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 |
|---|---|---|---|---|
| Hocm 200-249mg/ml iodine,1ml HCPCS Q9960 | not published | not published | $0.23 – $0.30 | 4 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | $49.76 | $49.76 | $0.18 – $46.77 | 8 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $365.12 | $365.12 | $0.19 – $180.67 | 9 |
| Ho flex frejka w/cov pre cst HCPCS L1600 | not published | not published | $137.80 – $346.89 | 7 |
| Ho flex pavlik harns pre cst HCPCS L1620 | not published | not published | $140.27 – $353.12 | 7 |
| Ho frejka cov only pre cst HCPCS L1610 | not published | not published | $42.23 – $106.29 | 7 |
| Holder tube cath-secure nonstrl lf disp HCPCS A4333 | not published | not published | $2.45 – $6.17 | 7 |
| Home health care supervision CPT 99374 | not published | not published | $53.05 – $131.06 | 7 |
| Home health care supervision CPT 99375 | not published | not published | $83.01 – $194.67 | 7 |
| Home health care supervision HCPCS G0181 | not published | not published | $101.06 – $212.82 | 8 |
| Home health re-certification physician g0179 HCPCS G0179 | not published | not published | $39.61 – $85.40 | 8 |
| Home/res vst est high mdm 60 CPT 99350 | $444.35 | $444.35 | $175.99 – $372.80 | 9 |
| Home/res vst est mod mdm 40 CPT 99349 | $320.45 | $320.45 | $121.27 – $256.88 | 9 |
| Home/res vst est sf mdm 20 CPT 99347 | $166.25 | $166.25 | $43.38 – $91.51 | 9 |
| Home/res vst new high mdm 75 CPT 99345 | $549.00 | $549.00 | $191.70 – $406.01 | 9 |
| Home/res vst new low mdm 30 CPT 99342 | $208.05 | $208.05 | $75.15 – $157.93 | 9 |
| Home/res vst new mod mdm 60 CPT 99344 | $455.40 | $455.40 | $135.51 – $286.72 | 9 |
| Home/res vst new sf mdm 15 CPT 99341 | $138.75 | $138.75 | $47.27 – $99.63 | 9 |
| Home sleep test/type 2 porta HCPCS G0398 | not published | not published | $74.53 – $184.00 | 8 |
| Home sleep test/type 3 porta HCPCS G0399 | $825.15 | $825.15 | $44.47 – $693.13 | 9 |
| Home sleep test/type 4 porta HCPCS G0400 | not published | not published | $76.38 – $154.81 | 8 |
| Home vent mgmt supervision CPT 94005 | not published | not published | $87.57 – $183.01 | 6 |
| Home visit est patient 99348 CPT 99348 | $310.85 | $310.85 | $73.46 – $154.55 | 9 |
| Home visit new patient CPT 99343 | not published | not published | $258.99 – $258.99 | 1 |
| Homocysteine CPT 83090 | $594.25 | $594.25 | $8.33 – $171.79 | 9 |
| Homogenization tissue CPT 87176 | not published | not published | $2.90 – $11.97 | 7 |
| Homovanillic acid (hva) CPT 83150 | $380.75 | $380.75 | $9.56 – $158.63 | 9 |
| Hook to hand cable adapter HCPCS L6670 | not published | not published | $48.55 – $122.21 | 7 |
| Hopd covid-19 spec collect HCPCS C9803 | not published | not published | $52.30 – $52.30 | 1 |
| Hopd mntl hlt, 15-29 min HCPCS C7900 | not published | not published | $28.83 – $29.70 | 5 |
| Hopd mntl hlt, 30-60 min HCPCS C7901 | not published | not published | $89.53 – $92.21 | 5 |
| Hopd mntl hlt, grp HCPCS C7903 | not published | not published | $28.83 – $29.70 | 5 |
| Ho post-op hip abduction HCPCS L1686 | not published | not published | $894.98 – $2,252.95 | 7 |
| Hospice care supervision CPT 99377 | not published | not published | $53.05 – $131.06 | 7 |
| Hospice care supervision CPT 99378 | not published | not published | $83.01 – $194.67 | 7 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-1 genotyping CPT 81105 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $122.22 – $248.86 | 7 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $122.22 – $248.86 | 7 |
| Hpv combo assay ca screen HCPCS G0476 | not published | not published | $17.33 – $71.45 | 7 |
| Hpv low-risk types CPT 87623 | not published | not published | $17.33 – $71.45 | 7 |
| Hpv types 16 & 18 only CPT 87625 | not published | not published | $17.33 – $82.57 | 7 |
| H pylori ag ia CPT 87339 | not published | not published | $6.40 – $32.58 | 7 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $33.26 – $137.16 | 7 |
| H pylori (c-13) breath CPT 83013 | not published | not published | $33.26 – $137.16 | 7 |
| H pylori drug admin CPT 83014 | not published | not published | $5.82 – $16.00 | 7 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $335.33 – $1,382.68 | 7 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | not published | not published | $216.76 – $893.75 | 6 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $288.84 – $1,190.97 | 7 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $584.90 – $1,190.97 | 7 |
