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 |
|---|---|---|---|---|
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $1,063.52 – $2,266.56 | 8 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $7,778.60 | $7,778.60 | $662.93 – $6,534.02 | 9 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $16,505.15 | $16,505.15 | $799.76 – $13,864.33 | 9 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $29,635.75 | $29,635.75 | $678.53 – $24,894.03 | 9 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $702.93 – $1,510.82 | 8 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $16,463.80 | $16,463.80 | $534.76 – $13,829.59 | 9 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $268.02 – $577.49 | 8 |
| Perq plmt bile duct stent CPT 47538 | $20,246.15 | $20,246.15 | $217.29 – $7,063.91 | 9 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $390.94 – $7,943.45 | 9 |
| Perq plmt bile duct stent CPT 47540 | $20,246.15 | $20,246.15 | $404.69 – $7,926.74 | 9 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $975.50 | $975.50 | $82.32 – $405.38 | 9 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $514.80 – $1,115.65 | 8 |
| Perq skel fix ulnar styld fx CPT 25651 | $5,353.65 | $5,353.65 | $475.15 – $4,497.07 | 9 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $185.80 – $185.80 | 1 |
| Perq transcath closure each CPT 93592 | $6,638.35 | $6,638.35 | $360.58 – $5,576.21 | 9 |
| Perq transcath closure pda CPT 93582 | $13,166.90 | $13,166.90 | $596.72 – $11,060.20 | 9 |
| Perq transcath cls aortic CPT 93591 | $13,375.10 | $13,375.10 | $826.20 – $11,235.08 | 9 |
| Perq transcath cls mitral CPT 93590 | $13,110.45 | $13,110.45 | $997.56 – $11,012.78 | 9 |
| Perq transcath septal reduxn CPT 93583 | not published | not published | $669.52 – $1,469.46 | 8 |
| Perq trluml angp nt/recr coa CPT 33897 | $23,137.10 | $23,137.10 | $523.97 – $19,435.16 | 9 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $238.92 – $981.05 | 9 |
| Perq tx malar fracture CPT 21355 | not published | not published | $318.04 – $873.11 | 9 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $439.53 – $1,410.86 | 9 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $723.97 – $1,541.32 | 8 |
| Pertussis ag if CPT 87265 | not published | not published | $5.92 – $25.08 | 7 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $48,950.70 | $48,950.70 | $14.72 – $16,686.29 | 9 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $63.39 – $125.49 | 8 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | not published | not published | $55.21 – $138.03 | 7 |
| Pessary reusable rub anytype HCPCS A4561 | not published | not published | $22.18 – $55.43 | 7 |
| Pet CT skull-mid thgh initial CPT 78815 | $8,278.55 | $8,278.55 | $107.99 – $2,442.80 | 9 |
| Pet CT whole body initial CPT 78816 | $8,278.55 | $8,278.55 | $108.85 – $2,442.80 | 9 |
| Pet fdg brain metoblic eval sb CPT 78608 | $8,278.55 | $8,278.55 | $65.62 – $2,442.80 | 9 |
| Pet image full body CPT 78813 | not published | not published | $86.69 – $183.01 | 8 |
| Pet image ltd area CPT 78811 | not published | not published | $67.78 – $141.66 | 8 |
| Pet image skull-thigh CPT 78812 | not published | not published | $85.08 – $178.94 | 8 |
| Pet image w/ct lmtd CPT 78814 | $8,278.55 | $8,278.55 | $96.53 – $2,442.80 | 9 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $388.91 – $400.57 | 5 |
| Pet scan brain perf study CPT 78609 | not published | not published | $70.89 – $149.19 | 6 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $25,750.00 | $25,750.00 | $22.10 – $30.54 | 9 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $64.55 | $64.55 | $21.80 – $46.26 | 9 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $95.65 | $95.65 | $30.58 – $63.61 | 9 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $32.25 | $32.25 | $11.06 – $25.05 | 9 |
| Phalangectomy ea toe 28150 CPT 28150 | $636.45 | $636.45 | $270.01 – $807.59 | 9 |
| Pharmacologic management w/psytx CPT 90863 | not published | not published | $23.44 – $48.19 | 7 |
| Ph body fluid CPT 83986 | $92.75 | $92.75 | $1.77 – $16.83 | 9 |
| Phencyclidine (pcp) CPT 83992 | $358.65 | $358.65 | $7.20 – $117.86 | 9 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $447.90 | $447.90 | $31.43 – $164.35 | 9 |
| Phenobarbital therapeutic drug level CPT 80184 | $247.40 | $247.40 | $6.12 – $108.38 | 9 |
| Phentolaine mesylate inj HCPCS J2760 | $4,987.52 | $4,987.52 | $399.33 – $676.71 | 9 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $154.27 | $154.27 | $0.02 – $0.94 | 9 |
