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 |
|---|---|---|---|---|
| Ped crit care transport CPT 99466 | not published | not published | $218.25 – $463.62 | 8 |
| Ped crit care transport addl CPT 99467 | not published | not published | $109.51 – $232.49 | 8 |
| Ped critical care initial CPT 99471 | not published | not published | $728.46 – $1,547.42 | 8 |
| Ped critical care subsq CPT 99472 | not published | not published | $375.92 – $796.42 | 8 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $87.72 – $155.97 | 7 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $151.43 – $479.20 | 7 |
| Pediatric electric hand HCPCS L7008 | not published | not published | $5,807.68 – $14,619.98 | 7 |
| Pediatric electric hook HCPCS L7045 | not published | not published | $1,532.41 – $3,857.62 | 7 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $624.67 – $1,509.15 | 9 |
| Ped term dev, hand, vol clos HCPCS L6714 | not published | not published | $1,231.60 – $3,100.38 | 7 |
| Ped term dev, hand, vol open HCPCS L6713 | not published | not published | $1,454.10 – $3,660.50 | 7 |
| Ped term dev, hook, vol clos HCPCS L6712 | not published | not published | $1,152.10 – $2,900.24 | 7 |
| Ped term dev, hook, vol open HCPCS L6711 | not published | not published | $625.73 – $1,575.18 | 7 |
| Pegademase bovine, 25 iu HCPCS J2504 | not published | not published | $323.98 – $586.04 | 4 |
| Pegaptanib sodium injection HCPCS J2503 | not published | not published | $785.50 – $1,901.90 | 4 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $24,048.55 – $49,524.72 | 8 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $23,031.00 | $23,031.00 | $39.50 – $9,675.33 | 9 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $14,084.90 | $14,084.90 | $62.38 – $13,239.81 | 9 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $14,982.00 | $14,982.00 | $122.10 – $7,498.18 | 9 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $229.11 – $589.70 | 8 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $7,491.00 | $7,491.00 | $103.71 – $5,471.97 | 9 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $149.21 – $362.78 | 8 |
| Peginesatide injection HCPCS J0890 | not published | not published | $8.20 – $21.26 | 3 |
| Peg interferon alfa-2a/180 HCPCS S0145 | not published | not published | $1,135.69 – $2,267.15 | 3 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $3,265.90 – $6,515.68 | 8 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $210.89 – $442.04 | 7 |
| Pelv band/spread bar thigh c HCPCS L1640 | not published | not published | $547.50 – $1,378.26 | 7 |
| Pelvic band & belt thigh fla HCPCS L2192 | not published | not published | $383.28 – $964.85 | 7 |
| Pelvic control band & belt b HCPCS L2640 | not published | not published | $391.62 – $985.85 | 7 |
| Pelvic control band & belt u HCPCS L2630 | not published | not published | $273.22 – $687.81 | 7 |
| Pelvic control hip heavy dut HCPCS L2620 | not published | not published | $317.25 – $798.64 | 7 |
| Pelvic control pelvic sling HCPCS L2580 | not published | not published | $460.84 – $1,160.08 | 7 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,125.30 | $3,125.30 | $54.93 – $1,620.11 | 9 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,871.10 | $2,871.10 | $52.33 – $1,462.48 | 9 |
| Pelvic CT scan (without contrast) CPT 72192 | $2,576.15 | $2,576.15 | $49.09 – $854.32 | 9 |
| Pelvic exenteration CPT 45126 | not published | not published | $2,557.32 – $5,517.97 | 8 |
| Pelvic & hip control thigh c HCPCS L1680 | not published | not published | $1,084.27 – $2,729.51 | 7 |
| Pelvic MRI (with and without contrast) CPT 72197 | $8,602.30 | $8,602.30 | $99.57 – $2,519.33 | 9 |
| Pelvic MRI (with contrast) CPT 72196 | $4,655.10 | $4,655.10 | $77.95 – $2,085.05 | 9 |
| Pelvic MRI (without contrast) CPT 72195 | $3,883.20 | $3,883.20 | $66.06 – $1,552.82 | 9 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $1,016.90 – $2,177.08 | 8 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $961.02 – $2,054.40 | 8 |
| Pelvic Ultrasound (complete) CPT 76856 | $817.05 | $817.05 | $31.14 – $669.86 | 9 |
| Pelvic Ultrasound (limited) CPT 76857 | $673.85 | $673.85 | $17.34 – $43.34 | 9 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $379.30 | $379.30 | $8.00 – $226.92 | 9 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $440.40 | $440.40 | $11.57 – $299.67 | 9 |
| Pelv & thor control gluteal HCPCS L2650 | not published | not published | $107.07 – $269.55 | 7 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $21,164.00 | $21,164.00 | $55.73 – $9,170.33 | 9 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $7,840.49 | $7,840.49 | $3.73 – $149.37 | 9 |
