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 multihance multipack HCPCS A9578 | not published | not published | $1.77 – $3.34 | 6 |
| Inj. mycophenolate mofetil HCPCS J7519 | $738.01 | $738.01 | $0.54 – $577.25 | 7 |
| Inj naloxone hydrochloride HCPCS J2310 | $335.93 | $335.93 | $7.29 – $151.47 | 9 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | not published | not published | $609.17 – $1,171.83 | 8 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $2,579.30 | $2,579.30 | $62.89 – $612.26 | 9 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | not published | not published | $2.17 – $3.65 | 6 |
| Inj nivolumab 2 mg hyaluron HCPCS J9289 | not published | not published | $26.74 – $27.54 | 5 |
| Inj, nogapendekin pmln, 1mcg HCPCS J9028 | not published | not published | $94.12 – $187.54 | 6 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $138.25 – $2,614.41 | 9 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | not published | not published | $109.33 – $2,455.50 | 9 |
| Inj, nyposi 1 mcg HCPCS Q5148 | not published | not published | $0.55 – $0.57 | 5 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | not published | not published | $47.24 – $48.66 | 5 |
| Inj, ocriplasmin, 0.125 mg HCPCS J7316 | not published | not published | $189.41 – $1,942.65 | 4 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | not published | not published | $33.43 – $82.25 | 7 |
| Inj ogivri 10 mg HCPCS Q5114 | $4,644.62 | $4,644.62 | $44.43 – $4,358.65 | 9 |
| Inj, olaratumab, 10 mg HCPCS J9285 | not published | not published | $52.07 – $96.61 | 3 |
| Inj, oliceridine 0.1 mg HCPCS C9101 | not published | not published | $0.75 – $1.34 | 7 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $376.97 – $723.38 | 8 |
| Inj, omacetaxine mep, 0.01mg HCPCS J9262 | not published | not published | $3.73 – $7.94 | 7 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $3.66 – $7.21 | 8 |
| Inj onase abepar-xioi treat HCPCS J3399 | not published | not published | $0.02 – $4,728,146.73 | 7 |
| Inj ontruzant 10 mg HCPCS Q5112 | $13,309.90 | $13,309.90 | $21.99 – $4,468.34 | 9 |
| Inj, pafolacianine, 0.1 mg HCPCS A9603 | not published | not published | $135.47 – $324.53 | 3 |
| Inj, palonosetron (posfrea) HCPCS J2468 | not published | not published | $58.84 – $121.54 | 6 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | not published | not published | $13.62 – $13.62 | 1 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $66.44 – $124.76 | 8 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $554.36 – $1,005.47 | 8 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $13,769.68 | $13,769.68 | $99.35 – $12,943.50 | 9 |
| Inj, pedmark, 100 mg HCPCS J0208 | not published | not published | $93.16 – $185.99 | 8 |
| Inj, pegcetacoplan, 1mg HCPCS J2781 | not published | not published | $141.91 – $287.96 | 8 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | not published | not published | $27.99 – $333.67 | 8 |
| Inj, pegulicianine, 1 mg HCPCS A9615 | not published | not published | $36.45 – $74.14 | 6 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $52.74 – $104.16 | 8 |
| Inj pemetrexed (accord) 10mg HCPCS J9296 | not published | not published | $9.66 – $18.55 | 8 |
| Inj, pemetrexed (avyxa) 10mg HCPCS J9292 | not published | not published | $83.28 – $165.54 | 6 |
| Inj pemetrexed (bluepoint) HCPCS J9322 | not published | not published | $9.80 – $16.23 | 3 |
| Inj pemetrexed ditromethamin HCPCS J9323 | not published | not published | $4.69 – $19.87 | 8 |
| Inj pemetrexed, hospira 10mg HCPCS J9294 | not published | not published | $1.97 – $10.55 | 8 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | not published | not published | $1.12 – $2.73 | 7 |
| Inj pemetrexed (teva) 10mg HCPCS J9314 | not published | not published | $3.79 – $14.10 | 8 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | not published | not published | $6,583.50 – $13,014.43 | 6 |
| Inj, pemrydi rtu, 10 mg HCPCS J9324 | not published | not published | $80.10 – $162.38 | 6 |
| Inj perflexane lip micros,ml HCPCS Q9955 | not published | not published | $13.25 – $99,999.99 | 4 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $36.57 – $77.27 | 8 |
| Inj., perseris, 0.5 mg HCPCS J2798 | not published | not published | $11.41 – $22.34 | 8 |
| Inj plasminogen tvmh 1mg HCPCS J2998 | not published | not published | $30.10 – $61.09 | 8 |
| Inj., plazomicin, 5 mg HCPCS J0291 | not published | not published | $3.45 – $6.90 | 8 |
| Inj pozelimab-bbfg, 1 mg HCPCS J9376 | not published | not published | $181.34 – $181.34 | 1 |
| Inj proc ankle arthr CPT 27648 | $1,471.90 | $1,471.90 | $48.31 – $406.69 | 9 |
| Inj proc elbow arthro CPT 24220 | $729.95 | $729.95 | $57.85 – $143.27 | 9 |
