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 |
|---|---|---|---|---|
| Infuse radioactive materials CPT 77750 | not published | not published | $131.13 – $502.41 | 8 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $65.01 – $164.47 | 9 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $70.53 – $237.71 | 9 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $309.90 | $309.90 | $43.20 – $90.83 | 9 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $1,941.21 – $4,886.72 | 7 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,386.77 – $3,491.00 | 7 |
| Initial care training 30 m HCPCS G0539 | $66.65 | $66.65 | $33.33 – $51.11 | 8 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,224.27 – $3,081.93 | 7 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $37.50 – $124.63 | 8 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | $1,255.15 | $1,255.15 | $319.31 – $678.48 | 9 |
| Initial nursing facility care/day 35 minutes CPT 99305 | $305.75 | $305.75 | $127.14 – $269.08 | 9 |
| Initial nursing facility care/day 45 minutes CPT 99306 | $418.10 | $418.10 | $173.53 – $367.37 | 9 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | $266.95 | $266.95 | $76.60 – $162.00 | 9 |
| Initial observation care CPT 99218 | not published | not published | $198.47 – $198.47 | 1 |
| Initial observation care CPT 99219 | not published | not published | $270.25 – $270.25 | 1 |
| Initial observation care CPT 99220 | not published | not published | $369.49 – $369.49 | 1 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $57.51 – $176.68 | 9 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $309.95 | $309.95 | $120.27 – $310.95 | 8 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $36.56 – $110.51 | 8 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $5.88 – $11.16 | 7 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $8,259.07 | $8,259.07 | $6.55 – $5,560.13 | 9 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.22 – $0.48 | 6 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.05 – $0.10 | 7 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.05 – $0.10 | 7 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.05 – $0.10 | 7 |
| Inj. acthar gel to 40 units HCPCS J0801 | $50,446.60 | $50,446.60 | $3,479.53 – $47,419.80 | 8 |
| Inj, adalimumab, 1 mg HCPCS J0139 | $9,842.58 | $9,842.58 | $91.73 – $6,805.44 | 9 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $10.64 – $27.20 | 6 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $61,200.00 – $121,990.27 | 8 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.98 – $11.48 | 8 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $35.59 – $68.33 | 6 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $869.08 – $895.16 | 5 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $319.74 – $650.49 | 6 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.44 – $2.79 | 8 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $2.57 – $4.93 | 4 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $4.54 – $8.70 | 8 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $131.12 – $290.36 | 6 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $42.60 – $112.97 | 8 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.18 – $18.33 | 7 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $127.50 – $254.52 | 8 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $16.55 – $32.93 | 8 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,348.99 – $6,855.46 | 4 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $1.84 – $3.69 | 7 |
| Inj., aristada initio, 1 mg HCPCS J1943 | $6,924.77 | $6,924.77 | $3.01 – $5,809.46 | 9 |
| Inj, artesunate, 1mg HCPCS J0391 | $9,219.52 | $9,219.52 | $46.18 – $8,666.35 | 9 |
| Inj. asceniv HCPCS J1554 | not published | not published | $491.40 – $943.96 | 8 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | $9,069.63 | $9,069.63 | $49.19 – $8,525.45 | 9 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $31.64 – $32.58 | 5 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $105.90 – $213.80 | 6 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $73.90 – $145.98 | 8 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $45.02 – $92.13 | 6 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $168.13 – $317.42 | 8 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $38.33 – $76.52 | 4 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $0.02 – $6,219,252.16 | 6 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.83 – $76.60 | 8 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $206.21 – $396.08 | 8 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.17 – $0.33 | 7 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $26.21 – $27.00 | 5 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $4.91 – $93.26 | 8 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $2.68 – $46.72 | 8 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $1.52 – $3.78 | 7 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $75.99 – $150.87 | 5 |
| Inj, brixadi, 7 days or less HCPCS J0577 | $4,346.61 | $4,346.61 | $422.83 – $4,085.81 | 9 |
| Inj brixadi, more than 7 day HCPCS J0578 | $6,129.20 | $6,129.20 | $1,691.31 – $5,103.61 | 9 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $321.16 – $625.60 | 8 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $666.62 – $1,678.11 | 7 |
| Inj, bupivacaine liposome HCPCS J0666 | $2,456.19 | $2,456.19 | $1.45 – $954.90 | 9 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.49 – $0.98 | 7 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $62.15 – $334.47 | 8 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $0.78 – $2.70 | 5 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $0.10 – $267.49 | 7 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $1.21 – $2.50 | 7 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $89.33 | $89.33 | $0.91 – $54.73 | 9 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $1.00 – $2.20 | 6 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $5.47 – $11.21 | 7 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $5.13 – $10.10 | 7 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $2,370.18 | $2,370.18 | $2.17 – $1,244.78 | 9 |
| Inj ceftolozane tazobactam HCPCS J0695 | $2,662.33 | $2,662.33 | $6.84 – $932.14 | 9 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $105.77 – $217.04 | 4 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $14.96 – $28.75 | 8 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $86.51 – $333.57 | 8 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $89.80 – $176.69 | 6 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $2.88 – $6.96 | 7 |
| Inj, clindamycin (baxter) HCPCS J0737 | $56.45 | $56.45 | $1.75 – $41.50 | 9 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $729.95 | $729.95 | $37.83 – $352.71 | 9 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $87.56 – $178.29 | 5 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $441.85 – $2,011.79 | 8 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $551.51 – $1,090.23 | 6 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $13.89 – $28.62 | 7 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $15.21 – $30.40 | 8 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $10.14 – $10.14 | 1 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $3.72 – $9.27 | 7 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.78 – $1.79 | 8 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $1.16 – $1.89 | 6 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $4.21 – $8.59 | 6 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.07 – $0.13 | 3 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.06 – $0.12 | 7 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.04 – $0.06 | 7 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $3.11 – $6.54 | 6 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $0.78 – $4.18 | 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.