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 |
|---|---|---|---|---|
| Ligation common iliac vein CPT 37660 | not published | not published | $1,219.85 – $2,665.10 | 8 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $226.66 – $492.09 | 8 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $708.85 – $1,514.89 | 8 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $666.34 – $1,471.50 | 8 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $680.36 – $1,472.86 | 8 |
| Ligation major artery chest CPT 37616 | not published | not published | $1,046.35 – $2,270.63 | 8 |
| Ligation/major artery/extremity 37618 CPT 37618 | $8,224.45 | $8,224.45 | $365.07 – $794.38 | 9 |
| Ligation major artery neck CPT 37615 | not published | not published | $488.40 – $1,047.20 | 8 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $577.62 – $1,227.51 | 8 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $1,217.19 – $2,664.43 | 8 |
| Ligation of femoral vein CPT 37650 | not published | not published | $418.58 – $919.10 | 8 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,594.61 – $3,491.35 | 8 |
| Ligation of neck artery CPT 37606 | not published | not published | $689.13 – $1,516.91 | 8 |
| Ligation of salivary duct CPT 42665 | not published | not published | $209.34 – $731.13 | 9 |
| Ligation of shunt CPT 49428 | $4,076.90 | $4,076.90 | $404.37 – $3,424.60 | 9 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $832.82 – $1,771.77 | 8 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $233.04 – $671.38 | 9 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $344.00 – $750.32 | 8 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $528.39 – $1,163.79 | 8 |
| Liletta, 52 mg HCPCS J7297 | $4,627.79 | $4,627.79 | $862.00 – $4,350.12 | 6 |
| Limb exercise test CPT 95875 | not published | not published | $55.42 – $116.57 | 8 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $200.29 – $432.43 | 8 |
| Limited ankle motion ea jnt HCPCS L2200 | not published | not published | $42.31 – $106.49 | 7 |
| Limited autopsy CPT 88036 | not published | not published | $44.64 – $212.83 | 4 |
| Limited autopsy CPT 88037 | not published | not published | $39.60 – $189.11 | 4 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $114.11 – $287.29 | 7 |
| Limited visual field xm CPT 92081 | not published | not published | $15.15 – $31.85 | 8 |
| Lincomycin injection HCPCS J2010 | not published | not published | $9.84 – $13.31 | 6 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $335.93 | $335.93 | $2.62 – $205.82 | 9 |
| Lipase CPT 83690 | $142.75 | $142.75 | $3.40 – $82.34 | 9 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $337.32 – $950.21 | 9 |
| Lipoprotein blood high res frac & quant CPT 83701 | $168.90 | $168.90 | $13.54 – $76.75 | 9 |
| Lipoprotein blood quant CPT 83704 | $288.05 | $288.05 | $15.58 – $120.84 | 9 |
| Lipoprotein direct measurement hdl CPT 83718 | $171.25 | $171.25 | $6.07 – $92.21 | 9 |
| Lipoprotein direct measurement ldl CPT 83721 | $183.25 | $183.25 | $7.07 – $79.34 | 9 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $14.02 – $69.62 | 7 |
| Lip surgery procedure CPT 40799 | $408.20 | $408.20 | $82.74 – $194.25 | 9 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $0.02 – $910,643.62 | 6 |
| Listeria monocytogenes CPT 86723 | not published | not published | $6.51 – $26.86 | 7 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $150.10 – $377.86 | 7 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $60.20 – $151.57 | 7 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $469.73 – $1,182.48 | 7 |
| Lithium therapeutic drug level CPT 80178 | $197.15 | $197.15 | $4.90 – $78.68 | 9 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,844.30 | $4,844.30 | $136.71 – $4,069.21 | 9 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $870.47 – $2,471.95 | 8 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,037.52 – $2,978.25 | 8 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,136.36 – $2,468.55 | 8 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $503.40 | 7 |
| Liver elastography 91200 CPT 91200 | not published | not published | $9.95 – $21.01 | 8 |
| Liver Function Test CPT 80076 | $260.40 | $260.40 | $4.04 – $97.24 | 9 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,327.76 – $2,896.92 | 8 |
