St Mary's Regional Medical Center
St Mary's Regional Medical Center in Lewiston, ME publishes cash prices for 47 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
93 Campus Avenue - Po Box 291, Lewiston, ME 04243 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD/PEL W CONT | $1,758.26 | $4,627.00 | 62% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD/PEL W CONT | $1,758.26 | $4,627.00 | 62% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT BRAIN W/O CONTRAST | $601.16 | $1,582.00 | 62% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT BRAIN W/O CONTRAST | $601.16 | $1,582.00 | 62% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST | $821.18 | $2,161.00 | 62% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST | $821.18 | $2,161.00 | 62% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMO DGX BILATERAL INCL CAD IF PERF | $211.66 | $557.00 | 62% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMO DGX BILATERAL INCL CAD IF PERF | $211.66 | $557.00 | 62% |
| Diagnostic mammogram, one breast one side CPT 77065 HC MAMMO DGX UNILATERAL INCL CAD IF PERF | $152.76 | $402.00 | 62% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMO DGX UNILATERAL INCL CAD IF PERF | $152.76 | $402.00 | 62% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXT JNT W/O CONT | $1,124.42 | $2,959.00 | 62% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXT JNT W/O CONT | $1,124.42 | $2,959.00 | 62% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXT JNT W&W/O CONT | $1,684.92 | $4,434.00 | 62% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXT JNT W&W/O CONT | $1,684.92 | $4,434.00 | 62% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN WO CTRST | $1,124.42 | $2,959.00 | 62% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN WO CTRST | $1,124.42 | $2,959.00 | 62% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN WO & W CONTRAST | $1,684.92 | $4,434.00 | 62% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN WO & W CONTRAST | $1,684.92 | $4,434.00 | 62% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-SPINE LUMBAR WO CONTRAST | $1,124.42 | $2,959.00 | 62% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-SPINE LUMBAR WO CONTRAST | $1,124.42 | $2,959.00 | 62% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC FETAL EVAL 2-3 TRIM SGL GEST | $440.80 | $1,160.00 | 62% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC FETAL EVAL 2-3 TRIM SGL GEST | $440.80 | $1,160.00 | 62% |
| Screening mammogram, both breasts CPT 77067 HC MAMMO SCREENING INCL CAD IF PERF | $185.44 | $488.00 | 62% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREENING INCL CAD IF PERF | $185.44 | $488.00 | 62% |
| Sleep study in a lab (polysomnography) CPT 95810 HC ADULT SLEEP STUDY (POLYSOMNOGRAM) | $1,629.82 | $4,289.00 | 62% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/> YRS 4/> PARAM | $1,629.82 | $4,289.00 | 62% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/> YRS 4/> PARAM | $1,629.82 | $4,289.00 | 62% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC ADULT SLEEP STUDY (POLYSOMNOGRAM) | $1,629.82 | $4,289.00 | 62% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB | $327.94 | $863.00 | 62% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB | $327.94 | $863.00 | 62% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $413.06 | $1,087.00 | 62% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE | $413.06 | $1,087.00 | 62% |
| X-ray of the lower back, 4 or more views CPT 72110 HC L-SPINE MIN 4 VIEWS | $329.84 | $868.00 | 62% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC L-SPINE MIN 4 VIEWS | $329.84 | $868.00 | 62% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $80.18 | $211.00 | 62% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $80.18 | $211.00 | 62% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC SO LIPID PANEL | $82.08 | $216.00 | 62% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $82.08 | $216.00 | 62% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $82.08 | $216.00 | 62% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC SO LIPID PANEL | $82.08 | $216.00 | 62% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC | $39.14 | $103.00 | 62% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC | $39.14 | $103.00 | 62% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC (HEMOGRAM) | $34.58 | $91.00 | 62% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC (HEMOGRAM) | $34.58 | $91.00 | 62% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $82.08 | $216.00 | 62% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $82.08 | $216.00 | 62% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $68.78 | $181.00 | 62% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $68.78 | $181.00 | 62% |
| Liver function blood test panel CPT 80076 HC LIVER PROFILE-HEPATIC PANEL | $63.46 | $167.00 | 62% |
| Liver function blood test panel inpatient CPT 80076 HC LIVER PROFILE-HEPATIC PANEL | $63.46 | $167.00 | 62% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN/FREE | $74.86 | $197.00 | 62% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC SO PROSTATE SPECIFIC ANTIGEN/FREE | $74.86 | $197.00 | 62% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC SO PROSTATE SPECIFIC ANTIGEN/FREE | $74.86 | $197.00 | 62% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN/FREE | $74.86 | $197.00 | 62% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PSA TOTAL | $72.58 | $191.00 | 62% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC SO ASSAY OF PSA TOTAL | $72.58 | $191.00 | 62% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC SO ASSAY OF PSA TOTAL | $72.58 | $191.00 | 62% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PSA TOTAL | $72.58 | $191.00 | 62% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT | $68.02 | $179.00 | 62% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC SO PTT | $68.02 | $179.00 | 62% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC SO PTT | $68.02 | $179.00 | 62% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT | $68.02 | $179.00 | 62% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $28.88 | $76.00 | 62% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC SO PROTHROMBIN TIME | $28.88 | $76.00 | 62% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC SO PROTHROMBIN TIME | $28.88 | $76.00 | 62% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $28.88 | $76.00 | 62% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE | $72.58 | $191.00 | 62% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC SO TSH 3RD GENERATION | $72.58 | $191.00 | 62% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE | $72.58 | $191.00 | 62% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC SO TSH 3RD GENERATION | $72.58 | $191.00 | 62% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS W/ MICROSCOPY | $41.04 | $108.00 | 62% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS W/ MICROSCOPY | $41.04 | $108.00 | 62% |
| Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS NONAUTO W/SCOPE | $28.50 | $75.00 | 62% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS NONAUTO W/SCOPE | $28.50 | $75.00 | 62% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $22.42 | $59.00 | 62% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $22.42 | $59.00 | 62% |
| Urinalysis without microscope exam, manual CPT 81002 HC NON-AUTOURINE W/O MICROSCOPY | $18.62 | $49.00 | 62% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC NON-AUTOURINE W/O MICROSCOPY | $18.62 | $49.00 | 62% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Gallbladder removal, laparoscopic CPT 47562 HC LAP CHOLECYSTECTOMY | $4,655.76 | $12,252.00 | 62% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 HC LAP CHOLECYSTECTOMY | $4,655.76 | $12,252.00 | 62% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,413.60 | $3,720.00 | 62% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,413.60 | $3,720.00 | 62% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,415.88 | $3,726.00 | 62% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,415.88 | $3,726.00 | 62% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ A/S TRANSFORAM LUMBAR | $965.58 | $2,541.00 | 62% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ A/S TRANSFORAM LUMBAR | $965.58 | $2,541.00 | 62% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC ELECTROCARDIOGRAM COMPLETE | $26.60 | $70.00 | 62% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC ELECTROCARDIOGRAM COMPLETE | $26.60 | $70.00 | 62% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PHP FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $122.36 | $322.00 | 62% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PHP FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $122.36 | $322.00 | 62% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OP FAMILY TX WO PT PPRESENT 50MIN | $122.36 | $322.00 | 62% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OP FAMILY TX WO PT PPRESENT 50MIN | $122.36 | $322.00 | 62% |
| Group psychotherapy session CPT 90853 HC PHP GROUP PSYCHOTHERAPY | $122.36 | $322.00 | 62% |
| Group psychotherapy session CPT 90853 HC PHP INTERACTIVE GRP PSYC 45-50MINUTES | $122.36 | $322.00 | 62% |
| Group psychotherapy session inpatient CPT 90853 HC PHP INTERACTIVE GRP PSYC 45-50MINUTES | $122.36 | $322.00 | 62% |
| Group psychotherapy session inpatient CPT 90853 HC PHP GROUP PSYCHOTHERAPY | $122.36 | $322.00 | 62% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PT E/M LEVEL 3 | $48.26 | $127.00 | 62% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PT OUTPT VISIT LEVEL 3 | $154.28 | $406.00 | 62% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PT OUTPT VISIT LEVEL 3 W/ PROCEDURE | $154.28 | $406.00 | 62% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW PT E/M LEVEL 3 | $48.26 | $127.00 | 62% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW PT OUTPT VISIT LEVEL 3 | $154.28 | $406.00 | 62% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW PT OUTPT VISIT LEVEL 3 W/ PROCEDURE | $154.28 | $406.00 | 62% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PT E/M LEVEL 4 | $48.26 | $127.00 | 62% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PT OUTPT VISIT LEVEL 4 | $196.46 | $517.00 | 62% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PT OUTPT VISIT LEVEL 4 W/ PROCEDURE | $196.46 | $517.00 | 62% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW PT E/M LEVEL 4 | $48.26 | $127.00 | 62% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW PT OUTPT VISIT LEVEL 4 W/ PROCEDURE | $196.46 | $517.00 | 62% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW PT OUTPT VISIT LEVEL 4 | $196.46 | $517.00 | 62% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PT E/M LEVEL 5 | $48.26 | $127.00 | 62% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PT OUTPT VISIT LEVEL 5 | $289.18 | $761.00 | 62% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PT OUTPT VISIT LEVEL 5 W/ PROCEDURE | $289.18 | $761.00 | 62% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW PT E/M LEVEL 5 | $48.26 | $127.00 | 62% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW PT OUTPT VISIT LEVEL 5 W/ PROCEDURE | $289.18 | $761.00 | 62% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW PT OUTPT VISIT LEVEL 5 | $289.18 | $761.00 | 62% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PREV VISIT NEW AGE18-39 | $104.12 | $274.00 | 62% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PREV VISIT NEW AGE18-39 | $104.12 | $274.00 | 62% |
| Psychotherapy session, 30 minutes CPT 90832 HC PHP PSYCHOTHERAPY W/PATIENT 30 MINUTES | $138.32 | $364.00 | 62% |
| Psychotherapy session, 30 minutes CPT 90832 HC OP PSYCH TX 30 MIN | $138.32 | $364.00 | 62% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OP PSYCH TX 30 MIN | $138.32 | $364.00 | 62% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PHP PSYCHOTHERAPY W/PATIENT 30 MINUTES | $138.32 | $364.00 | 62% |
| Psychotherapy session, 45 minutes CPT 90834 HC PHP PSYCHOTHERAPY W/PATIENT 45 MINUTES | $122.36 | $322.00 | 62% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PHP PSYCHOTHERAPY W/PATIENT 45 MINUTES | $122.36 | $322.00 | 62% |
| Psychotherapy session, 60 minutes CPT 90837 HC PHP PSYCHOTHERAPY W/PATIENT 60 MINUTES | $122.36 | $322.00 | 62% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PHP PSYCHOTHERAPY W/PATIENT 60 MINUTES | $122.36 | $322.00 | 62% |
Source file: https://stmarysmaine.com/CMS%20Files/010211551_st-mary-_s-regional-medical-center_standardcharges.csv