| Pemivibart infusion HCPCS M0224 | $1,173.85 | $1,173.85 | $399.11 – $666.79 | 9 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $14.71 – $33.35 | 8 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $4,375.56 | $4,375.56 | $18.96 – $1,327.70 | 9 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $517.93 | $517.93 | $0.77 – $35.75 | 9 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $20.33 – $48.61 | 8 |
| Penile injection CPT 54235 | $723.25 | $723.25 | $70.92 – $174.75 | 9 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $12,466.27 | $12,466.27 | $825.86 – $2,283.26 | 9 |
| Penile vascular study CPT 93980 | not published | not published | $56.67 – $117.93 | 8 |
| Penile vascular study CPT 93981 | not published | not published | $20.11 – $42.03 | 8 |
| Penile venous occlusion CPT 37790 | not published | not published | $463.78 – $985.52 | 8 |
| Penis plastic surgery CPT 54360 | not published | not published | $687.53 – $1,461.34 | 8 |
| Penis study CPT 54240 | not published | not published | $43.63 – $122.07 | 8 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $52.22 – $156.93 | 6 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $12.72 – $25.03 | 3 |
| Pentazocine injection HCPCS J3070 | not published | not published | $55.57 – $201.12 | 4 |
| Pentobarbital sodium inj HCPCS J2515 | $5,069.35 | $5,069.35 | $14.23 – $160.45 | 6 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $6,713.18 | $6,713.18 | $2,273.15 – $6,310.39 | 9 |
| Perc cryo ablate renal tum CPT 50593 | $7,021.90 | $7,021.90 | $428.55 – $5,898.40 | 9 |
| Perc d-e cor revasc chro add HCPCS C9608 | $5,423.85 | $5,423.85 | $3,989.78 – $5,098.42 | 6 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $14,686.65 | $14,686.65 | $10,803.50 – $17,900.61 | 9 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $3,415.45 | $3,415.45 | $2,512.41 – $3,210.52 | 6 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $16,085.60 | $16,085.60 | $10,975.86 – $15,120.46 | 9 |
| Perc d-e cor stent ather br HCPCS C9603 | $5,423.85 | $5,423.85 | $3,989.78 – $5,098.42 | 6 |
| Perc d-e cor stent ather s HCPCS C9602 | $9,355.05 | $9,355.05 | $6,881.57 – $17,900.61 | 9 |
| Perc drug-el cor stent bran HCPCS C9601 | $3,415.45 | $3,415.45 | $2,512.41 – $3,210.52 | 6 |
| Perc drug-el cor stent sing HCPCS C9600 | $16,317.90 | $16,317.90 | $10,975.86 – $15,338.83 | 9 |
| Perc rf ablate renal tumor CPT 50592 | $7,021.90 | $7,021.90 | $320.92 – $5,261.21 | 9 |
| Percut ablate liver rf CPT 47382 | $9,794.80 | $9,794.80 | $687.43 – $6,891.09 | 9 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $289.64 – $3,047.86 | 8 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $1,861.91 | $1,861.91 | $41.79 – $674.83 | 9 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $193.90 – $416.84 | 8 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $2,247.83 – $4,931.00 | 8 |
| Pericardiocentesis wwo imaging CPT 33016 | $3,106.10 | $3,106.10 | $212.66 – $465.66 | 9 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $761.66 – $1,651.81 | 8 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $684.49 – $1,452.52 | 8 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $258.49 – $555.12 | 8 |
| Peripheral vascular rehab CPT 93668 | $140.00 | $140.00 | $13.36 – $102.14 | 9 |
| Peri-proc device eval icd CPT 93287 | $276.25 | $276.25 | $20.66 – $232.05 | 9 |
| Peri-proc device eval pm CPT 93286 | $248.40 | $248.40 | $13.84 – $208.66 | 9 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $387.39 – $844.54 | 8 |
| Peritoneogram rs&i CPT 74190 | $877.60 | $877.60 | $20.75 – $737.18 | 9 |
| Perit-vens shunt pat tst CPT 78291 | $843.50 | $843.50 | $39.79 – $708.54 | 9 |
| Permanent tear duct plug HCPCS A4263 | not published | not published | $26.22 – $54.22 | 3 |
| Peroneal straps pair pre ots HCPCS L0980 | not published | not published | $20.72 – $52.17 | 7 |
| Perp bk ptb thermopls direct HCPCS L5520 | not published | not published | $1,810.77 – $4,558.32 | 7 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.55 – $1.36 | 4 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $6.38 – $12.31 | 3 |
| Perq art m-thrombect &/nfs CPT 61645 | $5,381.05 | $5,381.05 | $776.81 – $4,520.08 | 9 |
| Perq clsr tcat l atr apndge CPT 33340 | $19,472.05 | $19,472.05 | $707.05 – $16,356.52 | 9 |
| Perq dev breast 1st mr guide CPT 19287 | $885.75 | $885.75 | $117.60 – $744.03 | 9 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $92.83 – $496.62 | 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.