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 |
|---|---|---|---|---|
| Fetal non stress test CPT 59025 | $996.45 | $996.45 | $19.85 – $55.89 | 9 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $102.31 – $227.73 | 8 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $294.41 – $1,058.05 | 8 |
| #_fet/norfentcnfrmur CPT 80354 | $295.00 | $295.00 | $6.05 – $144.06 | 9 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $6.80 – $14.25 | 8 |
| Fibrin degradation d dimer quantitative CPT 85379 | $213.65 | $213.65 | $5.02 – $123.00 | 9 |
| Fibrin degradation products CPT 85362 | not published | not published | $3.40 – $14.03 | 7 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $3.89 – $19.79 | 7 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $5.02 – $20.73 | 7 |
| Fibrinogen activity CPT 85384 | $176.75 | $176.75 | $4.20 – $99.64 | 9 |
| Fibrinogen test CPT 85370 | not published | not published | $5.61 – $25.31 | 7 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $128.80 | $128.80 | $6.19 – $71.74 | 9 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $3.80 – $15.70 | 7 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $3.80 – $15.70 | 7 |
| Fibrinolytic plasminogen CPT 85415 | not published | not published | $8.49 – $35.00 | 7 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $5.03 – $20.73 | 7 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $480.50 | $480.50 | $3.22 – $13.44 | 9 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $2,311.49 – $4,947.95 | 8 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.28 – $0.55 | 8 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $4,214.44 | $4,214.44 | $0.99 – $3,193.10 | 9 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $4,468.56 | $4,468.56 | $0.20 – $2,625.29 | 9 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $642.36 – $1,363.73 | 8 |
| Filtered speech hearing test CPT 92571 | not published | not published | $28.07 – $63.04 | 8 |
| Filters elec/combo vad, rep HCPCS Q0500 | not published | not published | $28.64 – $71.57 | 7 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $8,352.10 | $8,352.10 | $937.89 – $1,198.50 | 6 |
| Filter vena cava fem denali HCPCS C1880 | $6,684.45 | $6,684.45 | $658.36 – $841.30 | 6 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $775.98 – $1,673.50 | 8 |
| Finasteride, 5 mg HCPCS S0138 | not published | not published | $0.16 – $4.07 | 3 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,867.80 | $1,867.80 | $83.72 – $585.28 | 9 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $785.65 | $785.65 | $48.44 – $271.77 | 9 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $221.90 | $221.90 | $40.75 – $100.87 | 9 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $785.65 | $785.65 | $46.91 – $115.64 | 9 |
| Fine needle asp without image guide 10021 CPT 10021 | $655.15 | $655.15 | $48.06 – $119.02 | 9 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | not published | not published | $425.89 – $1,072.10 | 7 |
| Finger tendon transfer CPT 26497 | not published | not published | $871.21 – $1,859.20 | 8 |
| Finger tendon transfer CPT 26498 | not published | not published | $1,129.39 – $2,419.08 | 8 |
| Finger X-ray (both hands) CPT 73140 | $293.05 | $293.05 | $6.38 – $165.61 | 9 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $1,029.30 – $2,199.46 | 8 |
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $636.41 – $1,356.27 | 8 |
| Fit aphakia spectcl monofocl CPT 92352 | not published | not published | $17.62 – $83.53 | 8 |
| Fit aphakia spectcl multifoc CPT 92353 | not published | not published | $24.12 – $95.72 | 8 |
| Fitg c-lens keratoconus 1st CPT 92072 | not published | not published | $88.70 – $239.64 | 9 |
| Fitg spect low vis 1system CPT 92354 | not published | not published | $12.42 – $39.13 | 7 |
| Fitg spect lw vis cmpnd lens CPT 92355 | not published | not published | $19.31 – $44.06 | 7 |
| Fit spectacles bifocal CPT 92341 | not published | not published | $22.78 – $76.46 | 7 |
| Fit spectacles monofocal CPT 92340 | not published | not published | $17.62 – $66.81 | 7 |
| Fit spectacles multifocal CPT 92342 | not published | not published | $25.79 – $81.60 | 7 |
| Fitting of diaphragm/cap 57170 CPT 57170 | $141.65 | $141.65 | $44.29 – $150.34 | 9 |
| Fixation of ankle joint CPT 27860 | not published | not published | $159.08 – $335.50 | 8 |
| Fixation of knee joint CPT 27570 | not published | not published | $147.55 – $318.56 | 8 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $933.38 – $1,995.44 | 8 |
