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 |
|---|---|---|---|---|
| Immune globulin ig human im use 90281 CPT 90281 | $85.30 | $85.30 | $62.75 – $80.18 | 6 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $261.65 | $261.65 | $10.28 – $148.24 | 9 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $261.65 | $261.65 | $10.28 – $75.44 | 9 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $15.34 – $52.07 | 7 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $161.45 | $161.45 | $5.92 – $52.78 | 9 |
| Immunodiffusion nes CPT 86329 | not published | not published | $6.94 – $28.61 | 7 |
| Immunoelectrophoresis assay CPT 86327 | not published | not published | $11.97 – $42.70 | 7 |
| Immunofixation electrophoresis serum CPT 86334 | $559.25 | $559.25 | $11.04 – $137.00 | 9 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | not published | not published | $25.82 – $56.93 | 8 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $241.95 | $241.95 | $33.64 – $176.57 | 9 |
| Immunoglobulin assay CPT 86023 | $712.25 | $712.25 | $6.15 – $241.25 | 9 |
| Immunotherapy 2/> injections CPT 95125 | not published | not published | $12.77 – $31.17 | 4 |
| Impedence cardiogram CPT 93701 | not published | not published | $14.23 – $52.03 | 8 |
| Imp extar knee shck absrb HCPCS C8003 | not published | not published | $17,798.63 – $18,332.58 | 5 |
| Impl absrb msh/prsth dly cls CPT 15778 | not published | not published | $362.42 – $778.79 | 8 |
| Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster HCPCS L8612 | $1,045.00 | $1,045.00 | $355.30 – $563.06 | 9 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | not published | not published | $800.66 – $2,001.22 | 7 |
| Implantation iris prosthesis CPT 66683 | not published | not published | $744.22 – $1,569.10 | 6 |
| Implant biventricular device 33976 CPT 33976 | not published | not published | $1,419.24 – $3,122.63 | 8 |
| Implant brain electrodes CPT 61531 | not published | not published | $1,153.16 – $2,545.15 | 8 |
| Implant brain electrodes CPT 61533 | not published | not published | $1,423.61 – $3,159.90 | 8 |
| Implant brain electrodes CPT 61760 | not published | not published | $1,476.70 – $3,260.22 | 8 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $4,935.00 | $4,935.00 | $20.64 – $335.92 | 9 |
| Implant cochlear device CPT 69930 | not published | not published | $1,154.41 – $2,465.85 | 8 |
| Implant cochlear osia osi300 HCPCS L8690 | $21,480.00 | $21,480.00 | $55.17 – $5,773.43 | 9 |
| Implant eye drug system CPT 67027 | not published | not published | $805.90 – $1,699.25 | 8 |
| Implant hormone pellet(s) 11980 CPT 11980 | not published | not published | $51.86 – $181.82 | 9 |
| Implant nerve end CPT 64787 | not published | not published | $220.05 – $470.40 | 8 |
| Implant neuroelectrde addl CPT 61864 | not published | not published | $256.30 – $575.45 | 8 |
| Implant neuroelectrde addl CPT 61868 | not published | not published | $451.62 – $1,016.70 | 8 |
| Implant neuroelectrode CPT 61863 | not published | not published | $1,407.29 – $3,118.56 | 8 |
| Implant neuroelectrode CPT 61867 | not published | not published | $2,111.42 – $4,703.26 | 8 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $795.15 – $1,735.17 | 8 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $306.15 – $7,456.46 | 9 |
| Implant neuroelectrodes CPT 64555 | not published | not published | $308.25 – $4,090.57 | 9 |
| Implant neuroelectrodes CPT 64561 | not published | not published | $287.16 – $1,413.42 | 9 |
| Implant neuroelectrodes CPT 61850 | not published | not published | $925.75 – $2,047.64 | 8 |
| Implant neuroelectrodes CPT 61860 | not published | not published | $1,453.98 – $3,231.75 | 8 |
| Implant neurostim arrays CPT 61886 | not published | not published | $830.28 – $1,832.09 | 8 |
| Implant open hernia repair w/mesh 49568 CPT 49568 | not published | not published | $546.14 – $546.14 | 1 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | not published | not published | $177.89 – $1,817.70 | 7 |
| Implant/replace hearing aid CPT 69710 | not published | not published | $1,220.05 – $1,220.05 | 1 |
| Implant single ventricular device 33975 CPT 33975 | not published | not published | $1,176.04 – $2,586.48 | 8 |
| Implant spinal canal cath CPT 62351 | not published | not published | $856.32 – $1,889.02 | 8 |
| Implant spine infusion pump CPT 62361 | not published | not published | $410.66 – $905.54 | 8 |
| Implant spine infusion pump CPT 62362 | not published | not published | $367.16 – $791.67 | 8 |
| Implant tcat pulm vlv perq CPT 33477 | $31,438.75 | $31,438.75 | $1,193.27 – $26,408.55 | 9 |
| Implant ureter in bowel CPT 50800 | not published | not published | $877.25 – $1,864.63 | 8 |
| Implant ureth bulk agent HCPCS L8606 | $3,177.46 | $3,177.46 | $204.03 – $313.96 | 9 |
