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 |
|---|---|---|---|---|
| Prep donor pancreas CPT 48551 | not published | not published | $222.80 – $483.13 | 8 |
| Prep donor pancreas/venous CPT 48552 | not published | not published | $215.13 – $473.78 | 8 |
| Prep donor renal graft CPT 50325 | not published | not published | $200.30 – $407.85 | 8 |
| Prepj skn cll ssp agrft 1st CPT 15013 | not published | not published | $7,017.32 – $7,227.84 | 5 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $151.14 – $331.45 | 8 |
| Pre-plan 3d model w/ccta HCPCS C9793 | not published | not published | $984.67 – $1,014.21 | 5 |
| Prep renal graft/arterial CPT 50328 | not published | not published | $173.92 – $381.60 | 8 |
| Prep renal graft/ureteral CPT 50329 | not published | not published | $165.28 – $361.26 | 8 |
| Prep renal graft/venous CPT 50327 | not published | not published | $197.99 – $435.16 | 8 |
| Prep skin cell susp, automtd HCPCS C8002 | not published | not published | $7,017.32 – $7,227.84 | 5 |
| Prep skin to 100cm2 other CPT 15004 | not published | not published | $246.63 – $755.54 | 9 |
| Prep skin to 100cm2 trk/ext CPT 15002 | not published | not published | $207.15 – $661.74 | 9 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $41.27 – $133.63 | 9 |
| Pressure max expiratory/inspiratory CPT 94799 | $19,070.30 | $19,070.30 | $50.27 – $138.98 | 9 |
| Pressure treatment esophagus CPT 43460 | $553.35 | $553.35 | $199.35 – $424.30 | 9 |
| Pressure velocity wire add ves CPT 93572 | $1,154.70 | $1,154.70 | $47.62 – $969.95 | 9 |
| Pre-tibial shell molded to p HCPCS L2340 | not published | not published | $397.73 – $1,001.22 | 7 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | not published | not published | $14.83 – $170.82 | 7 |
| Pretreat rbc absorption reference CPT 86978 | $316.45 | $316.45 | $14.83 – $106.03 | 9 |
| Pretreat rbc density gradient separation reference CPT 86972 | not published | not published | $17.28 – $170.82 | 7 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $150.80 | $150.80 | $12.38 – $70.74 | 9 |
| Pretreat rbc w enzyme reference CPT 86971 | $84.95 | $84.95 | $9.94 – $170.82 | 9 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $627.45 | $627.45 | $155.50 – $233.64 | 9 |
| Preventive counseling group CPT 99411 | not published | not published | $7.28 – $38.54 | 7 |
| Preventive counseling group CPT 99412 | not published | not published | $12.22 – $48.19 | 7 |
| Prev med cnsl indiv apprx 15 CPT 99401 | $145.45 | $145.45 | $23.44 – $51.79 | 9 |
| Prev med cnsl indiv apprx 30 CPT 99402 | $194.35 | $194.35 | $47.11 – $75.34 | 9 |
| Prev med cnsl indiv apprx 45 CPT 99403 | $230.00 | $230.00 | $66.73 – $96.21 | 9 |
| Prev med cnsl indiv apprx 60 CPT 99404 | $307.00 | $307.00 | $77.84 – $215.21 | 9 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | $412.40 | $412.40 | $124.49 – $319.94 | 9 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | $2,612.25 | $2,612.25 | $79.06 – $245.43 | 9 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $416.95 | $416.95 | $157.45 – $434.94 | 9 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $665.50 | $665.50 | $97.66 – $310.95 | 9 |
| Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 | not published | not published | $1,269.97 – $2,765.42 | 8 |
| Prgrmg dev eval impltbl sys CPT 93260 | $73.75 | $73.75 | $33.93 – $66.98 | 9 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $71.40 | $71.40 | $29.63 – $61.68 | 9 |
| Prgrmg dev eval scrms ip CPT 93285 | $73.75 | $73.75 | $23.79 – $61.95 | 9 |
| Prgrmg eval implantable dfb CPT 93282 | $73.75 | $73.75 | $36.09 – $69.33 | 9 |
| Prgrmg eval implantable dfb CPT 93283 | $84.60 | $84.60 | $36.09 – $79.52 | 9 |
| Prgrmg eval implantable dfb CPT 93284 | $52.45 | $52.45 | $36.09 – $49.30 | 9 |
| Prgr stim/pace a/iv drug CPT 93623 | $3,695.65 | $3,695.65 | $35.92 – $3,104.35 | 9 |
| Pr hospital ip/obs care initial high level per day CPT 99223 | $836.00 | $836.00 | $164.66 – $348.39 | 9 |
| Pr hospital ip/obs care initial moderate level per day CPT 99222 | $661.00 | $661.00 | $123.47 – $262.98 | 9 |
| Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 | $523.75 | $523.75 | $77.94 – $166.73 | 9 |
| Pr hospital ip/obs care subsequent high level per day CPT 99233 | $427.20 | $427.20 | $94.33 – $238.58 | 9 |
| Pr hospital ip/obs care subsequent moderate level per day CPT 99232 | $311.70 | $311.70 | $65.58 – $158.60 | 9 |
| Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 | $270.05 | $270.05 | $35.08 – $98.97 | 9 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $18,110.60 | $18,110.60 | $392.34 – $3,228.39 | 9 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $11,200.50 | $11,200.50 | $147.63 – $896.25 | 9 |
