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 |
|---|---|---|---|---|
| Larynscop remve cart + scop CPT 31561 | not published | not published | $320.68 – $687.97 | 8 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $248.05 – $530.72 | 8 |
| Laser surgery eye strands CPT 67031 | not published | not published | $337.56 – $743.98 | 9 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $140.46 – $400.26 | 9 |
| Laser surgery of prostate CPT 52647 | not published | not published | $622.09 – $3,003.53 | 9 |
| Laser surgery of prostate CPT 52648 | not published | not published | $661.20 – $3,097.32 | 9 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $93.57 – $276.90 | 9 |
| Laser treatment of retina CPT 67039 | not published | not published | $912.35 – $1,924.28 | 8 |
| Laser treatment of retina CPT 67040 | not published | not published | $984.45 – $2,077.46 | 8 |
| Lateral canthopexy CPT 21282 | not published | not published | $381.93 – $817.43 | 8 |
| Lateral thoracic extension HCPCS L1210 | not published | not published | $232.85 – $586.16 | 7 |
| Lateral trochanteric pad HCPCS L1290 | not published | not published | $75.12 – $189.08 | 7 |
| Latex suspension sleeve each HCPCS L6632 | not published | not published | $66.21 – $166.64 | 7 |
| Lat retinacular release open CPT 27425 | not published | not published | $439.45 – $946.20 | 8 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $106.21 – $360.43 | 9 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $1,055.04 – $2,280.80 | 8 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $708.50 – $1,728.87 | 9 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $2,200.00 | $2,200.00 | $1,066.62 – $1,363.00 | 6 |
| Lead capillary CPT 83655 | $134.80 | $134.80 | $8.97 – $49.54 | 9 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $475.00 | $475.00 | $248.63 – $317.72 | 6 |
| Leads any type vad, rep only HCPCS Q0487 | not published | not published | $319.99 – $799.78 | 7 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $3,880.00 | $3,880.00 | $1,471.20 – $1,880.00 | 6 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $1,280.84 – $2,694.26 | 8 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $1,314.01 – $2,764.75 | 8 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $1,631.93 – $3,437.80 | 8 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $1,354.15 – $2,849.48 | 8 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $1,558.71 – $3,337.48 | 8 |
| Left compres band >=3" <5"/yd HCPCS A6449 | not published | not published | $1.96 – $4.87 | 7 |
| Left compres band <3"/yd HCPCS A6448 | not published | not published | $1.28 – $3.20 | 7 |
| Left compres band >=5"/yd HCPCS A6450 | not published | not published | $1.96 – $4.87 | 7 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $2,312.95 | $2,312.95 | $35.01 – $74.56 | 9 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $2,716.15 | $2,716.15 | $52.33 – $1,426.24 | 9 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,599.70 | $2,599.70 | $44.98 – $854.32 | 9 |
| Legg perthes orth newington HCPCS L1710 | not published | not published | $2,121.11 – $5,339.59 | 7 |
| Legg perthes orthosis trilat HCPCS L1720 | not published | not published | $1,199.51 – $3,019.58 | 7 |
| Legg perthes orth scottish r HCPCS L1730 | not published | not published | $1,261.11 – $3,174.64 | 7 |
| Legg perthes patten bottom t HCPCS L1755 | not published | not published | $1,878.58 – $4,729.05 | 7 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $9.90 – $40.83 | 7 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $20.62 – $85.03 | 7 |
| Leg perthes orth toronto typ HCPCS L1700 | not published | not published | $1,726.86 – $4,347.12 | 7 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $850.43 – $1,874.79 | 8 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,963.00 | $1,963.00 | $30.58 – $1,047.62 | 9 |
| Leishmania antibody CPT 86717 | $25.60 | $25.60 | $6.05 – $24.06 | 9 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $639.38 – $1,354.93 | 8 |