| Inj proc for lymphang CPT 38790 | $1,746.30 | $1,746.30 | $78.05 – $1,466.89 | 9 |
| Inj proc lumbr disk ea lvl CPT 62290 | $986.60 | $986.60 | $148.81 – $501.27 | 9 |
| Inj proc myelogram lumbar CPT 62284 | $1,052.15 | $1,052.15 | $78.41 – $359.77 | 9 |
| Inj proc sialogram CPT 42550 | $800.45 | $800.45 | $58.04 – $294.89 | 9 |
| Inj progesterone per 50 mg HCPCS J2675 | not published | not published | $0.73 – $1.36 | 6 |
| Inj prohance multipack HCPCS A9576 | not published | not published | $1.46 – $2.87 | 6 |
| Inj protirelin per 250 mcg HCPCS J2725 | not published | not published | $21.78 – $33.68 | 3 |
| Inj recombin esperoct per iu HCPCS J7204 | not published | not published | $2.08 – $4.05 | 8 |
| Inj, releuko 1 mcg HCPCS Q5125 | $2,589.64 | $2,589.64 | $0.41 – $1,521.42 | 9 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | not published | not published | $0.68 – $1.45 | 8 |
| Inj retro urethrocysto CPT 51610 | $607.60 | $607.60 | $61.52 – $137.00 | 9 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | $114.95 | $114.95 | $12.36 – $108.05 | 9 |
| Inj roctavian ml 2x10^13vc g HCPCS J1412 | not published | not published | $11,554.69 – $23,066.34 | 7 |
| Inj., rolapitant, 0.5 mg HCPCS J2797 | not published | not published | $0.90 – $1.51 | 3 |
| Inj romidepsin non-lyo 0.1mg HCPCS J9318 | not published | not published | $28.52 – $65.14 | 8 |
| Inj, rykindo, 0.5 mg HCPCS J2801 | not published | not published | $13.03 – $27.30 | 6 |
| Inj scleros sol mult veins CPT 36471 | $643.65 | $643.65 | $69.08 – $238.69 | 9 |
| Inj scleros sol sgl vein CPT 36470 | $308.50 | $308.50 | $35.18 – $209.39 | 9 |
| Inj, sculptra, 0.5mg HCPCS Q2028 | not published | not published | $0.66 – $2.85 | 8 |
| Inj sebelipase alfa 1 mg HCPCS J2840 | not published | not published | $520.71 – $1,039.48 | 8 |
| Inj secretin synthetic human HCPCS J2850 | $4,348.23 | $4,348.23 | $33.47 – $4,087.34 | 9 |
| Inj secukinumab intrav 1mg HCPCS J3247 | not published | not published | $17.84 – $35.04 | 6 |
| Inj, sezaby, 1 mg HCPCS J2561 | not published | not published | $1.15 – $2.71 | 8 |
| Inj, spesolimab-sbzo, 1 mg HCPCS J1747 | not published | not published | $60.22 – $115.53 | 8 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | not published | not published | $386.68 – $398.28 | 5 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | not published | not published | $18.91 – $36.39 | 6 |
| Inj, susvimo 0.1 mg HCPCS J2779 | not published | not published | $78.43 – $154.38 | 8 |
| Inj, sutimlimab-jome, 10 mg HCPCS J1302 | not published | not published | $17.35 – $34.13 | 8 |
| Inj. tagraxofusp-erzs 10 mcg HCPCS J9269 | not published | not published | $325.56 – $627.48 | 8 |
| Inj, taliglucerace alfa 10 u HCPCS J3060 | not published | not published | $41.06 – $82.29 | 8 |
| Inj teclistamab cqyv 0.5 mg HCPCS J9380 | $14,068.90 | $14,068.90 | $30.85 – $5,363.19 | 9 |
| Inj tedizolid phosphate HCPCS J3090 | not published | not published | $1.69 – $3.48 | 8 |
| Inj teplizumab mzwv 5 mcg HCPCS J9381 | not published | not published | $36.26 – $69.88 | 8 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $22,832.60 | $22,832.60 | $328.00 – $20,442.82 | 9 |
| Inj testostero enanthate 1mg HCPCS J3121 | not published | not published | $0.05 – $0.10 | 6 |
| Inj, testosterone, azmiro HCPCS J1072 | not published | not published | $1.33 – $1.36 | 5 |
| Inj testosterone cypionate HCPCS J1071 | $242.17 | $242.17 | $0.02 – $32.75 | 7 |
| Inj theophylline per 40 mg HCPCS J2810 | not published | not published | $0.41 – $1.72 | 4 |
| Inj thiotepa nos 1 mg HCPCS J9342 | not published | not published | $12.24 – $12.60 | 5 |
| Inj thrc fascial pln blk bi w/wo image CPT 64468 | $1,222.44 | $1,222.44 | $65.16 – $180.16 | 9 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $1,222.44 | $1,222.44 | $62.18 – $180.16 | 9 |
| Inj. tigecycline (accord) HCPCS J3244 | not published | not published | $0.60 – $5.22 | 7 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | not published | not published | $126.24 – $263.27 | 8 |
| Inj, tislelizumab-jsgr HCPCS J9329 | not published | not published | $57.42 – $109.05 | 6 |
| Inj tofersen intrathec 1 mg HCPCS J1304 | not published | not published | $150.84 – $289.75 | 7 |
| Inj, tofidence, 1 mg HCPCS Q5133 | not published | not published | $5.79 – $11.86 | 6 |
| Inj travoprost intra impl HCPCS J7355 | not published | not published | $195.25 – $413.14 | 6 |
| Inj triamcinolone ace X-ray 1mg HCPCS J3304 | not published | not published | $17.20 – $33.60 | 8 |
| Inj triferic avnu 0.1mg iron HCPCS J1445 | not published | not published | $0.18 – $0.33 | 4 |
| Inj., triluron, 1 mg HCPCS J7332 | not published | not published | $10.10 – $19.95 | 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.