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 |
|---|---|---|---|---|
| Drainage of urinary leakage CPT 53080 | not published | not published | $404.80 – $858.10 | 8 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $619.96 – $1,315.61 | 8 |
| Drain bladder by trocar/cath CPT 51101 | $503.65 | $503.65 | $47.86 – $296.82 | 9 |
| Drain blood from under nail 11740 CPT 11740 | $165.45 | $165.45 | $20.03 – $48.55 | 9 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $4,094.75 | $4,094.75 | $191.41 – $1,431.41 | 9 |
| Drain cath image guided visceral pq CPT 49405 | $6,610.20 | $6,610.20 | $181.08 – $1,676.84 | 9 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,284.65 | $1,284.65 | $85.61 – $268.56 | 9 |
| Drain chest lesion CPT 21502 | not published | not published | $479.98 – $1,037.71 | 8 |
| Drain chst dry seal exp thorastat HCPCS A7041 | not published | not published | $82.46 – $206.12 | 7 |
| Drain finger abscess;simple 26010 CPT 26010 | $495.85 | $495.85 | $71.62 – $198.01 | 9 |
| Drain lower leg bursa CPT 27604 | $4,768.30 | $4,768.30 | $311.51 – $871.83 | 9 |
| Drain lower leg lesion 27603 CPT 27603 | $4,501.40 | $4,501.40 | $375.30 – $1,017.66 | 9 |
| Drain neck/chest lesion 21501 CPT 21501 | $4,706.15 | $4,706.15 | $321.76 – $948.92 | 9 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $1,055.18 – $2,297.06 | 8 |
| Drain ostomy pouch w/flange HCPCS A5063 | not published | not published | $3.01 – $7.51 | 7 |
| Drain ovarn cyst abd CPT 58805 | $4,404.55 | $4,404.55 | $407.46 – $3,699.82 | 9 |
| Drain ovary abscess open CPT 58820 | not published | not published | $324.49 – $694.74 | 8 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $1,027.93 – $2,235.38 | 8 |
| Drain penis lesion CPT 54015 | not published | not published | $290.40 – $618.15 | 8 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $657.70 – $1,396.96 | 8 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $213.52 – $837.77 | 9 |
| Drain shoulder lesion CPT 23030 | not published | not published | $244.64 – $851.92 | 9 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $488.66 – $1,311.91 | 9 |
| Drain thyroid/tongue cyst CPT 60000 | $1,407.20 | $1,407.20 | $151.70 – $363.00 | 9 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $722.82 – $1,571.13 | 8 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $478.85 | $478.85 | $61.39 – $169.72 | 9 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $327.20 | $327.20 | $52.89 – $152.02 | 9 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $591.20 | $591.20 | $115.67 – $147.82 | 9 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $41.71 – $90.14 | 8 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $3,780.00 | $3,780.00 | $42.86 – $1,861.20 | 7 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | $722.50 | $722.50 | $531.47 – $985.19 | 9 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $722.50 | $722.50 | $283.82 – $629.95 | 9 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $84,425.73 – $203,619.82 | 7 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $84.25 – $184.38 | 9 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $84.25 – $186.95 | 9 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $735.39 – $1,600.29 | 8 |
| Drng hand tendon sheath 26020 CPT 26020 | $3,620.00 | $3,620.00 | $538.32 – $3,040.80 | 9 |
| Drng of eyelid abscess 67700 CPT 67700 | $618.50 | $618.50 | $110.92 – $327.20 | 9 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,956.15 | $2,956.15 | $178.93 – $459.06 | 9 |
| Drng of hydrocele 55000 CPT 55000 | $1,318.25 | $1,318.25 | $80.63 – $232.57 | 9 |
| Drng of mouth lesion 40801 CPT 40801 | $858.60 | $858.60 | $190.60 – $563.44 | 9 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $302.05 – $705.42 | 9 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $475.72 – $1,019.40 | 8 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $406.15 – $870.29 | 8 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $410.42 – $877.74 | 8 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $224.22 – $767.75 | 9 |
| Drng of scrotum abscess 55100 CPT 55100 | $2,703.90 | $2,703.90 | $100.98 – $279.18 | 9 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | $1,905.70 | $1,905.70 | $1,034.74 – $1,791.36 | 9 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $942.71 – $2,040.86 | 8 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $677.07 – $1,458.63 | 8 |
