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 |
|---|---|---|---|---|
| Prophylactic tx radius&ulna CPT 25492 | not published | not published | $872.54 – $1,864.63 | 8 |
| Prophylactic tx ulna CPT 25491 | not published | not published | $712.99 – $1,525.72 | 8 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $305.39 | $305.39 | $0.09 – $16.87 | 9 |
| _propoxygc/msur CPT 80367 | $221.45 | $221.45 | $5.04 – $142.13 | 9 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $53.08 | $53.08 | $3.32 – $49.90 | 6 |
| Pros sheath/sock w gel cushn HCPCS L8417 | not published | not published | $69.89 – $175.95 | 7 |
| Pros soc insert gasket/seal HCPCS L7700 | not published | not published | $137.70 – $346.64 | 7 |
| Pros sock multi ply upper lm HCPCS L8435 | not published | not published | $25.74 – $64.77 | 7 |
| Pros sock single ply ak HCPCS L8480 | not published | not published | $11.06 – $27.83 | 7 |
| Pros sock single ply upper l HCPCS L8485 | not published | not published | $11.08 – $27.90 | 7 |
| Prostate biopsy, any mthd HCPCS G0416 | not published | not published | $166.94 – $348.39 | 8 |
| Prostate ca screening; dre HCPCS G0102 | not published | not published | $8.33 – $44.97 | 8 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $692.16 – $1,472.86 | 8 |
| Prostate laser enucleation CPT 52649 | not published | not published | $785.46 – $1,670.09 | 8 |
| Prostatic microwave thermotx CPT 53850 | not published | not published | $341.49 – $2,710.57 | 9 |
| Prostatic rf thermotx CPT 53852 | not published | not published | $366.31 – $2,646.32 | 9 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $389.90 | $389.90 | $101.64 – $216.20 | 9 |
| Prosthesis voc lopres 20f 22mm HCPCS L8507 | not published | not published | $38.98 – $98.12 | 7 |
| Prosthetic sock multi ply bk HCPCS L8420 | $61.65 | $61.65 | $19.71 – $57.95 | 9 |
| Prosthetic type socket molde HCPCS L2350 | not published | not published | $792.95 – $1,996.13 | 7 |
| Prost sock sgl ply blw knee ea HCPCS L8470 | not published | not published | $6.33 – $15.92 | 7 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $157.58 | $157.58 | $0.89 – $69.54 | 9 |
| Protect body sock ea pre ots HCPCS L0984 | not published | not published | $60.87 – $153.22 | 7 |
| Protector nerve neurawrap 4cm HCPCS C9353 | not published | not published | $1,096.25 – $1,096.25 | 1 |
| Protein analysis w/probe CPT 88372 | not published | not published | $0.52 – $35.25 | 8 |
| Protein c activity CPT 85303 | $183.75 | $183.75 | $6.83 – $79.05 | 9 |
| Protein c concentrate HCPCS J2724 | not published | not published | $15.01 – $28.85 | 8 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $227.30 | $227.30 | $5.30 – $91.35 | 9 |
| Protein s total CPT 85305 | $134.45 | $134.45 | $5.73 – $43.95 | 9 |
| Protein total 24 hour urine CPT 84156 | $119.15 | $119.15 | $1.81 – $43.05 | 9 |
| Protein total body fluid CPT 84157 | $119.45 | $119.45 | $1.81 – $37.13 | 9 |
| Protein total serum plasma whole blood CPT 84155 | $120.00 | $120.00 | $2.72 – $40.89 | 9 |
| Protein western blot tissue CPT 88371 | not published | not published | $0.55 – $37.95 | 8 |
| Prothrombin complex kcentra HCPCS J7168 | $5,346.90 | $5,346.90 | $2.14 – $3,982.74 | 9 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $282.85 | $282.85 | $1.95 – $61.48 | 9 |
| Proton treatment complex CPT 77525 | not published | not published | $995.40 – $2,297.46 | 8 |
| Proton trmt intermediate CPT 77523 | not published | not published | $934.84 – $2,079.01 | 8 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $787.77 – $1,787.34 | 8 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $559.87 – $1,782.85 | 8 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $4.25 – $19.83 | 7 |
| Provide inr test mater/equip HCPCS G0249 | not published | not published | $59.26 – $127.42 | 8 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $418.08 – $919.10 | 8 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $556.19 – $1,204.45 | 8 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $279.95 | $279.95 | $71.59 – $93.44 | 9 |
| Pr prolonged e&m service office outpatient each 15 minutes (g2212) HCPCS G2212 | $116.85 | $116.85 | $29.42 – $86.35 | 9 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | not published | not published | $327.98 – $15,453.22 | 9 |
| Prq av fstl crt uxtr sep acs CPT 36837 | not published | not published | $421.76 – $18,403.42 | 9 |
| Prq card angio/athrect addl CPT 92925 | $3,415.45 | $3,415.45 | $2,512.41 – $3,210.52 | 6 |
| Prq cardiac angio addl art CPT 92921 | $1,652.60 | $1,652.60 | $241.15 – $1,553.44 | 6 |
