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 |
|---|---|---|---|---|
| Mayo alpha 1 antitrypsin CPT 82103 | $233.70 | $233.70 | $6.64 – $66.46 | 9 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $227.75 | $227.75 | $7.44 – $127.75 | 9 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $13.00 – $13.00 | 1 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $267.35 | $267.35 | $4.03 – $245.81 | 9 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,065.65 | $1,065.65 | $60.06 – $421.97 | 9 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $611.55 | $611.55 | $36.82 – $529.41 | 9 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $1,104.85 | $1,104.85 | $54.80 – $168.78 | 9 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,304.10 | $2,304.10 | $24.24 – $1,313.23 | 9 |
| Mayo androstenedione CPT 82157 | $353.10 | $353.10 | $14.46 – $111.39 | 9 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $275.35 | $275.35 | $7.21 – $79.85 | 9 |
| Mayo antithrombin iii antigen CPT 85301 | not published | not published | $5.34 – $22.01 | 7 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $255.85 | $255.85 | $7.44 – $60.82 | 9 |
| Mayo avwpr vw factor activity CPT 85397 | $293.60 | $293.60 | $12.34 – $94.28 | 9 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $328.40 | $328.40 | $14.04 – $126.90 | 9 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $358.65 | $358.65 | $4.32 – $117.86 | 9 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $108.30 | $108.30 | $5.02 – $83.99 | 9 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $641.70 | $641.70 | $71.52 – $272.32 | 9 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $576.05 | $576.05 | $85.85 – $368.81 | 9 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | not published | not published | $6.37 – $26.27 | 7 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $18.00 | $18.00 | $4.18 – $16.92 | 7 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $43.65 | $43.65 | $6.51 – $41.03 | 9 |
| Mayo brcmg brucella antibody igm CPT 86622 | not published | not published | $4.41 – $18.18 | 7 |
| Mayo c1 esterase inhibitor CPT 83883 | $149.85 | $149.85 | $6.72 – $90.05 | 9 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $328.80 | $328.80 | $5.33 – $116.37 | 9 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $592.45 | $592.45 | $8.33 – $112.61 | 9 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $176.05 | $176.05 | $13.22 – $48.79 | 9 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $289.05 | $289.05 | $60.36 – $263.53 | 9 |
| Mayo ceruloplasmin CPT 82390 | $146.30 | $146.30 | $5.30 – $38.31 | 9 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $153.20 | $153.20 | $6.97 – $103.07 | 9 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $177.10 | $177.10 | $6.36 – $70.64 | 9 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $106.00 | $106.00 | $5.84 – $57.95 | 9 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $106.00 | $106.00 | $6.26 – $55.13 | 9 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $361.75 | $361.75 | $66.00 – $290.13 | 9 |
| Mayo chromium CPT 82495 | $225.80 | $225.80 | $10.02 – $117.74 | 9 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $336.95 | $336.95 | $4.90 – $123.75 | 9 |
| Mayo coccidioides antibody CPT 86635 | $367.35 | $367.35 | $5.67 – $93.06 | 9 |
| Mayo cocou cortisone urine CPT 82542 | $537.95 | $537.95 | $9.64 – $143.12 | 9 |
| Mayo cortisol free CPT 82530 | $184.35 | $184.35 | $8.25 – $81.55 | 9 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $84.85 | $84.85 | $25.41 – $76.75 | 9 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $139.35 | $139.35 | $5.99 – $108.29 | 9 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | not published | not published | $23.04 – $23.04 | 1 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $341.60 | $341.60 | $15.93 – $86.67 | 9 |
| Mayo cyanide CPT 82600 | not published | not published | $9.58 – $39.50 | 7 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | not published | not published | $54.63 – $113.86 | 8 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $190.35 | $190.35 | $6.54 – $97.81 | 9 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $408.20 | $408.20 | $12.48 – $216.58 | 9 |
| Mayo dihydrotestosterone CPT 82642 | $260.35 | $260.35 | $13.01 – $91.46 | 9 |
| Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 | not published | not published | $4.19 – $19.63 | 7 |
| Mayo efpo chloride stool CPT 82438 | not published | not published | $2.41 – $10.16 | 7 |
