Hospital

MaineHealth

MaineHealth in North Conway, NH publishes cash prices for 39 common procedures listed here, from its own machine-readable price file updated Sep 9, 2025. Click a procedure to compare it with other hospitals nearby.

3073 White Mountain Highway, North Conway, NH 03860 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELVIS W/ CONTRAST $2,276.70 $2,276.70
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELVIS W/ CONTRAST $2,276.70 $2,276.70
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST $1,728.30 $1,728.30
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST $1,728.30 $1,728.30
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST $2,400.80 $2,400.80
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST $2,400.80 $2,400.80
Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI $1,021.80 $1,021.80
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI $1,021.80 $1,021.80
Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI $854.40 $854.40
Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI $854.40 $854.40
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JOINT LOWER EXTREM W/O CONTRAST $3,614.95 $3,614.95
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JOINT LOWER EXTREM W/O CONTRAST $3,614.95 $3,614.95
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST $6,736.70 $6,736.70
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST $6,736.70 $6,736.70
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O CONTRAST $3,932.90 $3,932.90
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O CONTRAST $3,932.90 $3,932.90
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN STEM W/O & W/ CONTRAST $5,592.10 $5,592.10
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN STEM W/O & W/ CONTRAST $5,592.10 $5,592.10
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST $4,362.00 $4,362.00
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST $4,362.00 $4,362.00
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $102.10 $102.10
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME $1,119.90 $1,119.90
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION $102.10 $102.10
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME $1,119.90 $1,119.90
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD $1,036.15 $1,036.15
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD $1,036.15 $1,036.15
Sleep study in a lab (polysomnography) CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $887.05 $887.05
Sleep study in a lab (polysomnography) CPT 95810 HC SLEEP STUDY STANDARD $3,137.35 $3,137.35
Sleep study in a lab (polysomnography) inpatient CPT 95810 PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND $887.05 $887.05
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC SLEEP STUDY STANDARD $3,137.35 $3,137.35
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB $915.80 $915.80
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB $915.80 $915.80
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE REAL TIME $1,040.15 $1,040.15
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMINAL COMPLETE REAL TIME $1,040.15 $1,040.15
X-ray of the lower back, 4 or more views CPT 72110 HC XRAY EXAM L-2 SPINE 4/> VIEWS $485.40 $485.40
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XRAY EXAM L-2 SPINE 4/> VIEWS $485.40 $485.40

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 HC METAPANEL CALCIUM TOTAL $106.00 $106.00
Basic metabolic panel (blood test) inpatient CPT 80048 HC METAPANEL CALCIUM TOTAL $106.00 $106.00
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL $170.15 $170.15
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL $170.15 $170.15
Complete blood count (CBC) with differential CPT 85025 HC COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $95.50 $95.50
Complete blood count (CBC) with differential inpatient CPT 85025 HC COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $95.50 $95.50
Complete blood count (CBC), no differential CPT 85027 HC COUNT COMPLETE AUTOMATED $81.10 $81.10
Complete blood count (CBC), no differential inpatient CPT 85027 HC COUNT COMPLETE AUTOMATED $81.10 $81.10
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METAPANEL $134.75 $134.75
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METAPANEL $134.75 $134.75
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL $109.90 $109.90
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL $109.90 $109.90
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL $103.45 $103.45
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL $103.45 $103.45
PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE $183.20 $183.20
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE $183.20 $183.20
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL $181.40 $181.40
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING $183.20 $183.20
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL $181.40 $181.40
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING $183.20 $183.20
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMTIME PARTIAL PLASMA/WHOLE BLOOD $75.90 $75.90
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMTIME PARTIAL PLASMA/WHOLE BLOOD $75.90 $75.90
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMTIME $50.40 $50.40
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME $50.40 $50.40
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMTIME $50.40 $50.40
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME $50.40 $50.40
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH $210.65 $210.65
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH $210.65 $210.65
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TAREAGENT AUTO MICROSCOPY $41.80 $41.80
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TAREAGENT AUTO MICROSCOPY $41.80 $41.80
Urinalysis with microscope exam, manual CPT 81000 HC URINLS DIP STICK/TAREAGNT NON-AUTO MICRSCPY $32.45 $32.45
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINLS DIP STICK/TAREAGNT NON-AUTO MICRSCPY $32.45 $32.45
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TARGNT AUTO W/O MICROSCOPY $23.55 $23.55
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TARGNT AUTO W/O MICROSCOPY $23.55 $23.55
Urinalysis without microscope exam, manual CPT 81002 HC URINE DIP STICK $24.55 $24.55
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TARGNT NON-AUTO W/O MICRSCP $24.55 $24.55
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TARGNT NON-AUTO W/O MICRSCP $24.55 $24.55
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIP STICK $24.55 $24.55

Surgery and procedures

ProcedureCash price List priceOff list
Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ INTERLAMINAR LMBR/SAC W/O IMG GUIDE $1,594.70 $1,594.70
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ INTERLAMINAR LMBR/SAC W/O IMG GUIDE $1,594.70 $1,594.70

Doctor visits and therapy

ProcedureCash price List priceOff list
New patient office visit, about 30 minutes CPT 99203 HC OFFICE/OUTPT NEW LEV 3 $78.50 $78.50
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $200.25 $200.25
New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE/OUTPT NEW LEV 3 $78.50 $78.50
New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $200.25 $200.25
New patient office visit, about 45 minutes CPT 99204 HC OFFICE/OUTPT NEW LEV 4 $120.45 $120.45
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $307.40 $307.40
New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE/OUTPT NEW LEV 4 $120.45 $120.45
New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $307.40 $307.40
New patient office visit, about 60 minutes CPT 99205 HC OFFICE/OUTPT NEW LEV 5 $150.50 $150.50
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $387.25 $387.25
New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE/OUTPT NEW LEV 5 $150.50 $150.50
New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $387.25 $387.25
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES 1/> AREAS EA 15 MIN $102.10 $102.10
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES 1/> AREAS EA 15 MIN $102.10 $102.10
Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $346.75 $346.75
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $346.75 $346.75
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $511.50 $511.50
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $511.50 $511.50

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/7979/020222156-1760436216_mainehealth_standardcharges.csv