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 |
|---|---|---|---|---|
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $1,256.60 – $2,736.96 | 8 |
| Gastrojejunostomy w/vagotomy CPT 43825 | not published | not published | $1,224.48 – $2,669.85 | 8 |
| Gastro/jejuno tube, std HCPCS B4087 | not published | not published | $35.83 – $70.82 | 6 |
| Gastroplasty duodenal switch CPT 43845 | not published | not published | $1,827.72 – $3,981.40 | 8 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $578.85 – $1,250.53 | 8 |
| Gated heart multiple CPT 78473 | $2,248.40 | $2,248.40 | $65.30 – $1,888.66 | 9 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | not published | not published | $2.69 – $6.74 | 7 |
| Gauze >16 <=48 sq in w/bordr HCPCS A6220 | not published | not published | $2.88 – $7.21 | 7 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | not published | not published | $2.37 – $5.93 | 7 |
| Gauze <= 16 sq in w/border HCPCS A6219 | not published | not published | $1.06 – $2.65 | 7 |
| Gauze > 48 in no w/sal without b HCPCS A6224 | not published | not published | $4.00 – $10.00 | 7 |
| Gba gene CPT 81251 | $381.30 | $381.30 | $24.64 – $48.67 | 9 |
| Gc stocking full lngth 18-30 HCPCS A6536 | not published | not published | $72.01 – $142.35 | 7 |
| Gc stocking full lngth 30-40 HCPCS A6537 | not published | not published | $75.03 – $168.76 | 7 |
| Gc stocking full lngth 40+ HCPCS A6538 | not published | not published | $75.03 – $197.59 | 7 |
| Gc stocking thighlngth 18-30 HCPCS A6533 | not published | not published | $53.42 – $105.60 | 7 |
| Gc stocking thighlngth 30-40 HCPCS A6534 | not published | not published | $61.00 – $120.58 | 7 |
| Gc stocking thighlngth 40+ HCPCS A6535 | not published | not published | $58.52 – $138.83 | 7 |
| Gc stocking waistlngth 18-30 HCPCS A6539 | not published | not published | $95.29 – $188.37 | 7 |
| Gc stocking waistlngth 30-40 HCPCS A6540 | not published | not published | $113.61 – $224.59 | 7 |
| Gc stocking waistlngth 40+ HCPCS A6541 | not published | not published | $134.58 – $266.05 | 7 |
| Gefitinib oral HCPCS J8565 | not published | not published | $108.44 – $230.42 | 4 |
| Gel cap app device for trach HCPCS L8515 | not published | not published | $58.74 – $147.85 | 7 |
| Gel cap for trach voice pros HCPCS L8512 | not published | not published | $2.01 – $5.05 | 7 |
| Gel-one HCPCS J7326 | not published | not published | $497.29 – $1,003.44 | 8 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $0.49 – $1.10 | 7 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $922.03 | $922.03 | $3.30 – $57.62 | 9 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $14,038.15 | $14,038.15 | $221.84 – $13,195.86 | 9 |
| General health panel CPT 80050 | $530.85 | $530.85 | $17.36 – $364.96 | 9 |
| Generator barostim neo2 2014 HCPCS C1767 | $38,190.00 | $38,190.00 | $956.28 – $3,783.52 | 9 |
| Generator emblem MRI sicd subq HCPCS C1722 | $21,500.00 | $21,500.00 | $6,998.50 – $8,943.16 | 6 |
| Genetic counseling 30 min CPT 96040 | not published | not published | $45.32 – $105.07 | 6 |
| Genetic tstg severe inh cond CPT 81443 | $4,465.40 | $4,465.40 | $264.19 – $1,486.07 | 9 |
| Genioplasty augmentation CPT 21120 | not published | not published | $486.42 – $1,281.07 | 9 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $811.85 – $1,713.48 | 8 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $514.02 – $1,220.68 | 9 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $717.46 – $1,525.72 | 8 |
| Genome re-evaluation CPT 81427 | not published | not published | $423.14 – $4,759.92 | 7 |
| Genome sequence analysis CPT 81425 | not published | not published | $846.27 – $10,244.53 | 7 |
| Genome sequence analysis CPT 81426 | not published | not published | $846.27 – $5,518.00 | 7 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $62.81 | $62.81 | $2.07 – $28.94 | 9 |
| Gentamicin peak therapeutic drug level CPT 80170 | $313.15 | $313.15 | $8.09 – $194.25 | 9 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $5.13 – $9.92 | 8 |
| G-esoph reflx tst w/electrod CPT 91035 | $866.40 | $866.40 | $76.45 – $715.93 | 9 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $135.39 – $359.14 | 9 |
| Ghs abscess perianal iandd CPT 46050 | $1,517.10 | $1,517.10 | $96.97 – $457.43 | 9 |
| Ghs abscess postoperative iandd complex CPT 10180 | $4,395.70 | $4,395.70 | $170.12 – $508.84 | 9 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $3.92 – $19.98 | 7 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $419.10 | $419.10 | $7.94 – $141.24 | 9 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $824.90 | $824.90 | $24.64 – $105.33 | 9 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $269.35 | $269.35 | $17.52 – $36.61 | 9 |
