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 |
|---|---|---|---|---|
| Incision of urethra CPT 53010 | not published | not published | $285.55 – $608.66 | 8 |
| Incision of urethra CPT 53020 | not published | not published | $91.50 – $194.54 | 8 |
| Incision of urethra CPT 53025 | not published | not published | $65.67 – $138.95 | 8 |
| Incision of vagus nerve CPT 64760 | not published | not published | $494.66 – $1,068.88 | 8 |
| Incision of windpipe CPT 31601 | not published | not published | $419.90 – $908.94 | 8 |
| Incision of windpipe CPT 31610 | not published | not published | $912.52 – $1,943.94 | 8 |
| Incision of wrist capsule CPT 25085 | not published | not published | $434.90 – $934.00 | 8 |
| Incision secondary cataract CPT 66820 | not published | not published | $445.42 – $932.66 | 8 |
| Incision tendon sheath CPT 26055 | not published | not published | $282.27 – $1,144.22 | 9 |
| Incisn of toe tndn CPT 28010 | $7,142.85 | $7,142.85 | $201.18 – $455.51 | 9 |
| Incisn windpipe CPT 31600 | not published | not published | $283.10 – $614.77 | 8 |
| Incis spine 3 column adl seg CPT 22208 | not published | not published | $540.33 – $1,194.96 | 8 |
| Incis spine 3 column lumbar CPT 22207 | not published | not published | $2,241.89 – $4,910.66 | 8 |
| Incis spine 3 column thorac CPT 22206 | not published | not published | $2,291.04 – $5,019.78 | 8 |
| Incobotulinumtoxin a HCPCS J0588 | not published | not published | $5.19 – $9.98 | 8 |
| Inc&subq plmt crnl bone grf CPT 61316 | not published | not published | $79.53 – $178.27 | 8 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | not published | not published | $9.96 – $10.25 | 5 |
| Induced ab 1+vag supp d&c CPT 59856 | $1,540.70 | $1,540.70 | $463.11 – $1,021.44 | 9 |
| Induced ab 1+vag supp hyst CPT 59857 | not published | not published | $538.40 – $1,189.54 | 8 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | $2,417.60 | $2,417.60 | $396.34 – $2,030.78 | 9 |
| Induced abortion 1+njx d&c CPT 59851 | not published | not published | $402.20 – $880.46 | 8 |
| Induced abortion 1+njx hyst CPT 59852 | not published | not published | $550.92 – $1,206.49 | 8 |
| Induced abortion d&c CPT 59840 | $2,312.95 | $2,312.95 | $207.79 – $488.92 | 9 |
| Induced abortion dilat&evac CPT 59841 | $2,416.80 | $2,416.80 | $347.90 – $832.64 | 9 |
| Induction of vomiting CPT 99175 | not published | not published | $28.07 – $61.00 | 8 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $147.10 | 6 |
| Infec agen detec ampli probe HCPCS U0005 | not published | not published | $15.08 – $15.08 | 1 |
| Infect ag drug suscept pheno predict CPT 87900 | $518.45 | $518.45 | $64.37 – $295.96 | 9 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $6.00 – $30.54 | 7 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $5.92 – $28.77 | 7 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,146.00 | $1,146.00 | $127.14 – $1,077.24 | 9 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $127.14 – $524.22 | 7 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $63.57 – $262.12 | 7 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $915.90 | $915.90 | $127.14 – $535.61 | 9 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $13.11 – $66.73 | 7 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $14.12 – $71.86 | 7 |
| Infect ag ia optc obs influenza CPT 87804 | $130.85 | $130.85 | $9.93 – $123.00 | 9 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $5.92 – $25.08 | 7 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $8.10 – $37.38 | 7 |
| Infect ag if influenza a CPT 87276 | not published | not published | $6.43 – $32.72 | 7 |
| Infect ag if influenza b CPT 87275 | not published | not published | $5.92 – $24.94 | 7 |
| Infect ag if legionella pneumophila CPT 87278 | $242.80 | $242.80 | $6.24 – $128.69 | 9 |
| Infect ag if nos ea CPT 87299 | not published | not published | $6.44 – $32.78 | 7 |
| Infect ag if pneumocystis carinii CPT 87281 | not published | not published | $5.92 – $25.08 | 7 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $5.92 – $27.33 | 7 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $21.39 – $108.88 | 7 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $17.33 – $71.45 | 7 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $21.15 – $87.23 | 7 |
| Infect ag na hpv high-risk types CPT 87624 | $283.90 | $283.90 | $19.10 – $184.05 | 9 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $346.75 | $346.75 | $63.04 – $247.88 | 9 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $25.34 – $104.48 | 7 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $266.15 | $266.15 | $17.33 – $181.09 | 9 |
