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 |
|---|---|---|---|---|
| Lso sagit rigid panel prefab HCPCS L0635 | $2,400.50 | $2,400.50 | $870.42 – $2,256.47 | 9 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,402.00 – $3,529.33 | 7 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $266.38 – $670.58 | 7 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $216.91 – $428.80 | 7 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $972.04 – $2,446.98 | 7 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,087.69 – $2,738.12 | 7 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $10.86 – $44.78 | 7 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.51 – $4.44 | 7 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $56.61 – $142.51 | 7 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $75.12 – $189.08 | 7 |
| Lumbar diskogram s&i CPT 72295 | $5,936.70 | $5,936.70 | $37.84 – $4,986.83 | 9 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $69.43 – $174.77 | 7 |
| Lumbar sling HCPCS L1090 | not published | not published | $81.57 – $205.35 | 7 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,486.65 – $3,239.21 | 8 |
| Lumizyme injection HCPCS J0221 | not published | not published | $192.02 – $379.00 | 8 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $745.00 | $745.00 | $9.62 – $20.33 | 9 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $2.48 – $5.42 | 8 |
| Lung Function Test (Spirometry) CPT 94010 | $418.40 | $418.40 | $7.68 – $32.70 | 9 |
| Lung perfusion imaging CPT 78580 | $2,251.60 | $2,251.60 | $32.97 – $790.73 | 9 |
| Lung transplant double CPT 32853 | not published | not published | $4,164.20 – $9,127.25 | 8 |
| Lung transplant single CPT 32851 | not published | not published | $2,978.50 – $6,534.00 | 8 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,212.91 – $7,030.82 | 8 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,399.48 – $9,662.73 | 8 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,353.26 – $2,957.23 | 8 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $192.14 – $383.27 | 8 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $43,411.60 | $43,411.60 | $39.23 – $13,602.36 | 9 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $717.13 | $717.13 | $285.07 – $674.10 | 9 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $528.88 | $528.88 | $232.14 – $497.15 | 9 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $478.70 – $1,196.51 | 7 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $23.70 – $110.51 | 9 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $276.08 – $695.00 | 7 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $9.90 – $40.83 | 7 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $674.95 – $1,442.36 | 8 |
| Lymphatics/lymph node imaging CPT 78195 | $2,676.85 | $2,676.85 | $52.64 – $937.86 | 9 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $18.06 – $74.44 | 7 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $24.21 – $99.83 | 7 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $75.80 – $385.88 | 7 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $23.50 – $96.90 | 7 |
| Lymph vessel x-ray arm/leg CPT 75801 | $1,737.35 | $1,737.35 | $40.09 – $1,459.37 | 9 |
| Lymph vessel x-ray arms/legs CPT 75803 | $3,263.95 | $3,263.95 | $52.98 – $2,741.72 | 9 |
| Lymph vessel x-ray trunk CPT 75805 | $2,759.55 | $2,759.55 | $36.87 – $2,318.02 | 9 |
| Lymph vessel x-ray trunk CPT 75807 | $11,261.40 | $11,261.40 | $49.48 – $9,459.58 | 9 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $144.96 – $623.19 | 9 |
| Lysis of labial adhesions CPT 56441 | $403.60 | $403.60 | $15.26 – $171.30 | 9 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $192.48 – $497.26 | 9 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $15.53 – $30.58 | 7 |
| Macro exam dissect molec study ea CPT 88387 | $109.90 | $109.90 | $7.09 – $29.86 | 9 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $2.11 – $8.69 | 7 |
| Macroscopic exam parasite CPT 87169 | $92.75 | $92.75 | $2.11 – $23.03 | 9 |
| Magnesium CPT 83735 | $135.85 | $135.85 | $3.31 – $78.68 | 9 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $164.91 | $164.91 | $0.50 – $36.37 | 9 |
| Magnetic image bone marrow CPT 77084 | $1,848.60 | $1,848.60 | $72.55 – $1,552.82 | 9 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $20.14 – $33.18 | 4 |
| Malaria antibody CPT 86750 | not published | not published | $6.51 – $26.86 | 7 |
| Male sling procedure CPT 53440 | not published | not published | $717.39 – $1,525.05 | 8 |
| Mammosite ced HCPCS C1728 | $10,058.90 | $10,058.90 | $114.02 – $145.70 | 6 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,788.37 – $6,080.54 | 8 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $342.86 – $748.98 | 8 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $418.34 – $886.56 | 8 |
| Manipulation of hip joint CPT 27275 | not published | not published | $177.05 – $380.24 | 8 |
| Manipulation of spine CPT 22505 | not published | not published | $124.57 – $266.38 | 8 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $75.24 – $228.71 | 9 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $32.58 | $32.58 | $2.60 – $19.96 | 9 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $0.67 – $11.11 | 4 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $80.27 – $202.05 | 7 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $2.03 – $10.32 | 7 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $109.10 – $325.73 | 8 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $126.77 – $277.23 | 8 |
| Map tachycard site(s) CPT 93609 | $3,836.95 | $3,836.95 | $120.47 – $3,223.04 | 9 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $9,315.10 | $9,315.10 | $45.94 – $8,756.19 | 9 |
| Marker biop eviva buckle ss HCPCS A4648 | $1,663.25 | $1,663.25 | $40.34 – $51.55 | 9 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $783.00 | $783.00 | $441.36 – $11,721.31 | 9 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,061.97 – $2,314.69 | 8 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $105.91 – $228.23 | 3 |
| Mastectomy form HCPCS L8020 | not published | not published | $190.19 – $478.79 | 7 |
| Mastectomy partial CPT 19301 | not published | not published | $622.18 – $1,350.86 | 8 |
| Mast mod rad CPT 19307 | not published | not published | $1,110.15 – $2,409.58 | 8 |
| Mastoidectomy CPT 69501 | not published | not published | $679.88 – $1,447.11 | 8 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $901.00 – $1,918.85 | 8 |
| Mastoids complete CPT 70130 | $1,396.95 | $1,396.95 | $15.68 – $518.45 | 9 |
| Mastoid surgery revision CPT 69603 | not published | not published | $1,233.34 – $2,614.27 | 8 |
| Mastopexy CPT 19316 | not published | not published | $758.53 – $1,617.23 | 8 |
| Mast radical CPT 19305 | not published | not published | $1,078.35 – $2,347.23 | 8 |
| Mast rad urban type CPT 19306 | not published | not published | $1,151.06 – $2,494.30 | 8 |
| Mast simple complete CPT 19303 | not published | not published | $902.71 – $1,957.48 | 8 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $93.25 – $168.10 | 6 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $1,870.00 – $4,479.64 | 4 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $4,784.00 | $4,784.00 | $18.55 – $59.04 | 7 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $17.33 – $71.45 | 7 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $10.92 – $55.57 | 7 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $21.15 – $87.23 | 7 |
| Maxillofacial fixation CPT 21100 | not published | not published | $342.63 – $1,194.34 | 9 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $190.95 | $190.95 | $7.14 – $113.65 | 9 |
| Mayo aathr protein s free CPT 85306 | $256.80 | $256.80 | $7.57 – $67.59 | 9 |
| Mayo activated protein c resistance assay CPT 85307 | not published | not published | $7.57 – $31.19 | 7 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $434.55 | $434.55 | $15.43 – $384.46 | 9 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $219.60 | $219.60 | $13.47 – $145.09 | 9 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $198.40 | $198.40 | $4.46 – $169.72 | 9 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $163.60 | $163.60 | $7.30 – $67.49 | 9 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $163.00 | $163.00 | $8.21 – $88.92 | 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.