Maine Coast Regional Health Facilities
Maine Coast Regional Health Facilities in Ellsworth, ME publishes cash prices for 48 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
50 Union St, Ellsworth, Maine 04605 Collected Sep 22, 2026 Source price file
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel-Q | $46.00 | $184.00 | 75% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $46.00 | $184.00 | 75% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel-Q | $46.00 | $184.00 | 75% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $46.00 | $184.00 | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Advanced Lipid Panel w/Inflammation | $31.50 | $126.00 | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HDL 2 Profile | $31.50 | $126.00 | 75% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile (Non-Reflexive) | $31.50 | $126.00 | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HDL 2 Profile | $31.50 | $126.00 | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Advanced Lipid Panel w/Inflammation | $31.50 | $126.00 | 75% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile (Non-Reflexive) | $31.50 | $126.00 | 75% |
| Complete blood count (CBC) with differential CPT 85025 CBC | $25.25 | $101.00 | 75% |
| Complete blood count (CBC) with differential CPT 85025 CBC with DIFF | $25.25 | $101.00 | 75% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC | $25.25 | $101.00 | 75% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC with DIFF | $25.25 | $101.00 | 75% |
| Complete blood count (CBC), no differential CPT 85027 HM | $20.75 | $83.00 | 75% |
| Complete blood count (CBC), no differential CPT 85027 CBC without Differential-Q | $20.75 | $83.00 | 75% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HM | $20.75 | $83.00 | 75% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC without Differential-Q | $20.75 | $83.00 | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel-Q | $47.25 | $189.00 | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP Add On Panel | $47.25 | $189.00 | 75% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $47.25 | $189.00 | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel-Q | $47.25 | $189.00 | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $47.25 | $189.00 | 75% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP Add On Panel | $47.25 | $189.00 | 75% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $19.25 | $77.00 | 75% |
| Kidney function blood test panel CPT 80069 Renal Function Panel-Q | $19.25 | $77.00 | 75% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel-Q | $19.25 | $77.00 | 75% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $19.25 | $77.00 | 75% |
| Liver function blood test panel CPT 80076 HEPATIC | $24.75 | $99.00 | 75% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel-Q | $24.75 | $99.00 | 75% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel-Q | $24.75 | $99.00 | 75% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC | $24.75 | $99.00 | 75% |
| Obstetric blood test panel CPT 80055 AMB Prenatal Profile. | $95.50 | $382.00 | 75% |
| Obstetric blood test panel inpatient CPT 80055 AMB Prenatal Profile. | $95.50 | $382.00 | 75% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Free | $31.50 | $126.00 | 75% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Free | $31.50 | $126.00 | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA | $23.00 | $92.00 | 75% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Reflex | $23.00 | $92.00 | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA | $23.00 | $92.00 | 75% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Reflex | $23.00 | $92.00 | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 MIX CHG | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT LA w/Reflex | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT HEPZYME CHG | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT HEP REFLEX | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 MIX CHG | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT LA w/Reflex | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT HEPZYME CHG | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT HEP REFLEX | $18.00 | $72.00 | 75% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $18.00 | $72.00 | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 ISTAT INR | $11.75 | $47.00 | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin and INR POC Form | $11.75 | $47.00 | 75% |
