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 |
|---|---|---|---|---|
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | not published | not published | $3.82 – $6.33 | 5 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $163.20 – $325.79 | 4 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $175.70 – $344.12 | 8 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $15.06 – $32.44 | 8 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $2,332,000.00 – $4,609,957.80 | 6 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $8.78 – $17.51 | 8 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | $8,216.45 | $8,216.45 | $34.48 – $7,723.46 | 9 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $62.05 – $99,999.99 | 4 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $18.86 – $38.30 | 8 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $131.82 – $253.00 | 8 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.03 – $0.06 | 4 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.10 – $2.18 | 8 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $97.76 | $97.76 | $7.43 – $51.34 | 9 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $2.87 – $6.58 | 6 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $121.32 – $395.86 | 3 |
| Inj follitropin beta 75 iu HCPCS S0128 | not published | not published | $115.23 – $356.50 | 3 |
| Inj for ext venography CPT 36005 | $1,132.80 | $1,132.80 | $43.62 – $357.42 | 9 |
| Inj for mammo ductogram CPT 19030 | $579.10 | $579.10 | $71.00 – $315.44 | 9 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.16 – $2.04 | 8 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $400.51 – $1,300.95 | 8 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $3.16 – $4.74 | 5 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $2.70 – $53.00 | 8 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $3.13 – $47.60 | 8 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $3.91 – $11.26 | 3 |
| Inj, ganciclovir (exela) HCPCS J1574 | not published | not published | $51.00 – $101.81 | 4 |
| Inj ganirelix acetat 250 mcg HCPCS S0132 | not published | not published | $159.96 – $328.21 | 3 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $3.93 – $15.32 | 7 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $111.92 – $215.19 | 8 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $2,707.93 – $5,200.48 | 7 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | not published | not published | $1.85 – $3.98 | 6 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | not published | not published | $3.35 – $3.35 | 1 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $163.20 – $327.04 | 5 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $4.96 – $10.43 | 8 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $74.86 – $145.34 | 8 |
| Inj., haegarda 10 units HCPCS J0599 | not published | not published | $10.80 – $22.40 | 4 |
| Inj, hemgenix, per tx dose HCPCS J1411 | not published | not published | $0.02 – $7,126,700.00 | 6 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | not published | not published | $3.42 – $6.96 | 7 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $16,777.10 | $16,777.10 | $62.97 – $7,983.74 | 9 |
| Inj, hercessi, 10 mg HCPCS Q5146 | not published | not published | $76.18 – $184.82 | 6 |
| Inj herzuma 10 mg HCPCS Q5113 | $14,092.05 | $14,092.05 | $23.67 – $4,730.93 | 9 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $1,551.75 | $1,551.75 | $42.43 – $1,303.47 | 9 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $1,643.25 | $1,643.25 | $47.20 – $1,380.33 | 9 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $2,752.55 | $2,752.55 | $49.98 – $2,312.14 | 9 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $1,252.70 | $1,252.70 | $24.50 – $81.10 | 9 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $1,511.20 | $1,511.20 | $23.76 – $81.10 | 9 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.32 – $2.77 | 8 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $4,201.60 | $4,201.60 | $5.18 – $3,949.50 | 9 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | not published | not published | $13.91 – $35.80 | 5 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $71.00 – $143.39 | 8 |
