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 |
|---|---|---|---|---|
| Hypnotherapy CPT 90880 | not published | not published | $81.72 – $197.87 | 9 |
| Hypothermia ill neonate CPT 99184 | not published | not published | $202.45 – $429.72 | 8 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $16.19 – $32.54 | 8 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $1,017.00 – $2,189.98 | 8 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $938.14 – $2,023.90 | 8 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $1,000.36 – $2,158.80 | 8 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $866.65 – $1,870.05 | 8 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $253.82 – $565.29 | 8 |
| Hysterosalpingography s&i CPT 74740 | $1,744.05 | $1,744.05 | $17.30 – $580.56 | 9 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $230.67 – $4,026.32 | 9 |
| Hysteroscopy biopsy CPT 58558 | $775.95 | $775.95 | $217.38 – $2,540.95 | 9 |
| Hysteroscopy dx sep proc CPT 58555 | $549.80 | $549.80 | $143.16 – $696.43 | 9 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $265.88 – $575.45 | 8 |
| Hysteroscopy remove fb CPT 58562 | $882.00 | $882.00 | $207.88 – $832.64 | 9 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $334.92 – $725.25 | 8 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $292.67 – $633.74 | 8 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $795.12 – $1,754.15 | 8 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $435.15 | $435.15 | $201.85 – $402.96 | 6 |
| I-123 iobenguane diag HCPCS A9582 | $5,671.85 | $5,671.85 | $2,074.81 – $5,331.54 | 9 |
| I-123 ioflupane diag HCPCS A9584 | $7,429.25 | $7,429.25 | $1,388.02 – $6,055.95 | 9 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $508.40 | $508.40 | $77.84 – $122.72 | 9 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $38.25 – $99,999.99 | 5 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $176.46 – $99,999.99 | 4 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | not published | not published | $753.92 – $1,827.75 | 9 |
| I131 iodide cap, rx HCPCS A9517 | $43.85 | $43.85 | $23.13 – $41.22 | 9 |
| I131 iodide sol, rx HCPCS A9530 | not published | not published | $9.46 – $23.05 | 8 |
| I131 max 100uci HCPCS A9531 | $7.40 | $7.40 | $3.62 – $99,999.99 | 7 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $80.75 – $622.89 | 9 |
| I-131 sod iodide sol diag per mci HCPCS A9529 | not published | not published | $178.66 – $99,999.99 | 2 |
| Iaadi respiratory synctial virus CPT 87280 | not published | not published | $5.92 – $27.33 | 7 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $17.33 – $71.45 | 7 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $10.85 – $36.83 | 7 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $27.32 – $92.20 | 7 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $25.60 – $50.12 | 6 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $979.42 – $4,985.76 | 7 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $2.93 – $5.87 | 4 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $4,243.77 | $4,243.77 | $205.06 – $2,215.49 | 9 |
| Icatibant injection HCPCS J1744 | not published | not published | $95.06 – $207.02 | 8 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $14,838.00 | $14,838.00 | $7,879.01 – $10,068.34 | 6 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $19,540.00 | $19,540.00 | $10,249.85 – $13,097.96 | 6 |
| Icd crtp serena MRI HCPCS C2621 | $7,411.00 | $7,411.00 | $3,992.56 – $5,101.97 | 6 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $4,000.00 | $4,000.00 | $1,471.20 – $1,880.00 | 6 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $44.38 – $93.54 | 8 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $11.80 – $25.08 | 8 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $0.86 – $15.42 | 9 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $4.46 – $9.63 | 8 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $906.06 – $1,954.10 | 8 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $368.55 – $866.68 | 9 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $42.64 – $74.79 | 6 |
| I&d/bursa/foot 28001 CPT 28001 | $3,548.85 | $3,548.85 | $91.66 – $329.59 | 9 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $0.02 – $931,062.63 | 6 |
| Identify sperm tissue CPT 89264 | not published | not published | $51.71 – $53.26 | 5 |