| Prothrombin time (PT/INR) clotting test CPT 85610 International Normal Ratio | $11.75 | $47.00 | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ISTAT INR | $11.75 | $47.00 | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 International Normal Ratio | $11.75 | $47.00 | 75% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin and INR POC Form | $11.75 | $47.00 | 75% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyrotropin-TSH-Reflex | $38.75 | $155.00 | 75% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $38.75 | $155.00 | 75% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyrotropin-TSH-Reflex | $38.75 | $155.00 | 75% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $38.75 | $155.00 | 75% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis, Complete, Reflex to Culture | $14.50 | $58.00 | 75% |
| Urinalysis with microscope exam, automated CPT 81001 81001 Charge Transformation Order | $14.50 | $58.00 | 75% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 81001 Charge Transformation Order | $14.50 | $58.00 | 75% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Complete, Reflex to Culture | $14.50 | $58.00 | 75% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non-Auto w/o Scope POC | $5.50 | $22.00 | 75% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non-Auto w/o Scope POC | $5.50 | $22.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIP | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/Microscopic if Indicated | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine-Q | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine-Q | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Macroscopic-Q | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA DIP for Beva/Avastin treatment | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto w/o Scope POC | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated CPT 81003 UA-REFLEX | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine-Q | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Macroscopic-Q | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/Microscopic if Indicated | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP for Beva/Avastin treatment | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine-Q | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA-REFLEX | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto w/o Scope POC | $10.25 | $41.00 | 75% |
| Urinalysis without microscope exam, manual CPT 81002 Reducing Substance Urine | $4.50 | $18.00 | 75% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick POC | $4.50 | $18.00 | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Reducing Substance Urine | $4.50 | $18.00 | 75% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick POC | $4.50 | $18.00 | 75% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 OB Global Cesarean Delivery 59510 | $2,870.75 | $11,483.00 | 75% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 SURG PF DELIVERY CESAREAN W/ANTEPARTUM/POSTPART CARE 59510 | $2,870.75 | $11,483.00 | 75% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 SURG PF DELIVERY CESAREAN W/ANTEPARTUM/POSTPART CARE 59510 | $2,870.75 | $11,483.00 | 75% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB Global Cesarean Delivery 59510 | $2,870.75 | $11,483.00 | 75% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC COLONOSCOPY FLEXIBLE W/ENDOSCOPIC US | $1,469.75 | $5,879.00 | 75% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC COLONOSCOPY FLEXIBLE W/ENDOSCOPIC US | $1,469.75 | $5,879.00 | 75% |
| Colonoscopy with polyp removal CPT 45385 SURG PF COLONSC FLX W/RM TMR/POLYP/LES SNARE 45385 | $242.75 | $971.00 | 75% |
| Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY FLEX W/RMVL TUMOR/POLYP/LES SNARE | $1,450.50 | $5,802.00 | 75% |
| Colonoscopy with polyp removal inpatient CPT 45385 SURG PF COLONSC FLX W/RM TMR/POLYP/LES SNARE 45385 | $242.75 | $971.00 | 75% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY FLEX W/RMVL TUMOR/POLYP/LES SNARE | $1,450.50 | $5,802.00 | 75% |
| Colonoscopy with tissue sample CPT 45380 SURG PF COLONOSCOPY FLEX W/BX SNGL/MULT 45380 | $232.75 | $931.00 | 75% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY FLEX W/BX SNGL/MULT | $1,146.25 | $4,585.00 | 75% |
| Colonoscopy with tissue sample inpatient CPT 45380 SURG PF COLONOSCOPY FLEX W/BX SNGL/MULT 45380 | $232.75 | $931.00 | 75% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY FLEX W/BX SNGL/MULT | $1,146.25 | $4,585.00 | 75% |
| Colonoscopy, diagnostic CPT 45378 SURG PF COLONOSCOPY FLEX DX BRUSH/WASH HIGH RISK 45378 | $209.75 | $839.00 | 75% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEX DX BRUSH/WASH HIGH RISK | $1,055.50 | $4,222.00 | 75% |