| Prin care mgmt staff 1st 30 CPT 99426 | not published | not published | $47.04 – $119.50 | 9 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $646.30 | $646.30 | $82.74 – $165.91 | 9 |
| Pr incision & drainage abscess simple/single CPT 10060 | $408.20 | $408.20 | $82.74 – $156.28 | 9 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $654.10 | $654.10 | $65.84 – $182.03 | 9 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $665.50 | $665.50 | $100.74 – $194.25 | 9 |
| Pr management transitional care high w/in 7 days of discharge CPT 99496 | not published | not published | $124.73 – $539.68 | 9 |
| Pr management transitional care moderate w/in 14 days of discharge CPT 99495 | not published | not published | $124.73 – $398.97 | 9 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $273.00 | $273.00 | $11.34 – $97.02 | 9 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $580.43 – $1,247.82 | 8 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $10,014.35 | $10,014.35 | $882.72 – $1,128.00 | 6 |
| Probe nasolacrimal duct CPT 68810 | not published | not published | $121.93 – $309.67 | 9 |
| Probe nasolacrimal duct CPT 68811 | not published | not published | $128.67 – $272.48 | 8 |
| Probe nasolacrimal duct CPT 68815 | not published | not published | $211.52 – $720.20 | 9 |
| Probe nl duct w/balloon CPT 68816 | not published | not published | $150.14 – $1,625.44 | 9 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $1,358.85 | $1,358.85 | $139.82 – $1,277.32 | 9 |
| Procalcitonin CPT 84145 | $732.00 | $732.00 | $13.23 – $84.22 | 9 |
| Procarbazine 50 mg caps 100 each bottle HCPCS S0182 | not published | not published | $77.95 – $211.89 | 3 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $57.01 | $57.01 | $3.04 – $34.93 | 7 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | not published | not published | $0.36 – $0.67 | 5 |
| Proctectomy combined abd pull-thru px 45112 CPT 45112 | not published | not published | $1,704.96 – $3,648.61 | 8 |
| Proctectomy complete abd w/clst 45110 CPT 45110 | not published | not published | $1,699.88 – $3,666.22 | 8 |
| Proctosigmoidoscopy ablate CPT 45320 | not published | not published | $98.70 – $429.17 | 9 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | not published | not published | $104.60 – $425.95 | 9 |
| Proctosigmoidoscopy dilate 45303 CPT 45303 | not published | not published | $80.72 – $1,803.40 | 9 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $45.99 – $247.35 | 9 |
| Proctosigmoidoscopy removal CPT 45308 | not published | not published | $79.38 – $394.47 | 9 |
| Proctosigmoidoscopy removal CPT 45309 | not published | not published | $84.35 – $406.69 | 9 |
| Proctosigmoidoscopy tumor removal 45315 CPT 45315 | not published | not published | $99.35 – $438.80 | 9 |
| Proctosigmoidoscopy volvul CPT 45321 | not published | not published | $97.19 – $210.12 | 8 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $69.27 – $349.50 | 9 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | not published | not published | $94.29 – $411.82 | 9 |
| Proctosigmoidoscopy w/stent CPT 45327 | not published | not published | $109.71 – $237.24 | 8 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $91.08 – $221.46 | 6 |
| Progesterone CPT 84144 | $494.85 | $494.85 | $10.30 – $90.76 | 9 |
| Prolactin CPT 84146 | $511.00 | $511.00 | $9.57 – $54.24 | 9 |
| Prolng clin staff svc 1st hr CPT 99415 | not published | not published | $12.61 – $42.01 | 8 |
| Prolng clin staff svc ea add CPT 99416 | not published | not published | $7.21 – $19.65 | 8 |
| Prolng ip/obs e/m ea 15 min CPT 99418 | $76.80 | $76.80 | $27.97 – $61.04 | 9 |
| Prolng off/op e/m ea 15 min 99417 CPT 99417 | $61.25 | $61.25 | $28.44 – $60.33 | 9 |
| Prolng svc o/p 1st hour CPT 99354 | not published | not published | $242.81 – $242.81 | 1 |
| Prolng svc o/p ea addl 30 CPT 99355 | not published | not published | $180.18 – $180.18 | 1 |
| Prolonged IV inf, req pump HCPCS C8957 | $497.55 | $497.55 | $169.17 – $455.95 | 9 |
| Prolong home eval add 15m HCPCS G0318 | not published | not published | $28.44 – $60.33 | 8 |
| Prolong service without contact CPT 99358 | $376.80 | $376.80 | $88.47 – $244.80 | 8 |
| Prolong serv without contact add CPT 99359 | $158.70 | $158.70 | $41.58 – $101.19 | 8 |
| Promethazine 25 mg tablet HCPCS Q0169 | not published | not published | $0.04 – $1.36 | 4 |
| Promethazine hcl injection HCPCS J2550 | not published | not published | $3.17 – $5.95 | 6 |
| Proph rta dtchmnt crtx dthrm CPT 67141 | not published | not published | $205.90 – $518.47 | 9 |
| Proph rta dtchmnt pc CPT 67145 | not published | not published | $205.90 – $467.08 | 9 |
| Proph tx w/wo mthylmthcrylt CPT 24498 | not published | not published | $830.66 – $1,781.94 | 8 |
| Prophylactic tx radius CPT 25490 | not published | not published | $693.86 – $1,485.06 | 8 |
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.