| Inj, idacio, 1 mg HCPCS Q5144 | not published | not published | $8.92 – $23.55 | 6 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $3,218.12 | $3,218.12 | $2.43 – $3,025.03 | 9 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $59.57 – $148.04 | 7 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | not published | not published | $0.13 – $0.27 | 6 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $472.13 – $909.59 | 8 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | $2,132.95 | $2,132.95 | $136.13 – $599.43 | 9 |
| Inj. infugem, 100 mg HCPCS J9198 | not published | not published | $25.16 – $79.33 | 7 |
| Inj. insulin (fiasp) HCPCS J1812 | not published | not published | $1.48 – $2.95 | 4 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $307.30 | $307.30 | $28.03 – $90.97 | 9 |
| Inj intralesional > 7 lsns CPT 11901 | $344.15 | $344.15 | $43.08 – $135.56 | 9 |
| Inj, invega hafyera/trinza HCPCS J2427 | $60,779.64 | $60,779.64 | $12.21 – $10,334.91 | 9 |
| Inj ivig privigen 500 mg HCPCS J1459 | $27,025.75 | $27,025.75 | $48.13 – $3,355.16 | 9 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $1.72 – $3.52 | 8 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.22 – $4.48 | 8 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | $24.54 | $24.54 | $1.37 – $23.07 | 9 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | not published | not published | $2.03 – $4.19 | 7 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $84.46 – $173.65 | 4 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $24.45 – $60.66 | 8 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $1.33 – $2.57 | 8 |
| Inj lefamulin 1 mg HCPCS J0691 | not published | not published | $0.70 – $1.42 | 6 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $21.92 – $42.29 | 8 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $257.94 | $257.94 | $30.54 – $193.55 | 9 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.02 – $0.57 | 6 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $4,210.80 | $4,210.80 | $5.24 – $848.65 | 9 |
| Inj, levothyroxine, hikma HCPCS J0652 | not published | not published | $5.14 – $10.16 | 6 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $186.80 | $186.80 | $0.02 – $1.78 | 9 |
| Inj, linezolid (hospira) HCPCS J2021 | not published | not published | $14.34 – $28.24 | 7 |
| Inj, lovotibeglogene autotem HCPCS J3394 | not published | not published | $0.02 – $6,885,600.61 | 6 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $316.99 – $611.04 | 8 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $22.51 – $44.94 | 8 |
| Inj luxturna 1 billion vec g HCPCS J3398 | not published | not published | $2,890.00 – $5,769.23 | 7 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $1,205.50 | $1,205.50 | $41.70 – $389.04 | 9 |
| Inj marstacim-hncq, 0.5 mg HCPCS J7172 | not published | not published | $50.71 – $52.24 | 5 |
| Inj. meloxicam 1 mg HCPCS J1738 | not published | not published | $3.19 – $6.37 | 5 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $4,181.98 | $4,181.98 | $108.03 – $3,931.06 | 9 |
| Inj, melphalan (apotex) 1 mg HCPCS J9249 | not published | not published | $64.78 – $66.72 | 5 |
| Inj, melphalan flufenami 1mg HCPCS J9247 | not published | not published | $484.50 – $967.20 | 6 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $787.79 – $1,529.67 | 6 |
| Inj menotropins 75 iu HCPCS S0122 | not published | not published | $106.41 – $382.58 | 3 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $31.46 | $31.46 | $2.88 – $23.12 | 9 |
| Inj, meropenem (b. braun) HCPCS J2184 | not published | not published | $2.11 – $3.89 | 6 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $2,264.92 | $2,264.92 | $2.18 – $2,129.02 | 9 |
| Inj meropenem (wg crit care) HCPCS J2183 | $334.91 | $334.91 | $1.62 – $205.20 | 9 |
| Inj metaraminol bitartrate HCPCS J0380 | not published | not published | $1.14 – $2.03 | 4 |
| Inj, micafungin (par pharm) HCPCS J2247 | not published | not published | $0.34 – $0.97 | 7 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | not published | not published | $48.27 – $89.73 | 6 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $225.13 – $449.82 | 8 |
| Inj, motixafortide, 0.25 mg HCPCS J2277 | not published | not published | $25.22 – $49.85 | 6 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | not published | not published | $8.78 – $16.84 | 6 |
| Inj moxifloxacin (fres kabi) HCPCS J2281 | not published | not published | $5.81 – $14.89 | 7 |
| Inj multihance HCPCS A9577 | $206.00 | $206.00 | $1.83 – $56.02 | 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.