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 |
|---|---|---|---|---|
| Psytx complex interactive CPT 90785 | $123.15 | $123.15 | $12.20 – $28.27 | 9 |
| Psytx pt w/e&m 16-37 min CPT 90833 | $215.10 | $215.10 | $61.64 – $138.78 | 9 |
| Psytx pt w/e&m 38-52 min CPT 90836 | $282.00 | $282.00 | $78.11 – $122.76 | 9 |
| Psytx pt w/e&m 53+ min CPT 90838 | $230.00 | $230.00 | $94.97 – $124.29 | 9 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $69.70 | $69.70 | $6.05 – $17.20 | 9 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $103.35 | $103.35 | $18.77 – $66.10 | 9 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $167.20 | $167.20 | $13.88 – $37.47 | 9 |
| Pt application of modality traction mechanical CPT 97012 | $146.85 | $146.85 | $14.19 – $45.17 | 9 |
| Pt/caregiver traing home inr CPT 93792 | not published | not published | $65.34 – $139.62 | 8 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $120.00 – $610.86 | 7 |
| Pten gene full sequence CPT 81321 | not published | not published | $554.28 – $1,221.72 | 7 |
| Pten gene known fam variant CPT 81322 | not published | not published | $21.14 – $97.61 | 7 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $769.80 – $1,637.56 | 8 |
| Pt-focused hlth risk assmt CPT 96160 | $60.85 | $60.85 | $2.50 – $6.68 | 9 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | $52.05 | $52.05 | $23.14 – $48.80 | 9 |
| Pt prgrm for implt neurostim HCPCS L8681 | not published | not published | $1,022.79 – $2,574.71 | 7 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $207.65 | $207.65 | $34.06 – $81.60 | 9 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | not published | not published | $11.76 – $23.72 | 8 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $132.05 | $132.05 | $29.21 – $98.20 | 9 |
| Pt wheelchair management each 15 minutes CPT 97542 | $169.95 | $169.95 | $30.80 – $127.81 | 9 |
| Pul art balloon repr percut CPT 92997 | $20,493.60 | $20,493.60 | $576.32 – $17,214.62 | 9 |
| Pul art balloon repr percut CPT 92998 | $8,478.55 | $8,478.55 | $288.23 – $7,121.98 | 9 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $2,200.00 – $11,199.10 | 7 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $3,774.81 – $8,278.66 | 8 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $918.89 – $2,000.87 | 8 |
| Pulmonary vent imaging CPT 78579 | $2,493.70 | $2,493.70 | $21.51 – $915.35 | 9 |
| Pulse ox continuous overnight monitoring CPT 94762 | $524.75 | $524.75 | $23.68 – $50.16 | 9 |
| Pulse ox multiple CPT 94761 | $420.05 | $420.05 | $3.36 – $14.40 | 9 |
| Pulse ox single CPT 94760 | $115.75 | $115.75 | $2.10 – $44.52 | 9 |
| Punc of shunt for asp or inj CPT 61070 | $1,193.55 | $1,193.55 | $53.13 – $1,002.58 | 9 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $362.45 | $362.45 | $14.05 – $52.69 | 9 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $1,581.45 | $1,581.45 | $82.74 – $204.90 | 9 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $45.38 – $179.89 | 9 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,088.55 | $1,088.55 | $59.48 – $282.04 | 9 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $71.23 – $203.19 | 6 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $94.44 – $173.68 | 6 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $605.30 | $605.30 | $29.60 – $81.83 | 9 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $76.64 – $438.80 | 9 |
| Pvb thoracic single inj site CPT 64461 | $1,209.85 | $1,209.85 | $73.10 – $258.28 | 9 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $643.23 – $1,607.70 | 7 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $15,237.10 – $38,084.54 | 7 |
| Pyelotomy complicated CPT 50135 | not published | not published | $1,077.75 – $2,278.35 | 7 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $932.48 – $1,983.93 | 8 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $901.54 – $1,917.49 | 8 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $979.37 – $2,082.87 | 8 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $869.42 – $1,894.46 | 8 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $221.20 | $221.20 | $5.73 – $135.53 | 9 |
| Pyruvate CPT 84210 | not published | not published | $5.79 – $29.48 | 7 |
