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 |
|---|---|---|---|---|
| Reconstruction of jaw CPT 21245 | not published | not published | $910.99 – $2,348.85 | 9 |
| Reconstruction of jaw CPT 21246 | not published | not published | $817.25 – $1,718.90 | 8 |
| Reconstruction of jaw CPT 21248 | not published | not published | $767.89 – $1,890.13 | 9 |
| Reconstruction of jaw CPT 21249 | not published | not published | $1,075.47 – $2,560.87 | 9 |
| Reconstruction of jaw joint CPT 21240 | not published | not published | $1,012.12 – $2,120.84 | 8 |
| Reconstruction of jaw joint CPT 21242 | not published | not published | $975.82 – $2,050.35 | 8 |
| Reconstruction of jaw joint CPT 21243 | not published | not published | $1,555.85 – $3,301.57 | 8 |
| Reconstruction of lower jaw CPT 21244 | not published | not published | $964.21 – $2,048.32 | 8 |
| Reconstruction of midface CPT 21188 | not published | not published | $1,513.50 – $3,189.06 | 8 |
| Reconstruction of mouth CPT 40840 | not published | not published | $604.81 – $1,674.91 | 9 |
| Reconstruction of mouth CPT 40842 | not published | not published | $590.34 – $1,802.76 | 9 |
| Reconstruction of mouth CPT 40843 | not published | not published | $832.40 – $2,319.94 | 9 |
| Reconstruction of mouth CPT 40844 | not published | not published | $1,128.28 – $2,912.30 | 9 |
| Reconstruction of mouth CPT 40845 | not published | not published | $1,154.00 – $2,860.25 | 9 |
| Reconstruction of nail bed CPT 11762 | not published | not published | $180.54 – $556.37 | 9 |
| Reconstruction of nose CPT 30410 | not published | not published | $1,354.02 – $2,875.90 | 8 |
| Reconstruction of nose CPT 30420 | not published | not published | $1,381.10 – $2,932.16 | 8 |
| Reconstruction of orbit CPT 21256 | not published | not published | $1,186.45 – $2,524.13 | 8 |
| Reconstruction of throat CPT 42950 | not published | not published | $765.64 – $1,621.30 | 8 |
| Reconstruction of urethra CPT 53410 | not published | not published | $929.26 – $1,979.19 | 8 |
| Reconstruction of urethra CPT 53415 | not published | not published | $1,069.40 – $2,277.41 | 8 |
| Reconstruction of urethra CPT 53430 | not published | not published | $922.12 – $1,971.04 | 8 |
| Reconstruction of urethra CPT 54308 | not published | not published | $683.24 – $1,451.85 | 8 |
| Reconstruction of urethra CPT 54312 | not published | not published | $779.82 – $1,657.22 | 8 |
| Reconstruction of urethra CPT 54316 | not published | not published | $943.50 – $2,008.32 | 8 |
| Reconstruction of urethra CPT 54318 | not published | not published | $680.27 – $1,444.40 | 8 |
| Reconstruction of urethra CPT 54322 | not published | not published | $743.61 – $1,580.62 | 8 |
| Reconstruction of urethra CPT 54324 | not published | not published | $919.60 – $1,956.14 | 8 |
| Reconstruction of urethra CPT 54326 | not published | not published | $895.41 – $1,904.62 | 8 |
| Reconstruction tongue fold CPT 41520 | not published | not published | $242.58 – $710.57 | 9 |
| Reconstruct larynx & pharynx CPT 31395 | not published | not published | $2,783.32 – $5,949.74 | 8 |
| Reconstruct lip with flap CPT 40527 | not published | not published | $604.64 – $1,287.82 | 8 |
| Reconstruct lip w/local flap 40525 CPT 40525 | not published | not published | $530.08 – $1,130.58 | 8 |
| Reconstruct lower jaw bone CPT 21255 | not published | not published | $1,283.08 – $2,701.04 | 8 |
| Reconstruct lower jaw bone CPT 21247 | not published | not published | $1,516.45 – $3,191.76 | 8 |
| Reconstruct orbit/forehead CPT 21172 | not published | not published | $1,961.95 – $4,361.64 | 8 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $1,142.66 – $2,446.86 | 8 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $1,373.25 – $2,943.69 | 8 |
| Reconstruct ulna/radioulnar CPT 25337 | not published | not published | $856.73 – $1,831.42 | 8 |
| Reconstruct upper jaw bone CPT 21206 | not published | not published | $941.14 – $1,965.63 | 8 |
| Reconstruct urethra/bladder CPT 53431 | not published | not published | $1,091.32 – $2,323.51 | 8 |
| Reconstruct urethra stage 1 CPT 53420 | not published | not published | $798.84 – $1,699.25 | 8 |
| Reconstruct urethra stage 2 CPT 53425 | not published | not published | $888.07 – $1,889.72 | 8 |
| Reconstruct vena cava 34502 CPT 34502 | not published | not published | $1,411.78 – $3,089.40 | 8 |
| Reconstruct windpipe CPT 31780 | not published | not published | $1,140.97 – $2,438.72 | 8 |
| Reconstruct windpipe CPT 31781 | not published | not published | $1,363.15 – $2,919.97 | 8 |
| Rectal sensation test CPT 91120 | not published | not published | $45.65 – $96.24 | 8 |
| Red blood cells each unit HCPCS P9021 | not published | not published | $93.09 – $148.65 | 6 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | not published | not published | $485.37 – $499.93 | 5 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | $1,475.45 | $1,475.45 | $222.86 – $520.15 | 9 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $1,202.55 | $1,202.55 | $128.48 – $727.14 | 9 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $1,330.80 | $1,330.80 | $197.62 – $810.19 | 9 |