| Mayo estriol CPT 82677 | $266.15 | $266.15 | $11.94 – $73.65 | 9 |
| Mayo estrone CPT 82679 | $314.00 | $314.00 | $18.49 – $168.78 | 9 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $702.55 | $702.55 | $8.07 – $106.88 | 9 |
| Mayo everolimus therapeutic drug level CPT 80169 | $702.55 | $702.55 | $6.78 – $660.40 | 9 |
| Mayo factor ii CPT 85210 | $401.35 | $401.35 | $6.41 – $109.89 | 9 |
| Mayo factor v CPT 85220 | $466.60 | $466.60 | $8.72 – $158.44 | 9 |
| Mayo factor vii CPT 85230 | $944.35 | $944.35 | $8.84 – $184.48 | 9 |
| Mayo factor viii vw factor antigen CPT 85246 | $366.40 | $366.40 | $11.33 – $184.05 | 9 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $193.05 | $193.05 | $11.33 – $122.29 | 9 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $597.90 | $597.90 | $11.33 – $178.93 | 9 |
| Mayo factor x CPT 85260 | $1,006.05 | $1,006.05 | $8.84 – $176.30 | 9 |
| Mayo factor xi CPT 85270 | $739.60 | $739.60 | $8.84 – $186.54 | 9 |
| Mayo fat/lipids feces quantitative CPT 82710 | $243.55 | $243.55 | $8.30 – $135.36 | 9 |
| Mayo fbl culture fungi blood CPT 87103 | $233.65 | $233.65 | $8.18 – $92.21 | 9 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $15.54 – $163.83 | 7 |
| Mayo ffspg allergen clam igg CPT 86001 | $64.10 | $64.10 | $3.13 – $45.36 | 9 |
| Mayo fibrinogen antigen CPT 85385 | not published | not published | $5.78 – $29.44 | 7 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $181.80 | $181.80 | $8.67 – $137.29 | 9 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $4,138.90 | $4,138.90 | $303.74 – $839.75 | 9 |
| Mayo hemosiderin qualitative urine CPT 83070 | $167.20 | $167.20 | $2.34 – $39.20 | 9 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $330.50 | $330.50 | $17.33 – $175.83 | 9 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | not published | not published | $17.33 – $71.45 | 7 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $110.30 | $110.30 | $6.17 – $39.10 | 9 |
| Mayo hla typing a/b/c single antigen CPT 86812 | not published | not published | $12.74 – $52.55 | 7 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $154.20 | $154.20 | $6.58 – $77.36 | 9 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $215.45 | $215.45 | $6.68 – $113.46 | 9 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $378.00 | $378.00 | $13.42 – $109.04 | 9 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $342.95 | $342.95 | $6.91 – $142.46 | 9 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $109.80 | $109.80 | $7.40 – $39.76 | 9 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $330.30 | $330.30 | $10.28 – $118.16 | 9 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $505.05 | $505.05 | $10.28 – $55.65 | 9 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $35.09 – $73.53 | 6 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $116.90 | $116.90 | $6.43 – $51.75 | 9 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $343.05 | $343.05 | $5.92 – $115.90 | 9 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $415.50 | $415.50 | $17.33 – $226.12 | 9 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $287.45 | $287.45 | $14.04 – $197.73 | 9 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | not published | not published | $17.33 – $71.45 | 7 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | not published | not published | $35.09 – $73.53 | 6 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $652.35 | $652.35 | $21.15 – $466.38 | 9 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $633.60 | $633.60 | $28.88 – $329.66 | 9 |
| Mayo infliximab therapeutic drug level CPT 80230 | $384.40 | $384.40 | $15.43 – $340.05 | 9 |
| Mayo inhab inhibin a CPT 86336 | $178.70 | $178.70 | $7.70 – $112.57 | 9 |
| Mayo insft insulin free CPT 83527 | not published | not published | $6.39 – $26.37 | 7 |
| Mayo insulin antibodies CPT 86337 | $598.60 | $598.60 | $10.57 – $85.54 | 9 |
| Mayo iodine CPT 83789 | $170.25 | $170.25 | $9.64 – $77.36 | 9 |
| Mayo itraconazole therapeutic drug level CPT 80189 | not published | not published | $10.84 – $55.20 | 7 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $243.55 | $243.55 | $10.84 – $204.83 | 9 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $217.25 | $217.25 | $6.54 – $103.54 | 9 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $276.65 | $276.65 | $6.32 – $74.26 | 9 |
| Mayo legionella antibody CPT 86713 | $306.05 | $306.05 | $7.56 – $54.14 | 9 |
| Mayo leptospira antibody igm CPT 86720 | not published | not published | $6.51 – $32.99 | 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.