| Ghs antibodies (torch) igm CPT 86694 | not published | not published | $7.11 – $29.30 | 7 |
| Ghs aspiration bladder - needle CPT 51100 | $3,587.55 | $3,587.55 | $36.52 – $142.62 | 9 |
| Ghs bladder cath - complex-foley CPT 51703 | $371.15 | $371.15 | $47.60 – $131.60 | 9 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $2.23 – $9.81 | 7 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $959.90 | $959.90 | $51.82 – $213.29 | 9 |
| Ghs central line insert < age 5, failed CPT 36555 | $1,152.85 | $1,152.85 | $78.92 – $359.77 | 9 |
| Ghs change cysto/gastrost CPT 43762 | $624.25 | $624.25 | $34.64 – $405.38 | 9 |
| Ghs chemo >8 hrs CPT 96416 | $1,342.40 | $1,342.40 | $118.17 – $590.10 | 9 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $155.91 – $325.34 | 8 |
| Ghs chemo IV push, ea addtl CPT 96411 | $448.05 | $448.05 | $50.97 – $104.98 | 9 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | not published | not published | $17.33 – $71.45 | 7 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $1,022.25 | $1,022.25 | $74.73 – $206.61 | 9 |
| Ghs closed reduction ankle dislocation CPT 27840 | $1,328.00 | $1,328.00 | $77.84 – $215.21 | 9 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,394.35 | $1,394.35 | $64.07 – $177.14 | 9 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $1,361.70 | $1,361.70 | $164.90 – $359.69 | 9 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $3,226.90 | $3,226.90 | $453.02 – $578.90 | 9 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $2,655.60 | $2,655.60 | $761.16 – $2,230.70 | 9 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $863.45 | $863.45 | $232.17 – $367.59 | 9 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $2,620.80 | $2,620.80 | $426.26 – $974.62 | 9 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $1,867.80 | $1,867.80 | $478.84 – $1,080.63 | 9 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $1,320.35 | $1,320.35 | $77.84 – $215.21 | 9 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $907.95 | $907.95 | $74.73 – $206.61 | 9 |
| Ghs community re-entry 15 minutes CPT 97537 | $240.55 | $240.55 | $31.20 – $100.24 | 9 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $723.70 | $723.70 | $24.33 – $66.71 | 9 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $248.60 | $248.60 | $27.62 – $58.45 | 9 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $567.55 | $567.55 | $38.74 – $116.93 | 9 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $557.35 | $557.35 | $47.66 – $122.17 | 9 |
| Ghs cricothyroidotomy CPT 31605 | $3,874.50 | $3,874.50 | $224.75 – $663.56 | 9 |
| Ghs cutdown placement age 1 and over CPT 36425 | $744.70 | $744.70 | $36.62 – $625.55 | 9 |
| Ghs cutdown placement under 1 yr CPT 36420 | not published | not published | $43.02 – $94.90 | 8 |
| Ghs diphtheria toxoid ab igg CPT 86648 | not published | not published | $7.51 – $30.97 | 7 |
| Ghs dislocation elbow closed treatment CPT 24600 | $1,423.55 | $1,423.55 | $74.73 – $206.61 | 9 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $292.25 | $292.25 | $99.10 – $214.86 | 9 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $330.85 | $330.85 | $31.36 – $99.71 | 9 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,395.45 | $1,395.45 | $97.68 – $520.71 | 9 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $523.40 | $523.40 | $151.43 – $424.31 | 9 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $8.40 – $58.46 | 8 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $14.18 – $29.82 | 8 |
| Ghs elect vertical elct CPT 92547 | not published | not published | $4.07 – $20.55 | 8 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | not published | not published | $67.84 – $292.96 | 9 |
| Ghs excision ingrown nail CPT 11765 | $491.55 | $491.55 | $88.84 – $186.11 | 9 |
| Ghs eye exam CPT 92002 | not published | not published | $35.63 – $163.19 | 9 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $559.45 | $559.45 | $110.94 – $427.78 | 9 |
| Ghs fat & muscle CPT 89160 | not published | not published | $1.94 – $9.88 | 7 |
| Ghs fb removal foot - deep - left CPT 28192 | $6,688.10 | $6,688.10 | $300.56 – $884.03 | 9 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | $237.09 – $896.25 | 9 |
| Ghs fb removal - incisional CPT 10121 | $3,990.20 | $3,990.20 | $176.12 – $374.15 | 9 |
| Ghs fb removal - non-incisional CPT 20520 | $2,322.15 | $2,322.15 | $141.50 – $422.75 | 9 |
| Ghs febrile agglutinns(mayo) CPT 86000 | not published | not published | $3.45 – $14.21 | 7 |
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.