| Infect ag na resp virus 12-25 targets CPT 87633 | not published | not published | $308.73 – $848.65 | 7 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $241.31 – $1,023.96 | 7 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $12.87 – $53.08 | 7 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $11.61 – $84.26 | 7 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $144.55 | $144.55 | $5.92 – $81.64 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $5.92 – $27.33 | 7 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $145.25 | $145.25 | $5.92 – $50.24 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $145.25 | $145.25 | $5.92 – $106.03 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $609.60 | $609.60 | $7.10 – $120.18 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $200.75 | $200.75 | $5.10 – $75.44 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $570.10 | $570.10 | $5.10 – $32.52 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $241.85 | $241.85 | $11.89 – $69.00 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $474.65 | $474.65 | $8.88 – $323.78 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $389.50 | $389.50 | $5.92 – $136.54 | 9 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $130.85 | $130.85 | $5.92 – $62.04 | 9 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $287.20 | $287.20 | $19.88 – $142.65 | 9 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $328.40 | $328.40 | $19.88 – $116.23 | 9 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $362.70 | $362.70 | $17.33 – $140.58 | 9 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | not published | not published | $205.82 – $848.65 | 7 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $452.70 | $452.70 | $17.33 – $255.82 | 9 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | not published | not published | $17.33 – $71.45 | 7 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $607.65 | $607.65 | $17.33 – $338.17 | 9 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $328.40 | $328.40 | $19.88 – $116.04 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $86.85 | $86.85 | $28.05 – $77.55 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $169.70 | $169.70 | $55.96 – $154.72 | 9 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $86.05 – $290.42 | 7 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $26.00 – $71.45 | 7 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $320.55 | $320.55 | $19.15 – $76.66 | 9 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $160.45 | $160.45 | $76.77 – $150.82 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $205.82 – $848.65 | 7 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $303.20 | $303.20 | $63.35 – $198.48 | 9 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $622.20 | $622.20 | $105.40 – $406.88 | 9 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $392.85 | $392.85 | $21.15 – $202.99 | 9 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $726.35 | $726.35 | $21.15 – $439.54 | 9 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $539.00 | $539.00 | $21.15 – $343.01 | 9 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $797.55 | $797.55 | $42.02 – $371.91 | 9 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $380.20 | $380.20 | $95.03 – $293.42 | 9 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $4,871.58 | $4,871.58 | $31.18 – $3,939.31 | 9 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $4,181.98 | $4,181.98 | $20.89 – $1,978.70 | 9 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $4,642.81 | $4,642.81 | $10.66 – $3,744.82 | 9 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $11.69 – $59.50 | 7 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $40.04 – $165.06 | 8 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $23.46 – $36.50 | 8 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | $1,205.50 | $1,205.50 | $69.20 – $436.40 | 9 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,894.71 – $6,260.85 | 8 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,840.22 – $6,130.70 | 8 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | $1,222.44 | $1,222.44 | $65.16 – $180.16 | 9 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | $1,222.44 | $1,222.44 | $65.16 – $180.16 | 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.