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 |
|---|---|---|---|---|
| External newborn metabolic screening panel HCPCS S3620 | $250.15 | $250.15 | $23.12 – $63.92 | 9 |
| External ocular photography CPT 92285 | not published | not published | $2.81 – $6.10 | 8 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | not published | not published | $14.83 – $51.51 | 7 |
| External profiling gene expression oncology (breast) mrna 21 genes CPT 81519 | not published | not published | $1,549.20 – $8,115.31 | 7 |
| External recharg sys extern HCPCS L8695 | not published | not published | $15.49 – $38.99 | 7 |
| External recharg sys intern HCPCS L8689 | $1,400.00 | $1,400.00 | $662.04 – $2,093.43 | 9 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $460.80 | $460.80 | $71.56 – $326.37 | 9 |
| Extnd color vision xm CPT 92283 | not published | not published | $8.33 – $16.94 | 8 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $192.10 | $192.10 | $8.86 – $68.76 | 9 |
| Extraction of lens CPT 66930 | not published | not published | $815.72 – $1,719.58 | 8 |
| Extraction of lens CPT 66940 | not published | not published | $747.73 – $1,575.89 | 8 |
| Extraction of lens 66920 CPT 66920 | not published | not published | $713.89 – $1,505.40 | 8 |
| Extrnl counterpulse, per tx HCPCS G0166 | not published | not published | $97.25 – $203.34 | 8 |
| Eye allergy tests CPT 95060 | not published | not published | $34.95 – $79.98 | 8 |
| Eye implant band 40 HCPCS C1784 | $794.00 | $794.00 | $584.07 – $746.36 | 6 |
| Eye photodynamic ther add-on CPT 67225 | not published | not published | $25.87 – $55.25 | 9 |
| Eye Socket (Orbit) X-ray CPT 70200 | $465.15 | $465.15 | $12.87 – $276.36 | 9 |
| Eye Socket, Pituitary or Ear CT Scan (with and without contrast) CPT 70482 | $3,259.90 | $3,259.90 | $57.08 – $1,620.11 | 9 |
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $2,395.25 | $2,395.25 | $51.03 – $1,462.48 | 9 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $1,797.15 | $1,797.15 | $58.06 – $854.32 | 9 |
| Eye surgery follow-up add-on CPT 67331 | not published | not published | $119.48 – $296.18 | 8 |
| Eye suture during surgery CPT 67335 | not published | not published | $176.89 – $372.79 | 8 |
| Ezh2 gene common variants CPT 81237 | not published | not published | $70.16 – $357.15 | 7 |
| Ezh2 gene full gene sequence CPT 81236 | not published | not published | $113.15 – $576.00 | 7 |
| F-18 fdg pet diag HCPCS A9552 | $355.35 | $355.35 | $261.40 – $606.82 | 9 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $4,835.05 | $4,835.05 | $2,194.62 – $4,544.95 | 9 |
| F-18 fluciclovine per mci HCPCS A9588 | $910.43 | $910.43 | $268.42 – $855.80 | 9 |
| F-18 sodium fluoride HCPCS A9580 | $400.65 | $400.65 | $225.44 – $99,999.99 | 7 |
| F9 full gene sequence CPT 81238 | not published | not published | $600.00 – $1,221.72 | 7 |
| Fabrication & fitting HCPCS V2628 | not published | not published | $290.51 – $726.13 | 7 |
| Face bone graft CPT 21210 | not published | not published | $733.94 – $3,381.95 | 9 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $8,574.90 | $8,574.90 | $97.30 – $2,519.33 | 9 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $3,864.90 | $3,864.90 | $60.65 – $1,552.82 | 9 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $431.85 | $431.85 | $9.30 – $236.38 | 9 |
| Facial Bones X-ray (complete) CPT 70150 | $465.15 | $465.15 | $11.90 – $309.46 | 9 |
| Facial nerve function test CPT 92516 | not published | not published | $21.42 – $139.42 | 9 |
| Facility svs dental rehab HCPCS G0330 | not published | not published | $3,138.77 – $3,232.94 | 5 |
| Factor ix CPT 85250 | $678.00 | $678.00 | $9.40 – $160.98 | 9 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $3.11 – $6.66 | 8 |
| Factor ix complex HCPCS J7194 | not published | not published | $1.17 – $3.10 | 8 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $4.94 – $9.77 | 8 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.05 – $2.55 | 8 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $4.41 – $8.59 | 8 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.37 – $3.19 | 7 |
| Factor ix recombinant nos HCPCS J7195 | $4,564.05 | $4,564.05 | $1.41 – $4,290.21 | 9 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $1.95 – $4.47 | 7 |
| Factor viii CPT 85240 | $467.35 | $467.35 | $8.84 – $212.72 | 9 |
