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 |
|---|---|---|---|---|
| IV Push Injection (each additional drug) CPT 96375 | $211.95 | $211.95 | $14.25 – $116.74 | 9 |
| IV Push Injection (first drug) CPT 96374 | $394.65 | $394.65 | $12.90 – $71.16 | 9 |
| Ivp w/nephrotomography CPT 74415 | $1,396.95 | $1,396.95 | $22.05 – $1,173.44 | 9 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,396.95 | $1,396.95 | $21.84 – $833.62 | 9 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $21,687.75 | $21,687.75 | $124.32 – $5,401.16 | 9 |
| Jak2 targeted sequence analysis CPT 81279 | not published | not published | $74.08 – $377.10 | 7 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $511.34 – $1,098.71 | 8 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $576.96 – $1,211.23 | 8 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $1,054.10 | $1,054.10 | $10.92 – $205.51 | 9 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $594.10 | $594.10 | $11.57 – $351.37 | 9 |
| Jejunstmy tube plcmt CPT 44372 | $2,965.70 | $2,965.70 | $224.07 – $2,491.19 | 9 |
| John cunningham antibody CPT 86711 | $37.00 | $37.00 | $7.11 – $33.04 | 9 |
| J-tube placement CPT 44015 | not published | not published | $129.21 – $283.99 | 8 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,321.57 – $3,326.87 | 7 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,071.87 – $2,698.27 | 7 |
| Kafo fem fx cast molded to p HCPCS L2128 | not published | not published | $2,034.60 – $5,121.80 | 7 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $1,058.19 – $2,663.82 | 7 |
| Kafo fem fx cast thermoplas HCPCS L2126 | not published | not published | $1,277.87 – $3,216.85 | 7 |
| Kafo femoral fx cast rigid HCPCS L2136 | not published | not published | $1,182.79 – $2,977.49 | 7 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $751.72 – $1,892.34 | 7 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $1,858.72 – $4,679.05 | 7 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $1,976.29 – $4,975.03 | 7 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $163.68 – $412.00 | 7 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,024.69 – $2,579.50 | 7 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $3,806.44 – $9,582.13 | 7 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $931.37 – $2,344.58 | 7 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $1,696.43 – $4,270.52 | 7 |
| Keratomileusis CPT 65760 | not published | not published | $1,366.14 – $2,347.23 | 4 |
| Keratophakia CPT 65765 | not published | not published | $1,981.07 – $3,403.92 | 4 |
| Keratoprosthesis CPT 65770 | not published | not published | $1,338.21 – $2,823.72 | 8 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $510.00 – $1,175.98 | 4 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $4.90 – $50.16 | 4 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $7.00 – $31.50 | 7 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $226.75 | $226.75 | $6.05 – $97.24 | 9 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $17.82 | $17.82 | $0.33 – $4.37 | 9 |
| Kidney endoscopy CPT 50551 | not published | not published | $275.56 – $693.86 | 9 |
| Kidney endoscopy CPT 50553 | $3,441.30 | $3,441.30 | $294.26 – $744.62 | 9 |
| Kidney endoscopy CPT 50570 | not published | not published | $459.02 – $980.78 | 8 |
| Kidney endoscopy CPT 50575 | not published | not published | $666.03 – $1,421.35 | 8 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $319.86 – $793.44 | 9 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $527.62 – $1,125.84 | 8 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $323.75 – $806.93 | 9 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $368.92 – $916.80 | 9 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $526.33 – $1,122.43 | 8 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $566.52 – $1,209.87 | 8 |
| Kidney function study CPT 78725 | $765.60 | $765.60 | $16.10 – $643.10 | 9 |
| Kidney imaging morphology CPT 78700 | not published | not published | $19.89 – $41.36 | 8 |
| Kidney imag w/bld flow multi CPT 78709 | $2,931.95 | $2,931.95 | $61.73 – $1,405.66 | 9 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $2,093.35 | $2,093.35 | $42.05 – $1,027.53 | 9 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,040.15 | $1,040.15 | $33.30 – $605.68 | 9 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $783.00 | $783.00 | $20.40 – $50.73 | 9 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | not published | not published | $40.92 – $102.30 | 7 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | not published | not published | $7.77 – $19.43 | 7 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $4,700.00 | $4,700.00 | $3,457.32 – $4,418.00 | 6 |