| Impl ear abutment ba300 9mm HCPCS L8693 | not published | not published | $1,411.29 – $3,552.72 | 7 |
| Impl eye bio-eye 16mm HCPCS L8042 | $546.00 | $546.00 | $382.51 – $4,399.04 | 9 |
| Impl neurostim electr perc CPT 63650 | $8,279.45 | $8,279.45 | $396.31 – $4,388.04 | 9 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | not published | not published | $200.79 – $431.76 | 8 |
| Implnt spinl canal catheter 62350 CPT 62350 | $9,612.50 | $9,612.50 | $380.89 – $6,178.20 | 9 |
| Impl oi implt sk tc esp<100 CPT 69716 | not published | not published | $593.34 – $1,266.13 | 8 |
| Impl oi implt sk tc esp>=100 CPT 69729 | not published | not published | $641.87 – $1,371.86 | 8 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $474.85 – $1,011.95 | 8 |
| Impl/rplcmt gstr nstim eltrd CPT 43881 | not published | not published | $1,058.48 – $1,446.44 | 3 |
| Implt brain chemotx add-on 61517 CPT 61517 | not published | not published | $79.20 – $177.58 | 8 |
| Impltj ntrstrml crnl rng seg CPT 65785 | not published | not published | $422.32 – $4,082.87 | 9 |
| Impltj tot rplcmt hrt sys CPT 33927 | not published | not published | $2,287.44 – $5,056.39 | 8 |
| Implt neurostim elctr each HCPCS L8680 | not published | not published | $195.00 – $469.71 | 3 |
| Imp neurosti pls gn any type HCPCS L8679 | not published | not published | $7,766.02 – $19,549.82 | 7 |
| Imported lipodox inj HCPCS Q2049 | not published | not published | $508.43 – $797.01 | 8 |
| Impreg gauze no h20/sal/yard HCPCS A6266 | not published | not published | $2.13 – $5.31 | 7 |
| Impres&prep auricular prosth CPT 21086 | not published | not published | $1,239.59 – $3,027.94 | 9 |
| Impres&prep def obt prosth CPT 21080 | not published | not published | $1,275.18 – $3,191.12 | 9 |
| Impres&prep facial prosth CPT 21088 | not published | not published | $3,047.07 – $6,975.92 | 7 |
| Impres&prep intrm obt prosth CPT 21079 | not published | not published | $1,134.02 – $2,797.30 | 9 |
| Impres&prep mndbl res prosth CPT 21081 | not published | not published | $1,168.78 – $2,952.77 | 9 |
| Impres&prep nasal prosth CPT 21087 | not published | not published | $1,239.59 – $3,027.94 | 9 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $224.75 – $1,311.91 | 9 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $1,680.64 – $4,077.73 | 9 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $1,082.48 – $2,758.10 | 9 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $1,001.16 – $2,620.62 | 9 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $1,156.86 – $2,990.04 | 9 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $686.32 – $1,667.20 | 9 |
| Imuglucerase injection HCPCS J1786 | $5,456.35 | $5,456.35 | $43.29 – $5,128.97 | 9 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $3,647.78 – $99,999.99 | 5 |
| In-111 autol wbc diag per dose HCPCS A9570 | $4,109.55 | $4,109.55 | $1,031.39 – $3,862.98 | 9 |
| In-111 capromab pendet HCPCS A9507 | not published | not published | $1,641.76 – $4,483.93 | 9 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $798.02 – $9,304.01 | 9 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $2,200.95 | $2,200.95 | $772.64 – $2,068.89 | 9 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $4,134.10 | $4,134.10 | $715.29 – $1,826.66 | 9 |
| In-111 pentetreotide HCPCS A9572 | $9,236.30 | $9,236.30 | $1,914.61 – $8,682.12 | 9 |
| In-111 satumomab pend HCPCS A4642 | not published | not published | $1,396.92 – $3,401.88 | 3 |
| Inactivated je vacc im CPT 90738 | $474.05 | $474.05 | $115.23 – $445.61 | 6 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $429.86 – $927.22 | 8 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $567.32 – $1,222.07 | 8 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | not published | not published | $496.75 – $1,066.87 | 8 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $1,684.04 – $3,677.07 | 8 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $1,435.10 – $3,112.45 | 8 |
| Incis 1 vertebral seg thorac CPT 22212 | not published | not published | $1,436.71 – $3,111.78 | 8 |
| Incis addl spine segment CPT 22216 | not published | not published | $333.97 – $732.71 | 8 |
| Incise bile duct sphincter CPT 47460 | not published | not published | $1,185.22 – $2,583.10 | 8 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $405.56 – $879.78 | 8 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $105.45 – $233.21 | 9 |
| Incise flexor carpi radialis CPT 25001 | not published | not published | $336.09 – $727.27 | 8 |
| Incise hand/finger tendon CPT 26460 | not published | not published | $435.22 – $930.62 | 8 |
| Incise hip/thigh nerve CPT 64763 | not published | not published | $489.54 – $1,057.38 | 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.