| Prq card revasc chronic addl CPT 92944 | $3,415.45 | $3,415.45 | $378.80 – $3,210.52 | 6 |
| Prq card revasc mi 1 vsl CPT 92941 | $21,644.30 | $21,644.30 | $596.53 – $18,181.21 | 9 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $33,063.80 | $33,063.80 | $24,321.73 – $31,079.97 | 6 |
| Prq card stent/ath/angio CPT 92934 | $5,423.85 | $5,423.85 | $3,989.78 – $5,098.42 | 6 |
| Prq card stent w/angio addl CPT 92929 | $10,027.80 | $10,027.80 | $483.40 – $3,210.52 | 6 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $17,834.30 | $17,834.30 | $530.57 – $14,980.81 | 9 |
| Prq revasc byp graft addl CPT 92938 | $3,415.45 | $3,415.45 | $2,512.41 – $3,210.52 | 6 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $544.75 – $1,224.79 | 8 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $695.48 – $1,492.51 | 8 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $762.09 – $1,630.10 | 8 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $479.21 – $1,032.96 | 8 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $357.78 – $772.70 | 8 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $17,766.05 | $17,766.05 | $530.90 – $13,864.33 | 9 |
| Prq trlml c athrc st angiop1 CPT 92933 | $9,953.80 | $9,953.80 | $595.77 – $8,361.19 | 9 |
| Prq trluml c angiop 1art&/br CPT 92920 | $23,137.10 | $23,137.10 | $477.67 – $19,435.16 | 9 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $27,324.00 | $27,324.00 | $569.00 – $22,952.16 | 9 |
| Prq trluml revsc ch occ ant CPT 92943 | $16,295.95 | $16,295.95 | $596.41 – $13,688.60 | 9 |
| Pr removal drug delivery implant CPT 11982 | $503.90 | $503.90 | $54.07 – $78.42 | 9 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $323.20 | $323.20 | $30.67 – $84.79 | 9 |
| Pr removal intrauterine device CPT 58301 | $870.00 | $870.00 | $61.90 – $213.95 | 9 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $739.60 | $739.60 | $150.79 – $327.17 | 9 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $490.40 | $490.40 | $51.83 – $108.64 | 9 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $581.25 | $581.25 | $52.51 – $129.61 | 9 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $464.30 | $464.30 | $41.70 – $111.55 | 9 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $495.10 | $495.10 | $52.51 – $109.90 | 9 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | $9,427.65 | $9,427.65 | $683.74 – $1,678.77 | 9 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | $164.70 | $164.70 | $38.05 – $80.65 | 9 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $607.99 – $1,300.70 | 8 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $574.61 – $1,231.55 | 8 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $91.44 – $194.52 | 8 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $635.83 – $1,363.72 | 8 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $648.40 – $1,390.17 | 8 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,155.50 | $1,155.50 | $143.62 – $311.11 | 9 |
| Pr visit complexity e&m service serious/complex condition HCPCS G2211 | $35.00 | $35.00 | $12.48 – $32.54 | 9 |
| PSA (Prostate) Test CPT 84153 | $274.35 | $274.35 | $10.42 – $137.99 | 9 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | $36.45 | $36.45 | $2.10 – $30.62 | 9 |
| Psychoanalysis CPT 90845 | not published | not published | $83.63 – $188.88 | 9 |
| Psychoeducation 45 min + HCPCS G0177 | $311.25 | $311.25 | $228.96 – $292.58 | 6 |
| Psychophysiological therapy CPT 90875 | not published | not published | $57.45 – $117.26 | 7 |
| Psychophysiological therapy CPT 90876 | not published | not published | $91.30 – $197.87 | 7 |
| Psychotherapy group therapy CPT 90853 | $311.25 | $311.25 | $23.35 – $37.65 | 9 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $212.05 | $212.05 | $66.54 – $85.02 | 9 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $233.80 | $233.80 | $88.16 – $151.39 | 9 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $233.80 | $233.80 | $129.66 – $200.83 | 9 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $288.15 | $288.15 | $104.88 – $220.28 | 9 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | $180.35 | $180.35 | $70.65 – $90.29 | 9 |
| Psycl/nrpsyc tech 1st CPT 96138 | $36.45 | $36.45 | $26.81 – $39.02 | 9 |
| Psy evaluation of records CPT 90885 | not published | not published | $46.77 – $94.90 | 6 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $53.55 | $53.55 | $22.36 – $34.26 | 9 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | $42.00 | $42.00 | $8.94 – $19.62 | 9 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | $24.20 | $24.20 | $17.80 – $39.02 | 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.