| Pyruvate kinase CPT 84220 | $146.05 | $146.05 | $4.66 – $78.44 | 9 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $334.38 – $841.77 | 7 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $6.10 – $18.63 | 8 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $3,966.80 | $3,966.80 | $36.64 – $1,005.10 | 9 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,933.15 | $1,933.15 | $32.10 – $810.73 | 9 |
| Quest t3 uptake CPT 84479 | $169.95 | $169.95 | $3.19 – $67.59 | 9 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $539.31 – $1,357.64 | 7 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $4.26 – $493.97 | 8 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $200.47 – $746.44 | 8 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $236.67 – $482.11 | 8 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $12,209.80 | $12,209.80 | $266.44 – $2,693.05 | 9 |
| Rabies vaccine id CPT 90676 | not published | not published | $186.50 – $568.41 | 7 |
| Radial keratotomy CPT 65771 | not published | not published | $751.22 – $1,290.52 | 4 |
| Radiation handling CPT 77790 | $2,618.55 | $2,618.55 | $15.59 – $2,199.58 | 9 |
| Radiation physics consult CPT 77336 | $566.75 | $566.75 | $80.00 – $476.07 | 9 |
| Radiation therapy dose plan CPT 77300 | $566.75 | $566.75 | $31.82 – $474.81 | 9 |
| Radiation therapy management CPT 77431 | not published | not published | $104.50 – $218.26 | 8 |
| Radiation treatment aid(s) CPT 77332 | $566.75 | $566.75 | $16.58 – $476.07 | 9 |
| Radiation treatment aid(s) CPT 77333 | $836.75 | $836.75 | $38.65 – $702.87 | 9 |
| Radiation treatment aid(s) CPT 77334 | $1,109.75 | $1,109.75 | $58.67 – $932.19 | 9 |
| Radiation treatment delivery CPT 77401 | $480.70 | $480.70 | $38.39 – $403.79 | 9 |
| Radiation treatment delivery CPT 77402 | $448.05 | $448.05 | $105.98 – $421.17 | 9 |
| Radiation treatment delivery CPT 77412 | $924.25 | $924.25 | $254.52 – $868.80 | 9 |
| Radiation tx management x5 CPT 77427 | not published | not published | $185.77 – $386.35 | 8 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $1,724.95 – $3,716.37 | 8 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $1,431.55 – $3,067.05 | 8 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $1,832.97 – $3,932.59 | 8 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $1,675.18 – $3,594.38 | 8 |
| Radical resection of elbow CPT 24149 | not published | not published | $1,135.28 – $2,425.18 | 8 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,254.44 – $2,672.57 | 8 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $985.12 – $2,138.46 | 8 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $1,361.31 – $2,925.39 | 8 |
| Radiesse injection HCPCS Q2026 | not published | not published | $333.42 – $608.27 | 6 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $4,884.12 – $12,295.04 | 7 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $645.58 – $1,625.17 | 7 |
| Radiology port images(s) CPT 77417 | $344.95 | $344.95 | $12.74 – $289.76 | 9 |
| Radiotherapy dose plan imrt CPT 77301 | $5,744.60 | $5,744.60 | $409.04 – $4,825.46 | 9 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $179.55 | $179.55 | $132.08 – $176.93 | 9 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,532.45 | $2,532.45 | $35.24 – $1,276.88 | 9 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,942.80 | $2,942.80 | $44.32 – $2,471.95 | 9 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $2,631.00 | $2,631.00 | $80.00 – $2,079.25 | 9 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,451.80 | $2,451.80 | $47.56 – $1,506.08 | 9 |
| Radphm lcl tumor plr sgl day CPT 78800 | $761.40 | $761.40 | $28.96 – $588.84 | 9 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $20.21 – $42.03 | 8 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $1,467.39 – $3,147.03 | 8 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $1,068.75 – $2,307.91 | 8 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $1,254.02 – $2,703.75 | 8 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $971.84 – $2,099.83 | 8 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $681.33 – $1,426.09 | 8 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $1,254.04 – $2,708.49 | 8 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $715.14 – $1,532.51 | 8 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $1,013.80 – $2,149.31 | 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.