| Red blood cells washed each unit HCPCS P9022 | not published | not published | $173.11 – $408.78 | 6 |
| Red cell mass multiple CPT 78121 | not published | not published | $12.85 – $25.76 | 8 |
| Red cell mass single CPT 78120 | $1,704.65 | $1,704.65 | $8.96 – $1,431.91 | 9 |
| Red cell sequestration CPT 78140 | $2,467.35 | $2,467.35 | $23.22 – $906.70 | 9 |
| Red cell survival kinetics CPT 78135 | not published | not published | $64.75 – $64.75 | 1 |
| Red cell survival study CPT 78130 | $1,704.65 | $1,704.65 | $23.22 – $1,431.91 | 9 |
| Redo compl cardiac anomaly CPT 33622 | not published | not published | $3,098.41 – $6,825.44 | 8 |
| Redo endovas vena cava filtr CPT 37192 | $12,415.55 | $12,415.55 | $307.38 – $2,422.74 | 9 |
| Reduce bowel obstruction 44050 CPT 44050 | not published | not published | $876.18 – $1,905.96 | 8 |
| Reduce testis torsion CPT 54600 | not published | not published | $435.02 – $923.17 | 8 |
| Reduction of facial bones CPT 21209 | not published | not published | $584.83 – $1,533.56 | 9 |
| Reduction of procidentia 45900 CPT 45900 | not published | not published | $201.88 – $435.16 | 8 |
| Reduction of skull defect CPT 62115 | not published | not published | $1,579.15 – $3,495.42 | 8 |
| Reduction of skull defect CPT 62117 | not published | not published | $1,820.56 – $4,054.60 | 8 |
| Re-exploration of chest 32120 CPT 32120 | not published | not published | $810.14 – $1,758.22 | 8 |
| Reexploration pelvic wound 49014 CPT 49014 | not published | not published | $349.77 – $765.24 | 8 |
| Re-explore parathyroids CPT 60502 | not published | not published | $1,225.93 – $2,656.98 | 8 |
| Refill maint impl spine pump CPT 95991 | not published | not published | $37.08 – $213.29 | 9 |
| Refill/maint pump/resvr syst CPT 96522 | $584.55 | $584.55 | $108.89 – $339.49 | 9 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $2,623.85 | $2,623.85 | $3.39 – $124.74 | 9 |
| Reimplant artery each 35697 CPT 35697 | not published | not published | $130.53 – $289.43 | 8 |
| Reimplant ureter in bladder CPT 50782 | not published | not published | $1,018.36 – $2,166.92 | 8 |
| Reimplant ureter in bladder CPT 50783 | not published | not published | $1,066.57 – $2,271.30 | 8 |
| Reimplant ureter in bladder CPT 50785 | not published | not published | $1,148.27 – $2,444.15 | 8 |
| Reinforce clavicle CPT 23490 | not published | not published | $828.09 – $1,769.05 | 8 |
| Reinforced solid stirrup HCPCS L2260 | not published | not published | $178.39 – $449.06 | 7 |
| Reinforce eye wall CPT 67250 | not published | not published | $858.16 – $1,802.26 | 8 |
| Reinforce/graft eye wall CPT 67255 | not published | not published | $656.20 – $1,385.42 | 8 |
| Reinforce hip bones CPT 27187 | not published | not published | $955.68 – $2,042.21 | 8 |
| Reinforce shoulder bones CPT 23491 | not published | not published | $974.49 – $2,082.87 | 8 |
| Reinforce thigh CPT 27495 | not published | not published | $1,079.98 – $2,311.29 | 8 |
| Reinforce tibia CPT 27745 | not published | not published | $707.38 – $1,519.63 | 8 |
| Reinnervate larynx CPT 31590 | not published | not published | $889.86 – $1,891.73 | 8 |
| Reinsertion of spinal fixation device 22849 CPT 22849 | not published | not published | $1,228.76 – $2,679.33 | 8 |
| Reinsert ocular implant CPT 65155 | not published | not published | $921.44 – $1,935.11 | 8 |
| Release encircling material CPT 67115 | not published | not published | $474.92 – $1,005.18 | 8 |
| Release eye tissue CPT 67343 | not published | not published | $639.88 – $1,358.31 | 8 |
| Release facial nerve CPT 69720 | not published | not published | $1,128.28 – $2,401.45 | 8 |
| Release facial nerve CPT 69725 | not published | not published | $1,775.81 – $3,794.33 | 8 |
| Release facial nerve CPT 69955 | not published | not published | $1,867.06 – $3,990.88 | 8 |
| Release finger contracture CPT 26525 | not published | not published | $663.19 – $1,402.37 | 8 |
| Release forearm/hand tendon CPT 26449 | not published | not published | $675.71 – $1,450.49 | 8 |
| Release inner ear canal CPT 69960 | not published | not published | $1,788.17 – $3,827.54 | 8 |
| Release knuckle contracture CPT 26520 | not published | not published | $658.50 – $1,392.21 | 8 |
| Release middle ear bone CPT 69650 | not published | not published | $768.09 – $1,632.13 | 8 |
| Release muscles of hand CPT 26593 | not published | not published | $624.18 – $1,325.09 | 8 |
| Release of eye fluid CPT 67015 | not published | not published | $576.08 – $1,211.92 | 8 |
| Release of foot tendon CPT 28220 | not published | not published | $295.60 – $869.90 | 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.