| Liver imaging CPT 78201 | $654.25 | $654.25 | $19.24 – $549.57 | 9 |
| Liver imag w/vasclr flow CPT 78202 | $971.80 | $971.80 | $22.70 – $816.31 | 9 |
| Liver/spleen imag static only CPT 78215 | $804.85 | $804.85 | $21.84 – $676.07 | 9 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,656.45 | $1,656.45 | $25.95 – $1,391.42 | 9 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $69.95 – $145.73 | 8 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $1,043.85 | $1,043.85 | $451.38 – $1,274.01 | 9 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $2,642.35 – $6,651.72 | 7 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $1.04 – $1.95 | 7 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $38.63 – $170.73 | 3 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $195.65 – $385.13 | 8 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $139.74 – $351.77 | 7 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $14.48 | $14.48 | $1.12 – $6.45 | 9 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $58.96 – $116.55 | 7 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | not published | not published | $72.40 – $182.24 | 7 |
| Loudness balance test CPT 92562 | not published | not published | $44.65 – $98.29 | 8 |
| Low back disk surgery CPT 63030 | not published | not published | $867.39 – $1,887.68 | 8 |
| Low cost skin substitute app HCPCS C5271 | $1,762.50 | $1,762.50 | $592.44 – $986.53 | 9 |
| Low cost skin substitute app HCPCS C5273 | $2,999.55 | $2,999.55 | $1,770.40 – $2,767.83 | 9 |
| Low cost skin substitute app HCPCS C5275 | $1,762.50 | $1,762.50 | $592.44 – $986.53 | 9 |
| Low cost skin substitute app HCPCS C5277 | $1,762.50 | $1,762.50 | $592.44 – $986.53 | 9 |
| Low cost skin substitute app HCPCS C5272 | $880.55 | $880.55 | $131.05 – $167.46 | 6 |
| Low cost skin substitute app HCPCS C5274 | $2,587.45 | $2,587.45 | $430.95 – $550.70 | 6 |
| Low cost skin substitute app HCPCS C5276 | $880.55 | $880.55 | $131.05 – $167.46 | 6 |
| Low cost skin substitute app HCPCS C5278 | $880.55 | $880.55 | $131.05 – $167.46 | 6 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $2,107.70 | $2,107.70 | $48.76 – $165.77 | 9 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,104.70 | $3,104.70 | $57.08 – $1,620.11 | 9 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,481.90 | $2,481.90 | $54.93 – $1,462.48 | 9 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,107.70 | $2,107.70 | $44.98 – $854.32 | 9 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $8,730.55 | $8,730.55 | $104.00 – $2,519.33 | 9 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $4,713.95 | $4,713.95 | $80.98 – $2,085.05 | 9 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $4,362.00 | $4,362.00 | $67.03 – $1,552.82 | 9 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $534.95 | $534.95 | $10.27 – $299.67 | 9 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $861.90 | $861.90 | $12.22 – $408.71 | 9 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $924.25 | $924.25 | $14.06 – $286.61 | 9 |
| Lower jaw bone graft CPT 21215 | not published | not published | $761.87 – $7,811.10 | 9 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $393.95 | $393.95 | $7.35 – $185.01 | 9 |
| Low frequency non-thermal Ultrasound CPT 97610 | $368.40 | $368.40 | $13.36 – $309.46 | 9 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $15.30 – $30.54 | 4 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $694.15 – $1,493.19 | 8 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $796.60 – $1,718.22 | 8 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $785.73 – $1,693.15 | 8 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $856.68 – $1,848.36 | 8 |
| Lso corset front HCPCS L0972 | not published | not published | $91.58 – $230.56 | 7 |
| Lso flex no ri stays pre ots HCPCS L0628 | $198.80 | $198.80 | $63.45 – $179.31 | 9 |
| Lso full corset HCPCS L0976 | not published | not published | $152.10 – $382.91 | 7 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $150.44 – $378.71 | 7 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,225.15 – $3,084.13 | 7 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $898.49 – $1,776.22 | 7 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $122.50 – $242.17 | 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.