| Phenylep ketorolac opth soln HCPCS J1097 | $1,678.15 | $1,678.15 | $94.28 – $1,577.46 | 9 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $14.15 | $14.15 | $0.43 – $7.24 | 7 |
| Phenytoin total therapeutic drug level CPT 80185 | $181.80 | $181.80 | $6.54 – $112.42 | 9 |
| Phlebotomy therapeutic CPT 99195 | $448.75 | $448.75 | $87.60 – $147.82 | 9 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $5,004.00 | $5,004.00 | $246.38 – $806.29 | 9 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $303.35 – $948.28 | 9 |
| Phone e/m phys/qhp 11-20 min CPT 99442 | not published | not published | $44.06 – $174.75 | 8 |
| Phone e/m phys/qhp 21-30 min CPT 99443 | not published | not published | $64.43 – $247.35 | 8 |
| Phone e/m phys/qhp 5-10 min CPT 99441 | not published | not published | $22.73 – $108.58 | 8 |
| Phosphorus CPT 84100 | $368.95 | $368.95 | $2.34 – $61.29 | 9 |
| Phosphorus 24 hour urine CPT 84105 | $87.50 | $87.50 | $2.56 – $61.48 | 9 |
| Photchmtx tar&uvb/ptrltm&uvb CPT 96910 | not published | not published | $57.49 – $237.92 | 8 |
| Photochemotherapy puva CPT 96912 | not published | not published | $57.49 – $201.98 | 8 |
| Photochemotherapy uv-a or b CPT 96913 | not published | not published | $142.46 – $306.37 | 8 |
| Photodynamic tx addl 15 min CPT 96571 | not published | not published | $23.55 – $50.15 | 8 |
| Photodynmc tx 30 min add-on CPT 96570 | not published | not published | $50.43 – $101.00 | 8 |
| Photo patch test CPT 95052 | not published | not published | $5.45 – $12.21 | 8 |
| Photopheresis CPT 36522 | not published | not published | $91.21 – $2,564.07 | 9 |
| Photosensitivity tests CPT 95056 | not published | not published | $47.37 – $106.41 | 8 |
| Phys blood bank serv authrj CPT 86079 | not published | not published | $44.25 – $96.93 | 9 |
| Phys blood bank serv reactj CPT 86078 | not published | not published | $44.25 – $97.60 | 9 |
| Phys blood bank serv xmatch CPT 86077 | not published | not published | $23.70 – $96.93 | 9 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $675.65 | $675.65 | $98.13 – $269.90 | 9 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $675.65 | $675.65 | $98.13 – $269.90 | 9 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $675.65 | $675.65 | $98.13 – $269.90 | 9 |
| Physical Therapy Re-Evaluation CPT 97164 | $405.05 | $405.05 | $48.93 – $132.37 | 9 |
| Physician standby services CPT 99360 | $198.10 | $198.10 | $57.45 – $148.58 | 8 |
| Phys review of motion tests CPT 96004 | not published | not published | $101.10 – $214.87 | 8 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $498.46 | $498.46 | $2.85 – $154.24 | 9 |
| Pierce earlobes 69090 CPT 69090 | not published | not published | $34.28 – $62.36 | 4 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $1,296.97 | $1,296.97 | $332.44 – $1,219.15 | 9 |
| Pik3ca gene trgt seq alys CPT 81309 | not published | not published | $109.93 – $559.61 | 7 |
| Pild/placebo control clin tr HCPCS G0276 | not published | not published | $346.81 – $741.51 | 8 |
| Pillow shldr abduc inflat univ HCPCS L3960 | not published | not published | $760.38 – $1,914.13 | 7 |
| Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 | not published | not published | $442.00 – $1,135.23 | 9 |
| Pin finger dislocation CPT 26776 | not published | not published | $437.00 – $940.11 | 8 |
| Pin finger fracture each CPT 26756 | $5,681.45 | $5,681.45 | $412.98 – $4,050.95 | 9 |
| Pin hand dislocation CPT 26676 | not published | not published | $495.34 – $1,064.83 | 8 |
| Pin knuckle dislocation CPT 26706 | not published | not published | $434.96 – $934.00 | 8 |
| Pin service 60m per month HCPCS G0023 | not published | not published | $47.04 – $155.47 | 8 |
| Pinworm exam CPT 87172 | $78.90 | $78.90 | $2.11 – $36.28 | 9 |
| Pinworm examinations HCPCS Q0113 | not published | not published | $2.11 – $8.69 | 7 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $400.48 | $400.48 | $1.05 – $38.49 | 9 |
| Pituitary evaluation panel CPT 80418 | not published | not published | $286.17 – $1,179.94 | 7 |
| Place breast cath for rad CPT 19297 | not published | not published | $86.15 – $189.10 | 8 |
| Place breast rad tube/caths CPT 19298 | not published | not published | $308.13 – $1,673.62 | 9 |
| Place cath intracranial art CPT 36228 | $4,194.15 | $4,194.15 | $227.20 – $2,474.78 | 9 |
| Place cath xtrnl carotid CPT 36227 | $4,194.15 | $4,194.15 | $110.11 – $467.71 | 9 |
| Place cecostomy tube perc CPT 49442 | $1,711.75 | $1,711.75 | $195.29 – $1,437.87 | 9 |
| Place device/marker, non pro HCPCS C9728 | $2,581.40 | $2,581.40 | $1,324.26 – $2,426.52 | 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.