| Idet 1 or more levels CPT 22527 | not published | not published | $147.77 – $3,090.26 | 7 |
| Idet single level CPT 22526 | not published | not published | $317.86 – $3,764.84 | 7 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $665.30 – $1,408.47 | 8 |
| Idh1 common variants CPT 81120 | not published | not published | $193.25 – $393.50 | 7 |
| Idh2 common variants CPT 81121 | not published | not published | $295.79 – $602.29 | 7 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $421.64 – $902.16 | 8 |
| I&d lacrimal gland CPT 68400 | not published | not published | $125.23 – $570.52 | 9 |
| I&d lacrimal sac CPT 68420 | not published | not published | $159.02 – $636.68 | 9 |
| Iduc valve sply repl HCPCS A4342 | not published | not published | $860.84 – $1,711.75 | 6 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $2,095.90 | $2,095.90 | $206.91 – $696.43 | 9 |
| Idursulfase injection HCPCS J1743 | $7,000.88 | $7,000.88 | $542.92 – $6,580.83 | 9 |
| I & d vag hematoma non-ob 57023 CPT 57023 | $2,563.65 | $2,563.65 | $303.65 – $2,153.47 | 9 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $172.80 – $371.44 | 8 |
| Ifnl3 gene CPT 81283 | not published | not published | $73.37 – $149.40 | 7 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $1,094.70 | $1,094.70 | $25.72 – $351.56 | 7 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $82.92 – $422.12 | 7 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $27.42 – $139.58 | 7 |
| Igh gene rearrange amp meth CPT 81261 | not published | not published | $97.77 – $403.15 | 7 |
| Igh@ var region somatic mutation analy CPT 81263 | $1,382.45 | $1,382.45 | $145.44 – $626.79 | 9 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $73.74 – $351.71 | 7 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $539.35 | $539.35 | $26.51 – $132.15 | 9 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $1,046.65 | $1,046.65 | $36.25 – $350.24 | 9 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $534.75 | $534.75 | $32.68 – $132.57 | 9 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | $29.70 | $29.70 | $13.99 – $27.92 | 6 |
| Ikbkap gene CPT 81260 | $316.85 | $316.85 | $15.72 – $40.49 | 9 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $973.16 – $2,107.96 | 8 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $2,492.52 – $5,356.65 | 8 |
| Iliac/fem angio cath insert HCPCS G0278 | $1,805.75 | $1,805.75 | $12.09 – $1,516.83 | 9 |
| Iliac revasc add-on 37222 CPT 37222 | $11,899.40 | $11,899.40 | $166.53 – $1,120.79 | 9 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $142.57 – $282.18 | 6 |
| Imatinib 100 mg tab HCPCS S0088 | not published | not published | $3.03 – $5.38 | 3 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $832.47 – $1,807.70 | 8 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $57.02 – $110.16 | 6 |
| Img rta detcj/mntr ds staff CPT 92227 | not published | not published | $15.56 – $35.92 | 8 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | not published | not published | $12.98 – $31.48 | 8 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $26.03 – $83.36 | 8 |
| Immntx 1 sting insect CPT 95130 | not published | not published | $17.81 – $43.37 | 4 |
| Immntx 4 sting insects CPT 95133 | not published | not published | $32.93 – $80.65 | 4 |
| Immntx 5 sting insects CPT 95134 | not published | not published | $39.65 – $96.92 | 4 |
| Immob elbow child sm HCPCS L3762 | $172.80 | $172.80 | $58.75 – $162.43 | 9 |
| Immobilizer shldr cntor adlt HCPCS L3670 | not published | not published | $98.47 – $247.89 | 7 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | not published | not published | $72.82 – $143.96 | 7 |
| Immobilizer shldr sling med HCPCS L3660 | not published | not published | $119.34 – $300.42 | 7 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $728.17 – $1,550.14 | 8 |
| Immune complex assay CPT 86332 | not published | not published | $12.04 – $49.62 | 7 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $18,797.65 | $18,797.65 | $44.15 – $3,455.02 | 9 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $6,016.09 | $6,016.09 | $74.63 – $556.21 | 9 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $20,912.00 | $20,912.00 | $42.66 – $3,717.42 | 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.