| Factor viii HCPCS J7190 | not published | not published | $0.97 – $2.14 | 8 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $2.06 – $4.24 | 8 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $1.18 – $2.40 | 8 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $1.97 – $3.95 | 8 |
| Factor viii recombinant nos HCPCS J7192 | $20.57 | $20.57 | $1.22 – $14.66 | 9 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.28 – $2.65 | 8 |
| Factor viii recomb obizur HCPCS J7188 | $30.03 | $30.03 | $3.22 – $28.23 | 9 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $9.68 – $19.51 | 8 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $16.84 – $32.86 | 8 |
| Fallopian tube recnl CPT 58345 | not published | not published | $274.41 – $591.04 | 8 |
| Fam adapt bhv tx gdn phy/qhp CPT 97156 | not published | not published | $28.83 – $70.49 | 7 |
| Family therapy without pt 50min 90846 CPT 90846 | $410.25 | $410.25 | $95.17 – $197.92 | 9 |
| Family therapy with patient 50 min 90847 CPT 90847 | $295.05 | $295.05 | $99.25 – $170.09 | 9 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $228.02 | $228.02 | $1.21 – $2.44 | 9 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $10,531.40 | $10,531.40 | $26.14 – $9,899.52 | 9 |
| Fancc gene CPT 81242 | $294.95 | $294.95 | $14.65 – $37.72 | 9 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $885.72 – $1,905.96 | 8 |
| Fat/lipids feces qualitative CPT 82705 | $146.30 | $146.30 | $2.52 – $41.64 | 9 |
| Fatty acids nonesterified CPT 82725 | $168.90 | $168.90 | $7.51 – $121.50 | 9 |
| Fda ide #g240020 carry bag HCPCS Q0499 | not published | not published | $156.44 – $391.03 | 7 |
| Fecal bilirubin test CPT 82252 | not published | not published | $2.25 – $9.29 | 7 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $62.98 – $121.42 | 8 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $66.38 – $252.49 | 8 |
| #fecal-sodium CPT 84302 | $96.95 | $96.95 | $2.40 – $47.42 | 9 |
| Feeding tube reposition CPT 74355 | not published | not published | $34.60 – $72.53 | 8 |
| Fees w/laryngeal sense i&r CPT 92617 | not published | not published | $38.51 – $81.34 | 9 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $95.34 – $440.73 | 9 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $217.90 | $217.90 | $7.46 – $55.84 | 9 |
| Fem focal defic constant fri HCPCS L5230 | not published | not published | $3,784.13 – $9,525.97 | 7 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $209.02 – $464.29 | 8 |
| Femoral lgth sock fx or equa HCPCS L2850 | not published | not published | $70.55 – $177.58 | 7 |
| Fem/popl revasc w/stent CPT 37226 | $25,256.20 | $25,256.20 | $464.47 – $6,038.47 | 9 |
| Fem urinary collect pouch HCPCS A4328 | not published | not published | $9.87 – $24.64 | 7 |
| Feno poc CPT 95012 | not published | not published | $17.43 – $37.95 | 8 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $244.31 | $244.31 | $0.34 – $0.94 | 9 |
| Fern test HCPCS Q0114 | $69.00 | $69.00 | $3.90 – $51.75 | 9 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,284.45 | $5,284.45 | $1.13 – $4,875.11 | 9 |
| Ferritin CPT 82728 | $261.65 | $261.65 | $6.73 – $111.16 | 9 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $4,525.62 | $4,525.62 | $0.31 – $4,026.35 | 9 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.31 – $0.75 | 8 |
| Fetal aneuploidy trisom risk CPT 81507 | not published | not published | $645.00 – $1,618.78 | 7 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $948.85 | $948.85 | $47.81 – $175.73 | 9 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $303.62 – $1,545.58 | 7 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $2,290.80 | $2,290.80 | $88.91 – $781.82 | 9 |
| Fetal contract stress test 59020 - 26 CPT 59020 | not published | not published | $33.47 – $70.67 | 8 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $184.08 – $408.71 | 8 |
| Fetal fibronectin CPT 82731 | $1,030.35 | $1,030.35 | $31.81 – $704.11 | 9 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $283.11 – $743.34 | 9 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $316.70 | $316.70 | $3.82 – $92.21 | 9 |
| Fetal hemoglobin rosette CPT 85461 | $85.30 | $85.30 | $3.74 – $67.73 | 9 |
| Fetal lung maturity assess lam body dnst CPT 83664 | not published | not published | $9.34 – $39.34 | 7 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $38.10 – $84.72 | 8 |
| Fetal monitor w/report CPT 59050 | not published | not published | $45.65 – $101.00 | 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.