| Fix g/colon tube w/device CPT 49460 | not published | not published | $47.23 – $1,385.81 | 9 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $5,353.65 | $5,353.65 | $645.79 – $1,388.14 | 9 |
| Flebogamma injection HCPCS J1572 | $7,599.05 | $7,599.05 | $45.43 – $2,095.07 | 9 |
| Flecainide (tambocor)-sendout CPT 80181 | $217.90 | $217.90 | $7.46 – $145.51 | 9 |
| Fl exam g/colon tube w contrast CPT 49465 | $862.15 | $862.15 | $28.32 – $261.48 | 9 |
| Flex/ext wrist w/wo friction HCPCS L6621 | not published | not published | $2,128.86 – $5,359.10 | 7 |
| Flex foot system HCPCS L5980 | not published | not published | $4,126.57 – $10,388.02 | 7 |
| Flexible keel foot HCPCS L5972 | not published | not published | $389.50 – $980.49 | 7 |
| Flexible metal hinge pair HCPCS L6610 | not published | not published | $157.84 – $397.36 | 7 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $53.63 – $359.14 | 9 |
| Flexion/extension wrist unit HCPCS L6620 | not published | not published | $305.43 – $768.87 | 7 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $693.03 – $1,482.35 | 8 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $756.76 – $1,617.23 | 8 |
| Flex thermoplastic collar mo HCPCS L0130 | not published | not published | $151.52 – $381.42 | 7 |
| Flex-walk sys low ext prosth HCPCS L5981 | not published | not published | $3,073.23 – $7,736.40 | 7 |
| Floor of mouth biopsy 41108 CPT 41108 | $2,432.45 | $2,432.45 | $88.14 – $325.73 | 9 |
| Florbetaben f18 diagnostic HCPCS Q9983 | not published | not published | $1,273.76 – $5,701.36 | 8 |
| Flortaucipir inj 1 millicuri HCPCS A9601 | not published | not published | $357.00 – $7,126.70 | 8 |
| Flotufolastat f18 diag 1 mci HCPCS A9608 | not published | not published | $608.81 – $1,288.28 | 7 |
| Flow cytometry interp 16 or more CPT 88189 | not published | not published | $78.73 – $166.05 | 8 |
| Flow cytometry marker each additional CPT 88185 | $208.50 | $208.50 | $22.21 – $100.59 | 9 |
| Flow cytometry one marker technical component CPT 88184 | $361.65 | $361.65 | $69.27 – $101.43 | 9 |
| Floweramnioflo, 0.1 cc HCPCS Q4177 | not published | not published | $153.00 – $366.52 | 4 |
| Floweramniopatch, per sq cm HCPCS Q4178 | not published | not published | $83.49 – $143.04 | 6 |
| #flow interp 9 - 15 markers CPT 88188 | not published | not published | $57.88 – $122.00 | 8 |
| Floxuridine injection HCPCS J9200 | not published | not published | $89.68 – $7,162.33 | 8 |
| Flt3 gene CPT 81245 | $688.55 | $688.55 | $66.20 – $340.61 | 9 |
| Flt3 gene analysis CPT 81246 | $345.30 | $345.30 | $33.20 – $170.80 | 9 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $211.74 | $211.74 | $2.45 – $19.14 | 9 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | not published | not published | $71.65 – $332.69 | 8 |
| Fluidotherapy charges pt CPT 97022 | $276.00 | $276.00 | $15.53 – $231.84 | 9 |
| Fluid pressure muscle 20950 CPT 20950 | $1,207.20 | $1,207.20 | $83.85 – $186.48 | 9 |
| Flulaval vacc, 3 yrs & >, im HCPCS Q2036 | $52.75 | $52.75 | $8.57 – $39.56 | 6 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $488.70 – $936.53 | 8 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $299.05 – $574.45 | 8 |
| Fluorescein angioscopy i&r CPT 92230 | not published | not published | $30.08 – $264.05 | 9 |
| Fluorescein angrph mltiframe CPT 92235 | not published | not published | $40.51 – $84.05 | 8 |
| Fluorescein&icg angiography CPT 92242 | $1,086.05 | $1,086.05 | $51.66 – $912.28 | 9 |
| Fluorescent antibody titer dna CPT 86256 | $161.15 | $161.15 | $5.95 – $55.19 | 9 |
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $498.62 – $936.41 | 8 |
| Fluoroestradiol f 18 HCPCS A9591 | not published | not published | $498.67 – $9,670.43 | 8 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $557.85 | $557.85 | $26.92 – $123.63 | 9 |
| Fluoroguide needle placement CPT 77002 | $655.45 | $655.45 | $25.31 – $136.05 | 9 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $9.34 – $38.50 | 7 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $1,385.75 | $1,385.75 | $14.27 – $284.84 | 9 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $291.30 | $291.30 | $2.42 – $32.73 | 9 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $157.76 | $157.76 | $8.92 – $82.85 | 7 |
| Flurpiridaz f18, diag, 1 mci HCPCS A9611 | not published | not published | $530.00 – $545.90 | 5 |
| Flutamide 125 mg HCPCS S0175 | not published | not published | $3.38 – $58.91 | 3 |
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.