| Hrv skn cll ssp agrft 1st 25 CPT 15011 | not published | not published | $1,770.40 – $1,823.51 | 5 |
| Hsv dna dir probe CPT 87528 | not published | not published | $9.90 – $40.83 | 7 |
| Htt gene charac alleles CPT 81274 | not published | not published | $109.93 – $559.61 | 7 |
| Htt gene detc abnor alleles CPT 81271 | not published | not published | $54.80 – $278.96 | 7 |
| Human epididymis protein 4 (he4) CPT 86305 | $217.80 | $217.80 | $10.28 – $204.73 | 9 |
| Human ig IV CPT 90283 | not published | not published | $59.29 – $107.80 | 4 |
| Human ig sc CPT 90284 | not published | not published | $15.88 – $28.45 | 4 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $6,918.37 | $6,918.37 | $1.26 – $4,209.95 | 9 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $21.20 – $91.46 | 4 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $0.48 – $0.67 | 6 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $343.80 | $343.80 | $0.36 – $104.51 | 9 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $145.77 | $145.77 | $4.11 – $21.83 | 9 |
| Hydrocolld drg >16<=48 w/bdr HCPCS A6238 | not published | not published | $25.34 – $63.35 | 7 |
| Hydrocolld drg >16<=48 without b HCPCS A6235 | not published | not published | $18.70 – $46.73 | 7 |
| Hydrocolld drg <=16 in w/bdr HCPCS A6237 | not published | not published | $8.79 – $21.97 | 7 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | not published | not published | $7.27 – $18.20 | 7 |
| Hydrocolld drg filler paste HCPCS A6240 | not published | not published | $13.61 – $34.02 | 7 |
| Hydrocortisone acetate inj HCPCS J1700 | not published | not published | $0.59 – $0.65 | 3 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $229.04 | $229.04 | $17.85 – $140.33 | 9 |
| Hydrocortisone sodium ph inj HCPCS J1710 | not published | not published | $4.68 – $9.61 | 3 |
| Hydrogel drg <= 16 in w/bdr HCPCS A6245 | not published | not published | $8.08 – $20.20 | 7 |
| Hydrogel drg >48 in without bdr HCPCS A6244 | not published | not published | $43.67 – $109.14 | 7 |
| Hydrogel drg > 48 sq in w/b HCPCS A6247 | not published | not published | $26.44 – $66.07 | 7 |
| Hydrogel drsg gel filler HCPCS A6248 | not published | not published | $18.06 – $45.14 | 7 |
| Hydrogel dsg>16<=48 sq in HCPCS A6232 | not published | not published | $7.62 – $19.08 | 7 |
| Hydrogel dsg<=16 sq in HCPCS A6231 | not published | not published | $5.20 – $12.99 | 7 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $1,246.98 | $1,246.98 | $0.17 – $16.22 | 9 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $197.49 | $197.49 | $56.13 – $71.72 | 6 |
| Hydromorphone 250 mg HCPCS S0092 | not published | not published | $85.09 – $156.56 | 3 |
| Hydromorphone injection HCPCS J1170 | not published | not published | $2.70 – $6.60 | 6 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | $254.39 | $254.39 | $0.01 – $239.13 | 9 |
| Hydroxyurea 500 mg HCPCS S0176 | not published | not published | $0.57 – $2.03 | 3 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $328.39 | $328.39 | $9.91 – $72.85 | 9 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | not published | not published | $0.08 – $4.07 | 4 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | not published | not published | $8.66 – $36.45 | 7 |
| Hymenotomy CPT 56442 | not published | not published | $45.59 – $96.92 | 8 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $16.99 – $33.64 | 8 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $938.56 – $2,006.29 | 8 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $18.98 – $55.08 | 6 |
| Hyperbaric oxygen therapy CPT 99183 | $272.30 | $272.30 | $78.73 – $212.82 | 9 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $5.02 – $20.73 | 7 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $93.04 – $201.98 | 8 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $68.97 – $143.69 | 8 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $76.99 – $167.42 | 8 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $67.00 – $139.62 | 8 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $94.39 – $195.88 | 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.