published | $158.42 – $367.49 | 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.