| Colonoscopy, diagnostic inpatient CPT 45378 SURG PF COLONOSCOPY FLEX DX BRUSH/WASH HIGH RISK 45378 | $209.75 | $839.00 | 75% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEX DX BRUSH/WASH HIGH RISK | $1,055.50 | $4,222.00 | 75% |
| Knee arthroscopy with meniscus trim CPT 29881 SURG PF ARTHROSCOPY KNEE W/MENISCECTOMY DEBRID/SHAVING 29881 | $373.00 | $1,492.00 | 75% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 SURG PF ARTHROSCOPY KNEE W/MENISCECTOMY DEBRID/SHAVING 29881 | $373.00 | $1,492.00 | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection Therapeutic Agent Lumbar Spine with Navigation | $713.50 | $2,854.00 | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 BCE INJ DX/TH INTLAM LSACRL IMG GD 62323 | $713.50 | $2,854.00 | 75% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/THER INTLAM L/SACRL IMG GDE 62323 | $804.50 | $3,218.00 | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 BCE INJ DX/TH INTLAM LSACRL IMG GD 62323 | $713.50 | $2,854.00 | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection Therapeutic Agent Lumbar Spine with Navigation | $713.50 | $2,854.00 | 75% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DX/THER INTLAM L/SACRL IMG GDE 62323 | $804.50 | $3,218.00 | 75% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inj Dx/Ther Interlaminar L/Sacral W/O Img 62322 | $723.75 | $2,895.00 | 75% |
| Lower-back epidural injection, without imaging guidance CPT 62322 WC$ OB Epidural / Intrathecal -> Lumbar/Sacral | $802.25 | $3,209.00 | 75% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inj Dx/Ther Interlaminar L/Sacral W/O Img 62322 | $723.75 | $2,895.00 | 75% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 WC$ OB Epidural / Intrathecal -> Lumbar/Sacral | $802.25 | $3,209.00 | 75% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ ANES/STRD EPID W/IMG GUIDE L/S SNGL LVL | $623.25 | $2,493.00 | 75% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ ANES/STRD EPID W/IMG GUIDE L/S SNGL LVL | $623.25 | $2,493.00 | 75% |
| Prostate biopsy CPT 55700 SURG PF BX PROSTATE NEEDLE/PUNCH 55700 | $179.50 | $718.00 | 75% |
| Prostate biopsy CPT 55700 Bx/prostate/needle/punch/sng/mul 55700 | $1,041.75 | $4,167.00 | 75% |
| Prostate biopsy inpatient CPT 55700 SURG PF BX PROSTATE NEEDLE/PUNCH 55700 | $179.50 | $718.00 | 75% |
| Prostate biopsy inpatient CPT 55700 Bx/prostate/needle/punch/sng/mul 55700 | $1,041.75 | $4,167.00 | 75% |
| Removal of a breast lump, open surgery CPT 19120 SURG PF EXC CYST/LES OPEN>=1 LES 19120 | $287.25 | $1,149.00 | 75% |
| Removal of a breast lump, open surgery CPT 19120 Removal Of Breast Lesion 19120 | $1,979.75 | $7,919.00 | 75% |
| Removal of a breast lump, open surgery inpatient CPT 19120 SURG PF EXC CYST/LES OPEN>=1 LES 19120 | $287.25 | $1,149.00 | 75% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Removal Of Breast Lesion 19120 | $1,979.75 | $7,919.00 | 75% |
| Total hip replacement CPT 27130 SURG PF ARTHROPLASTY HIP TTL 27130 | $827.00 | $3,308.00 | 75% |
| Total hip replacement inpatient CPT 27130 SURG PF ARTHROPLASTY HIP TTL 27130 | $827.00 | $3,308.00 | 75% |
| Total knee replacement CPT 27447 SURG PF ARTHROPLASTY KNEE TIBIAL/FEMORAL MEDIAL AND LAT 27447 | $693.00 | $2,772.00 | 75% |
| Total knee replacement inpatient CPT 27447 SURG PF ARTHROPLASTY KNEE TIBIAL/FEMORAL MEDIAL AND LAT 27447 | $693.00 | $2,772.00 | 75% |
| Upper endoscopy (EGD) with biopsy CPT 43239 SURG PF EGD FLEX TRANSORAL W/BX SNGL/MULT 43239 | $239.50 | $958.00 | 75% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD FLEX TRANSORAL W/BX SNGL/MULT | $1,155.50 | $4,622.00 | 75% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 SURG PF EGD FLEX TRANSORAL W/BX SNGL/MULT 43239 | $239.50 | $958.00 | 75% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD FLEX TRANSORAL W/BX SNGL/MULT | $1,155.50 | $4,622.00 | 75% |
| Upper endoscopy (EGD), diagnostic CPT 43235 SURG PF EGD FLEX TRNSRL DIAG W/COLLECT SPEC BRUSH/WASH 43235 | $154.50 | $618.00 | 75% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD FLEX TRNSRL DIAG W/COLLECT SPEC BRUSH/WASH | $856.25 | $3,425.00 | 75% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 SURG PF EGD FLEX TRNSRL DIAG W/COLLECT SPEC BRUSH/WASH 43235 | $154.50 | $618.00 | 75% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD FLEX TRNSRL DIAG W/COLLECT SPEC BRUSH/WASH | $856.25 | $3,425.00 | 75% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 SURG PF DELIVERY VAG W/ANTE/POST CARE S/P C-SECT 59610 | $1,541.00 | $6,164.00 | 75% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 SURG