| Kit gene analys d816 variant CPT 81273 | $1,096.05 | $1,096.05 | $49.95 – $886.66 | 9 |
| Kit hfx iq ipg bundle HCPCS C1822 | $22,500.00 | $22,500.00 | $103.72 – $132.54 | 6 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $15.09 – $37.73 | 7 |
| Kit lead specify 5-6-5 HCPCS C1778 | $7,500.00 | $7,500.00 | $29.42 – $1,257.05 | 9 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $12,750.00 | $12,750.00 | $24.33 – $2,292.85 | 7 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | not published | not published | $1,602.84 – $4,034.91 | 7 |
| Kit trach suct cls 30.5cm HCPCS A4605 | not published | not published | $2.70 – $29.72 | 3 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $598.53 – $1,280.36 | 8 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $497.42 – $1,065.50 | 8 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $392.75 – $1,079.34 | 9 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $521.96 – $1,118.36 | 8 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $601.52 – $1,289.85 | 8 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $893.16 – $1,907.33 | 8 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $516.94 – $1,114.31 | 8 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $517.09 – $1,111.60 | 8 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $479.02 – $1,026.88 | 8 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $628.62 – $1,345.44 | 8 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $637.10 – $1,363.72 | 8 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $542.07 – $1,160.39 | 8 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $664.37 – $1,416.60 | 8 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $807.59 – $1,732.46 | 8 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $596.99 – $1,278.33 | 8 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $613.47 – $1,314.94 | 8 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $724.91 – $1,553.52 | 8 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $931.96 – $1,994.09 | 8 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $1,174.79 – $2,510.57 | 8 |
| Knee cap medial or lateral p HCPCS L2800 | not published | not published | $126.57 – $318.60 | 7 |
| Knee control condylar pad HCPCS L2810 | not published | not published | $92.67 – $233.29 | 7 |
| Knee control full kneecap HCPCS L2795 | not published | not published | $100.82 – $253.81 | 7 |
| Knee disart expand wall sock HCPCS L5653 | not published | not published | $577.81 – $1,454.56 | 7 |
| Knee disarticulat leather so HCPCS L5640 | not published | not published | $606.23 – $1,526.11 | 7 |
| Knee disc/dial lock/adj flex HCPCS L2425 | not published | not published | $133.15 – $335.18 | 7 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | not published | not published | $133.15 – $335.18 | 7 |
| Knee joint cam lock each joi HCPCS L2415 | not published | not published | $112.82 – $284.01 | 7 |
| Knee joint drop lock ea jnt HCPCS L2405 | not published | not published | $80.98 – $203.86 | 7 |
| Knee lift loop drop lock rin HCPCS L2492 | not published | not published | $105.57 – $265.76 | 7 |
| Knee MRI (with and without contrast) CPT 73723 | $6,736.70 | $6,736.70 | $97.62 – $2,519.33 | 9 |
| Knee MRI (with contrast) CPT 73722 | $3,945.95 | $3,945.95 | $73.53 – $2,085.05 | 9 |
| Knee MRI (without contrast) CPT 73721 | $3,614.95 | $3,614.95 | $61.31 – $1,552.82 | 9 |
| Knee orth pos locking joint HCPCS L1831 | not published | not published | $273.39 – $688.26 | 7 |
| Knee-shin exo fluid swing ph HCPCS L5724 | not published | not published | $1,720.82 – $4,331.91 | 7 |
| Knee-shin exo frct swg & sta HCPCS L5718 | not published | not published | $997.09 – $2,510.04 | 7 |
| Knee-shin exo frict swg & st HCPCS L5712 | not published | not published | $513.19 – $1,291.89 | 7 |
| Knee-shin exo mech stance ph HCPCS L5716 | not published | not published | $830.11 – $2,089.69 | 7 |
| Knee-shin exo mnl lock ultra HCPCS L5711 | not published | not published | $645.88 – $1,625.89 | 7 |
| Knee-shin exo variable frict HCPCS L5714 | not published | not published | $462.04 – $1,163.12 | 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.