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 |
|---|---|---|---|---|
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $3.46 – $16.71 | 9 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $4,274.92 | $4,274.92 | $0.34 – $0.94 | 9 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $31.81 – $131.15 | 7 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $8.28 – $34.62 | 7 |
| Alpha-fetoprotein tumor marker CPT 82105 | $194.65 | $194.65 | $8.28 – $63.31 | 9 |
| Alprostadil for injection HCPCS J0270 | $1,641.74 | $1,641.74 | $4.74 – $862.22 | 6 |
| Alprostadil urethral suppos HCPCS J0275 | not published | not published | $25.72 – $117.10 | 3 |
| Als 1 HCPCS A0426 | not published | not published | $350.00 – $671.96 | 3 |
| Als1-emergency HCPCS A0427 | not published | not published | $350.00 – $1,063.94 | 3 |
| Als 2 HCPCS A0433 | not published | not published | $350.00 – $1,539.89 | 3 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $31,580.10 | $31,580.10 | $88.97 – $732.82 | 9 |
| Alt/sgpt CPT 84460 | $103.85 | $103.85 | $3.92 – $40.80 | 9 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.63 – $8.90 | 8 |
| Aluminum - quest CPT 82108 | $193.75 | $193.75 | $12.58 – $158.77 | 9 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $233.35 – $740.76 | 9 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $1,612.70 | $1,612.70 | $37.51 – $109.21 | 9 |
| Amantadine (symmetrel)-sendout CPT 80375 | $558.85 | $558.85 | $8.64 – $139.54 | 9 |
| Ambl bp mntr w/software CPT 93784 | not published | not published | $43.52 – $93.54 | 8 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $4.92 – $11.52 | 8 |
| Ambl bp mntr w/sw i&r CPT 93790 | $83.10 | $83.10 | $17.09 – $41.55 | 9 |
| Amifostine HCPCS J0207 | not published | not published | $888.59 – $1,808.82 | 4 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $49.76 | $49.76 | $0.79 – $46.77 | 7 |
| Amines vaginal fluid qual CPT 82120 | not published | not published | $3.59 – $12.20 | 7 |
| Amino acid screen, urine CPT 82128 | not published | not published | $6.85 – $28.24 | 7 |
| Amino acid single qual CPT 82127 | not published | not published | $6.85 – $28.87 | 7 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $8.33 – $39.93 | 7 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $101.80 | $101.80 | $19.69 – $45.40 | 9 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.65 – $3.26 | 8 |
| Aminolevulinic acid delta CPT 82135 | $279.75 | $279.75 | $8.12 – $113.65 | 9 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $392.32 – $761.72 | 8 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $185.07 | $185.07 | $5.13 – $113.39 | 9 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $470.29 | $470.29 | $2.42 – $172.77 | 9 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $152.27 | $152.27 | $0.51 – $11.49 | 9 |
| Amitriptyline (elavil) -sendout CPT 80335 | $229.95 | $229.95 | $2.02 – $108.29 | 9 |
| Amitriptyline injection HCPCS J1320 | not published | not published | $2.24 – $3.67 | 3 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $13,660.30 | $13,660.30 | $19.98 – $12,840.68 | 9 |
| Ammonia CPT 82140 | $247.40 | $247.40 | $7.20 – $105.28 | 9 |
| Amnioarmor 1 sq cm HCPCS Q4188 | not published | not published | $543.20 – $1,654.50 | 4 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $74.22 – $229.37 | 9 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $163.27 – $361.94 | 8 |
| Amniocore per sq cm HCPCS Q4227 | not published | not published | $96.19 – $1,038.80 | 6 |
| Amnio-maxx or lite per sq cm HCPCS Q4239 | not published | not published | $68.68 – $5,164.83 | 4 |
| Amniotic fluid scan CPT 82143 | not published | not published | $3.74 – $19.04 | 7 |
| Amniowrap2 per sq cm HCPCS Q4221 | not published | not published | $1,696.00 – $3,257.92 | 4 |
| Amobarbital 125 mg inj HCPCS J0300 | not published | not published | $23.72 – $300.38 | 5 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $3,517.65 | $3,517.65 | $662.64 – $1,927.80 | 9 |
| Amphetamine confirm urine -sendout CPT 80324 | $267.35 | $267.35 | $6.05 – $245.81 | 9 |
| Amphetamines 5 or more CPT 80326 | $168.90 | $168.90 | $9.23 – $105.80 | 9 |