| Drng peritoneal abscess open 49020 CPT 49020 | $1,905.70 | $1,905.70 | $1,401.83 – $1,791.36 | 9 |
| Drng salivary gland simple 42300 CPT 42300 | $2,217.50 | $2,217.50 | $151.29 – $418.25 | 9 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $940.60 | $940.60 | $130.71 – $330.86 | 9 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $0.72 – $2.69 | 6 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $108.21 | $108.21 | $6.10 – $66.30 | 9 |
| Drop lock knee HCPCS L2182 | not published | not published | $108.71 – $273.67 | 7 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $30.51 – $76.81 | 7 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $4,938.00 | $4,938.00 | $13.24 – $1,282.51 | 9 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $12.36 – $24.13 | 6 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $11.79 – $23.84 | 6 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $336.20 | $336.20 | $7.84 – $35.22 | 7 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | not published | not published | $25.89 – $33.21 | 3 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $12.15 – $30.38 | 7 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $1,723.88 | $1,723.88 | $188.42 – $1,296.35 | 6 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | $1,750.00 | $1,750.00 | $16.91 – $141.00 | 7 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $15,495.00 | $15,495.00 | $48.58 – $2,425.48 | 9 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | $290.30 | $290.30 | $17.64 – $22.54 | 6 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $138.31 – $168.77 | 2 |
| Drug admin & hemodynmic meas CPT 93463 | $612.15 | $612.15 | $56.20 – $105.03 | 9 |
| Drug assay caffeine CPT 80155 | not published | not published | $15.43 – $78.54 | 7 |
| Drug assay posaconazole CPT 80187 | $258.95 | $258.95 | $10.84 – $130.19 | 9 |
| Drug assay rufinamide CPT 80210 | not published | not published | $10.84 – $55.20 | 7 |
| Drug assay vedolizumab CPT 80280 | $84.45 | $84.45 | $15.43 – $75.44 | 9 |
| Drug assay voriconazole CPT 80285 | $219.45 | $219.45 | $10.84 – $108.01 | 9 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $7.46 – $37.95 | 7 |
| Drug of abuse screen urine CPT 80305 | $35.55 | $35.55 | $8.08 – $33.42 | 9 |
| Drug screening tapentadol CPT 80372 | not published | not published | $5.04 – $50.16 | 4 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $10.84 – $55.20 | 7 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $8.93 – $50.16 | 4 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $45.77 – $404.67 | 7 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $45.77 – $233.00 | 6 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $45.77 – $502.78 | 7 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $45.77 – $318.85 | 7 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $28.73 – $126.53 | 7 |
| Drug test prsmv instrmnt CPT 80306 | $206.65 | $206.65 | $7.18 – $126.29 | 9 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $345.50 | $345.50 | $31.92 – $171.17 | 9 |
| Drvvt confirm - quest CPT 85597 | not published | not published | $8.88 – $37.68 | 7 |
| Dry needling (97799) CPT 97799 | $235.15 | $235.15 | $47.52 – $60.72 | 6 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $242.79 – $565.37 | 9 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | not published | not published | $140.74 – $749.11 | 9 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $193.95 – $549.31 | 9 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $163.99 – $470.93 | 9 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $191.25 – $534.53 | 9 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $259.36 – $685.50 | 9 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $528.19 – $1,263.72 | 8 |
| Ductogram sgl duct CPT 77053 | $905.40 | $905.40 | $16.32 – $449.36 | 9 |
| Duodenal exclusion CPT 48547 | not published | not published | $1,664.46 – $3,637.08 | 8 |
| Duodenal motility study CPT 91022 | not published | not published | $68.38 – $143.68 | 8 |
| Duplex scan bilateral study 93985 CPT 93985 | $477.20 | $477.20 | $35.18 – $400.85 | 9 |
| Duplex scan unilateral study 93986 CPT 93986 | $224.00 | $224.00 | $21.37 – $188.16 | 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.