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 |
|---|---|---|---|---|
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $1,233.41 – $2,695.60 | 8 |
| Esophagoplasty congenital CPT 43313 | not published | not published | $2,701.09 – $5,891.44 | 8 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $182.98 – $389.73 | 8 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $92.33 – $407.33 | 9 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $219.79 – $469.04 | 8 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $176.30 – $378.20 | 8 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $146.48 – $312.47 | 8 |
| Esophagoscopy balloon <30mm CPT 43220 | $1,385.00 | $1,385.00 | $111.55 – $1,163.40 | 9 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $154.81 – $1,139.73 | 9 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $96.97 – $684.87 | 9 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $82.80 – $507.55 | 9 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $76.96 – $367.49 | 9 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $132.70 – $754.90 | 9 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $184.09 – $1,359.46 | 9 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $126.17 – $785.09 | 9 |
| Esophagoscopy retro balloon CPT 43213 | $3,673.45 | $3,673.45 | $241.99 – $2,336.65 | 9 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $176.38 – $375.50 | 8 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $148.40 – $315.86 | 8 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $522.82 – $1,114.98 | 8 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $150.49 – $808.86 | 9 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $185.94 – $397.19 | 8 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $186.76 – $397.18 | 8 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $161.68 – $343.65 | 8 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $161.58 – $344.99 | 8 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $181.97 – $384.98 | 8 |
| Esophagotomy thrc rmvl fb CPT 43045 | not published | not published | $1,205.13 – $2,629.87 | 8 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $132.33 – $282.63 | 8 |
| Esophagus motility study CPT 91010 | $852.30 | $852.30 | $60.80 – $715.93 | 9 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $46.07 – $97.61 | 8 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $143.99 – $2,058.46 | 9 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $122.75 – $742.05 | 9 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $781.12 – $1,660.60 | 8 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $1,027.24 – $2,252.32 | 8 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $8.65 – $18.29 | 8 |
| Esoph imped function test CPT 91037 | not published | not published | $46.30 – $96.92 | 8 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $52.47 – $110.47 | 8 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $125.63 – $584.01 | 9 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $127.46 – $270.45 | 8 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $97.83 – $500.48 | 9 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $3,244.15 – $7,123.69 | 8 |
| Esphg thrsc moblj CPT 43288 | not published | not published | $3,426.57 – $7,512.74 | 8 |
| Esphg tot w/laps moblj CPT 43286 | not published | not published | $2,923.06 – $6,374.71 | 8 |
| Esphg tot w/thrcm CPT 43112 | not published | not published | $3,112.68 – $6,856.62 | 8 |
| Esrd home pt serv p mo 12-19 CPT 90965 | not published | not published | $475.71 – $1,003.83 | 8 |
| Esrd home pt serv p mo 20+ CPT 90966 | not published | not published | $282.01 – $591.05 | 8 |
| Esrd home pt serv p mo 2-11 CPT 90964 | not published | not published | $493.96 – $1,045.85 | 8 |
| Esrd home pt serv p mo <2yrs CPT 90963 | not published | not published | $575.99 – $1,220.05 | 8 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | not published | not published | $195.22 – $408.03 | 8 |
| Esrd serv 1 visit p mo <2yrs CPT 90953 | not published | not published | $555.17 – $1,132.60 | 4 |
| Esrd serv 1 vst p mo 12-19 CPT 90959 | not published | not published | $311.61 – $656.10 | 8 |
| Esrd serv 2-3 vsts p mo <2yr CPT 90952 | not published | not published | $766.36 – $1,700.59 | 4 |
| Esrd serv 4 visits p mo <2yr CPT 90951 | not published | not published | $1,104.45 – $2,345.19 | 8 |
| Esrd serv 4 vsts p mo 2-11 CPT 90954 | not published | not published | $952.18 – $2,018.49 | 8 |