| Ampho b cholesteryl sulfate HCPCS J0288 | not published | not published | $14.00 – $148.44 | 4 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $488.62 | $488.62 | $7.47 – $28.88 | 7 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $10.30 – $37.95 | 8 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $3,240.21 | $3,240.21 | $21.63 – $1,559.88 | 9 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $168.60 | $168.60 | $0.88 – $21.98 | 9 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $96.62 | $96.62 | $1.77 – $20.40 | 9 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $262.99 – $551.08 | 6 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $967.35 | $967.35 | $404.95 – $863.51 | 9 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $666.18 – $1,445.74 | 8 |
| Amputate hand at wrist CPT 25922 | not published | not published | $624.40 – $1,335.95 | 8 |
| Amputate hand at wrist CPT 25920 | not published | not published | $704.77 – $1,505.40 | 8 |
| Amputate leg at thigh CPT 27591 | not published | not published | $924.50 – $1,975.11 | 8 |
| Amputate leg at thigh CPT 27592 | not published | not published | $630.75 – $1,360.34 | 8 |
| Amputate lower leg at knee CPT 27598 | not published | not published | $652.36 – $1,409.15 | 8 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $737.40 – $1,569.10 | 8 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $724.88 – $1,588.76 | 8 |
| Amputate upper arm & implant CPT 24931 | not published | not published | $892.99 – $1,908.69 | 8 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $550.58 – $1,180.73 | 8 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $593.86 – $1,273.58 | 8 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $661.90 – $1,414.57 | 8 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $578.71 – $1,241.04 | 8 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $768.54 – $1,636.89 | 8 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $479.99 – $1,031.62 | 8 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $545.87 – $1,178.70 | 8 |
| Amputation follow-up surgery CPT 24930 | not published | not published | $745.14 – $1,592.15 | 8 |
| Amputation follow-up surgery CPT 25924 | not published | not published | $688.53 – $1,470.83 | 8 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $832.91 – $1,819.22 | 8 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $609.57 – $1,319.68 | 8 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $599.77 – $1,300.01 | 8 |
| Amputation of foot at ankle CPT 27888 | not published | not published | $529.20 – $1,160.39 | 8 |
| Amputation of forearm CPT 25900 | not published | not published | $691.13 – $1,479.65 | 8 |
| Amputation of forearm CPT 25905 | not published | not published | $677.09 – $1,449.14 | 8 |
| Amputation of forearm CPT 25915 | not published | not published | $1,113.19 – $2,385.18 | 8 |
| Amputation of hand CPT 25927 | not published | not published | $830.51 – $1,771.77 | 8 |
| Amputation of leg at hip CPT 27290 | not published | not published | $1,542.77 – $3,309.03 | 8 |
| Amputation of leg at hip CPT 27295 | not published | not published | $1,188.05 – $2,571.58 | 8 |
| Amputation of lower leg CPT 27882 | not published | not published | $550.29 – $1,199.04 | 8 |
| Amputation of lower leg CPT 27881 | not published | not published | $774.74 – $1,687.73 | 8 |
| Amputation of midtarsal 28800 CPT 28800 | $1,217.40 | $1,217.40 | $508.73 – $1,076.36 | 9 |
| Amputation of upper arm CPT 24900 | not published | not published | $709.87 – $1,523.02 | 8 |
| Amputation of upper arm CPT 24920 | not published | not published | $706.98 – $1,510.82 | 8 |
| Amputation thru metatarsal CPT 28805 | $1,641.65 | $1,641.65 | $674.04 – $1,434.91 | 9 |
| Amputation toe interphalangeal joint CPT 28825 | $838.25 | $838.25 | $164.41 – $562.16 | 9 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $891.70 | $891.70 | $168.51 – $571.15 | 9 |
| Amylase CPT 82150 | $142.75 | $142.75 | $4.80 – $76.23 | 9 |
| Anabolic steroid 1 or 2 CPT 80327 | not published | not published | $8.93 – $50.16 | 4 |
| Anabolic steroid 3 or more CPT 80328 | not published | not published | $24.87 – $24.87 | 1 |
| Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 | $8,103.10 | $8,103.10 | $58.32 – $7,616.91 | 9 |
| Ana ds-dna CPT 86226 | not published | not published | $5.98 – $24.66 | 7 |
| Analgesics non-opioid 3-5 CPT 80330 | not published | not published | $5.10 – $5.10 | 1 |
| Analgesics non-opioid 6/more CPT 80331 | not published | not published | $8.15 – $8.15 | 1 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $367.65 | $367.65 | $4.61 – $345.59 | 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.