PF DELIVERY VAG W/ANTE/POST CARE S/P C-SECT 59610 | $1,541.00 | $6,164.00 | 75% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 SURG PF DELIVERY VAG W/ANTEPARTUM & POSTPARTUM CARE 59400 | $2,611.50 | $10,446.00 | 75% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 OB Global Vaginal Delivery 59400 | $2,611.50 | $10,446.00 | 75% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 SURG PF DELIVERY VAG W/ANTEPARTUM & POSTPARTUM CARE 59400 | $2,611.50 | $10,446.00 | 75% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB Global Vaginal Delivery 59400 | $2,611.50 | $10,446.00 | 75% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy with Patient 90847 | $144.75 | $579.00 | 75% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy with Patient 90847 | $144.75 | $579.00 | 75% |
| Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy w/o Patient 90846 | $138.00 | $552.00 | 75% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy w/o Patient 90846 | $138.00 | $552.00 | 75% |
| Group psychotherapy session CPT 90853 Group Therapy 90853 | $62.50 | $250.00 | 75% |
| Group psychotherapy session inpatient CPT 90853 Group Therapy 90853 | $62.50 | $250.00 | 75% |
| New patient office visit, about 30 minutes CPT 99203 Office Visit Level 3 New (30+min) 99203 | $104.50 | $418.00 | 75% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Visit Level 3 New (30+min) 99203 | $104.50 | $418.00 | 75% |
| New patient office visit, about 45 minutes CPT 99204 Office Visit Level 4 New (45+min) 99204 | $151.00 | $604.00 | 75% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Visit Level 4 New (45+min) 99204 | $151.00 | $604.00 | 75% |
| New patient office visit, about 60 minutes CPT 99205 Office Visit Level 5 New (60+min) 99205 | $225.50 | $902.00 | 75% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Visit Level 5 New (60+min) 99205 | $225.50 | $902.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 SLP Therapeutic Exericse Units | $32.50 | $130.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Units | $31.00 | $124.00 | 75% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 SLP Therapeutic Exericse Units | $32.50 | $130.00 | 75% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $145.00 | $580.00 | 75% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Comp Preventive Med 18 to 39 years New 99385 | $145.00 | $580.00 | 75% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $175.50 | $702.00 | 75% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Comp Preventive Med 40 to 64 years New 99386 | $175.50 | $702.00 | 75% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 Minutes 90832 | $134.50 | $538.00 | 75% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy, 30 Minutes 90832 | $134.50 | $538.00 | 75% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Minutes 90834 | $194.75 | $779.00 | 75% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy, 45 Minutes 90834 | $194.75 | $779.00 | 75% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 Minutes 90837 | $216.50 | $866.00 | 75% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy, 60 Minutes 90837 | $216.50 | $866.00 | 75% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 ED NEW/EST CONSULTATION LEVEL 3 (30 min) 99243 | $72.00 | $288.00 | 75% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consult Level 3 Est 99243 | $137.50 | $550.00 | 75% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consult Level 3 New 99243 | $137.50 | $550.00 | 75% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ED NEW/EST CONSULTATION LEVEL 3 (30 min) 99243 | $72.00 | $288.00 | 75% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consult Level 3 Est 99243 | $137.50 | $550.00 | 75% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consult Level 3 New 99243 | $137.50 | $550.00 | 75% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ED NEW/EST CONSULTATION LEVEL 4 (40 min) 99244 | $101.50 | $406.00 | 75% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consult Level 4 New 99244 | $183.25 | $733.00 | 75% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consult Level 4 Est 99244 | $183.25 | $733.00 | 75% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ED NEW/EST CONSULTATION LEVEL 4 (40 min) 99244 | $101.50 | $406.00 | 75% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consult Level 4 New 99244 | $183.25 | $733.00 | 75% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consult Level 4 Est 99244 | $183.25 | $733.00 | 75% |
Source file: https://northernlighthealth.org/NLH/media/Price-Transparency/010198331_Maine-Coast-Hospital_standardcharges.csv