| Esrd srv 1 visit p mo 2-11 CPT 90956 | not published | not published | $334.03 – $700.17 | 8 |
| Esrd srv 2-3 vsts p mo 12-19 CPT 90958 | not published | not published | $476.66 – $1,005.86 | 8 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | not published | not published | $282.01 – $591.05 | 8 |
| Esrd srv 2-3 vsts p mo 2-11 CPT 90955 | not published | not published | $498.75 – $1,049.91 | 8 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | not published | not published | $339.52 – $711.69 | 8 |
| Esrd srv 4 vsts p mo 12-19 CPT 90957 | not published | not published | $731.36 – $1,545.39 | 8 |
| Esrd svc pr day pt 12-19 CPT 90969 | not published | not published | $16.01 – $33.88 | 8 |
| Esrd svc pr day pt <2 CPT 90967 | not published | not published | $16.66 – $35.25 | 8 |
| Esrd svc pr day pt 20+ CPT 90970 | not published | not published | $9.26 – $18.98 | 8 |
| Esrd svc pr day pt 2-11 CPT 90968 | not published | not published | $16.33 – $34.57 | 8 |
| Essure 58565 CPT 58565 | not published | not published | $434.40 – $3,193.70 | 9 |
| Establish access to aorta CPT 36160 | $1,842.60 | $1,842.60 | $113.16 – $1,045.93 | 9 |
| Establish access to artery CPT 36100 | not published | not published | $137.53 – $1,028.69 | 9 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $969.79 – $2,139.13 | 8 |
| Establish brain cavity shunt CPT 62180 | not published | not published | $1,490.22 – $3,309.70 | 8 |
| Establish brain cavity shunt CPT 62190 | not published | not published | $877.72 – $1,934.45 | 8 |
| Establish brain cavity shunt CPT 62192 | not published | not published | $923.38 – $2,063.89 | 8 |
| Establish brain cavity shunt CPT 62200 | not published | not published | $1,284.56 – $2,850.15 | 8 |
| Establish brain cavity shunt CPT 62220 | not published | not published | $910.55 – $2,015.78 | 8 |
| Established Patient Office Visit (level 1) CPT 99211 | $175.35 | $175.35 | $5.78 – $15.98 | 9 |
| Established Patient Office Visit (level 2) CPT 99212 | $202.55 | $202.55 | $12.02 – $33.23 | 9 |
| Established Patient Office Visit (level 3) CPT 99213 | $339.80 | $339.80 | $16.90 – $46.72 | 9 |
| Established Patient Office Visit (level 4) CPT 99214 | $341.20 | $341.20 | $24.91 – $68.86 | 9 |
| Established Patient Office Visit (level 5) CPT 99215 | $410.50 | $410.50 | $33.35 – $92.21 | 9 |
| Estim aid bone healg invasiv CPT 20975 | not published | not published | $166.12 – $358.55 | 8 |
| Estradiol total CPT 82670 | $569.70 | $569.70 | $13.80 – $127.93 | 9 |
| Estradiol valerate 10 mg inj HCPCS J1380 | not published | not published | $8.32 – $15.69 | 6 |
| Estrogens total-sendout CPT 82672 | $349.45 | $349.45 | $10.71 – $146.26 | 9 |
| Etanercept injection HCPCS J1438 | not published | not published | $294.84 – $1,113.31 | 8 |
| Ethanolamine oleate 100 mg HCPCS J1430 | $4,186.01 | $4,186.01 | $468.15 – $3,934.85 | 9 |
| Eth estr and eton monthly HCPCS J7295 | not published | not published | $125.17 – $265.68 | 4 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $905.55 – $1,906.66 | 8 |
| Ethylene glycol -sendout CPT 82693 | $193.65 | $193.65 | $7.36 – $109.89 | 9 |
| Etonogestrel implant system HCPCS J7307 | $1,357.55 | $1,357.55 | $998.61 – $1,276.10 | 6 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $773.64 | $773.64 | $0.88 – $98.56 | 7 |
| Etoposide 50 mg cap HCPCS J8560 | $359.87 | $359.87 | $75.76 – $149.20 | 8 |
| Euflexxa inj per dose HCPCS J7323 | $5,527.60 | $5,527.60 | $114.48 – $5,195.94 | 9 |
| Euglobulin lysis CPT 85360 | not published | not published | $4.15 – $17.12 | 7 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $504.51 – $1,097.36 | 8 |
| Eval aud funcj ea addl 15 CPT 92627 | not published | not published | $16.78 – $39.20 | 9 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $71.67 – $165.76 | 9 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $508.40 | $508.40 | $120.12 – $295.34 | 9 |
| Evaluation cervical mucus CPT 89330 | not published | not published | $4.88 – $21.14 | 7 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $812.50 | $812.50 | $39.24 – $210.61 | 9 |
| Evaluation heart device CPT 93640 | $4,074.95 | $4,074.95 | $159.97 – $3,422.96 | 9 |
| Evaluation of speech fluency 92521 CPT 92521 | $680.25 | $680.25 | $130.70 – $267.93 | 9 |
| Evaluation psychiatric diagnostic CPT 90791 | $847.00 | $847.00 | $142.05 – $214.79 | 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.