| Lengthening of palate CPT 42227 | not published | not published | $814.42 – $1,722.30 | 8 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $874.66 – $1,848.36 | 8 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $1,132.19 – $2,423.81 | 8 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $486.05 – $1,039.07 | 8 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $631.53 – $1,354.24 | 8 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $849.11 – $1,815.15 | 8 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $1,025.84 – $2,196.08 | 8 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $894.04 – $1,903.93 | 8 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $955.97 – $2,042.90 | 8 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $1,079.30 – $2,311.29 | 8 |
| Lens, intraocular (new tech) HCPCS C1780 | $175.00 | $175.00 | $128.73 – $164.50 | 6 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $709.67 | $709.67 | $37.40 – $103.40 | 9 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $150.00 | $150.00 | $45.56 – $117.50 | 9 |
| Lepirudin HCPCS J1945 | not published | not published | $304.33 – $1,058.67 | 4 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $431.28 | $431.28 | $3.48 – $191.37 | 7 |
| Leukacyte transfusion CPT 86950 | not published | not published | $32.11 – $170.82 | 7 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $4.16 – $21.16 | 7 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $16,963.50 | $16,963.50 | $155.42 – $1,787.55 | 9 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $19,390.00 | $19,390.00 | $773.23 – $1,789.21 | 9 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $4,819.82 – $9,316.59 | 3 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $4.65 – $17.62 | 7 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $220.74 – $465.10 | 8 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $51.41 – $110.51 | 8 |
| Lev 1 hosp type b ed visit HCPCS G0380 | $193.65 | $193.65 | $81.37 – $182.03 | 9 |
| Lev 2 hosp type b ed visit HCPCS G0381 | $172.10 | $172.10 | $107.10 – $161.77 | 9 |
| Lev 3 hosp type b ed visit HCPCS G0382 | $284.15 | $284.15 | $180.59 – $267.10 | 9 |
| Lev 4 hosp type b ed visit HCPCS G0383 | $405.85 | $405.85 | $276.37 – $381.50 | 9 |
| Lev 5 hosp type b ed visit HCPCS G0384 | $836.00 | $836.00 | $390.90 – $785.84 | 9 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $0.07 – $4.07 | 3 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.26 – $0.45 | 6 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.04 – $0.08 | 6 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $407.18 | $407.18 | $0.06 – $52.00 | 9 |
| Levetiracetam therapeutic drug level CPT 80177 | $369.65 | $369.65 | $6.54 – $134.28 | 9 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $50.10 | $50.10 | $0.86 – $26.20 | 9 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $323.41 – $831.84 | 3 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $506.75 | $506.75 | $10.64 – $476.35 | 9 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $5,505.20 | $5,505.20 | $244.48 – $4,624.37 | 9 |
| Liberta rc ipg HCPCS C1820 | $33,895.00 | $33,895.00 | $731.92 – $935.30 | 6 |
| Lidocaine injection HCPCS J2001 | not published | not published | $0.03 – $0.06 | 6 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $139.67 | $139.67 | $0.02 – $0.86 | 9 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $197.20 | $197.20 | $0.01 – $56.14 | 9 |
| Lidocaine therapeutic drug level CPT 80176 | not published | not published | $7.26 – $29.91 | 7 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $0.07 | $0.07 | $0.05 – $0.07 | 6 |
| Lift assist for elbow HCPCS L6635 | not published | not published | $170.85 – $430.09 | 7 |
| Lift heel adj small gl60404sm HCPCS L3332 | not published | not published | $68.50 – $172.45 | 7 |
| Lift heel adjustable med HCPCS L3334 | not published | not published | $35.45 – $89.25 | 7 |
| Lifts elevation metal extens HCPCS L3330 | not published | not published | $525.72 – $1,323.43 | 7 |
| Ligate esophagus veins CPT 43400 | not published | not published | $1,417.18 – $3,094.84 | 8 |
| Ligate leg veins open CPT 37761 | not published | not published | $487.44 – $1,069.57 | 8 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $523.43 – $1,152.27 | 8 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $70.33 – $152.51 | 8 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $1,345.35 – $2,937.59 | 8 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $418.34 – $920.46 | 8 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $359.19 – $786.93 | 8 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $352.82 – $759.13 | 8 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $191.13 – $600.06 | 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.