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Hospital

Sebasticook Valley Health

Sebasticook Valley Health in Pittsfield, ME publishes cash prices for 42 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.

447 Main St, Pittsfield, ME 04967 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 > PARAMETERS $1,586.10 $4,665.00 66%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 > PARAMETERS $1,586.10 $4,665.00 66%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL-Q $64.94 $191.00 66%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PAN $64.94 $191.00 66%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL-Q $64.94 $191.00 66%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PAN $64.94 $191.00 66%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE $45.90 $135.00 66%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE $45.90 $135.00 66%
Complete blood count (CBC) with differential CPT 85025 CBC/AUTO DIFF $41.48 $122.00 66%
Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFF-Q $41.48 $122.00 66%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC/AUTO DIFF $41.48 $122.00 66%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFF-Q $41.48 $122.00 66%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM $23.80 $70.00 66%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFFERENTIAL-Q $23.80 $70.00 66%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM $23.80 $70.00 66%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFFERENTIAL-Q $23.80 $70.00 66%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PAN $96.56 $284.00 66%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANL-Q $96.56 $284.00 66%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PAN $96.56 $284.00 66%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANL-Q $96.56 $284.00 66%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL-Q $34.68 $102.00 66%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $34.68 $102.00 66%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $34.68 $102.00 66%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL-Q $34.68 $102.00 66%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL-Q $49.64 $146.00 66%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PAN $49.64 $146.00 66%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PAN $49.64 $146.00 66%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL-Q $49.64 $146.00 66%
Obstetric blood test panel CPT 80055 PRENATAL PROFILE $165.58 $487.00 66%
Obstetric blood test panel inpatient CPT 80055 PRENATAL PROFILE $165.58 $487.00 66%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE $55.42 $163.00 66%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE $55.42 $163.00 66%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (PART OF PSA FREE) $49.98 $147.00 66%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPE-AG/LAB $49.98 $147.00 66%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPE-AG/LAB $49.98 $147.00 66%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (PART OF PSA FREE) $49.98 $147.00 66%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL $28.56 $84.00 66%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT SUBSTITUTION, EA $28.56 $84.00 66%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT/LAB $28.56 $84.00 66%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT/LAB $28.56 $84.00 66%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT SUBSTITUTION, EA $28.56 $84.00 66%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL $28.56 $84.00 66%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/LAB $15.98 $47.00 66%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/LAB $15.98 $47.00 66%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH/LAB $54.40 $160.00 66%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH/LAB $54.40 $160.00 66%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS/AUTO/MIC $15.98 $47.00 66%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS REFLEX TO CULTURE-Q $15.98 $47.00 66%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS REFLEX TO CULTURE-Q $15.98 $47.00 66%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS/AUTO/MIC $15.98 $47.00 66%
Urinalysis without microscope exam, automated CPT 81003 UA MACROSCOPIC $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 URINE SCREEN/LAB $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 URINE PH/LAB $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY/LAB $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 URINE SCREEN AUTOMATED $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/MICROSCOPIC-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACROSCOPIC-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 PH URINE-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated CPT 81003 RH URINALYSIS AUTO W/O SCOPE $12.92 $38.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA MACROSCOPIC $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SCREEN/LAB $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH/LAB $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY/LAB $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SCREEN AUTOMATED $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACROSCOPIC-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/MICROSCOPIC-Q $12.58 $37.00 66%
Urinalysis without microscope exam, automated inpatient CPT 81003 RH URINALYSIS AUTO W/O SCOPE $12.92 $38.00 66%
Urinalysis without microscope exam, manual CPT 81002 RH UA NONAUTO W/O SCOPE $4.76 $14.00 66%
Urinalysis without microscope exam, manual CPT 81002 RH URINALYSIS, MANUAL TEST $9.18 $27.00 66%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS MANUAL TEST $9.18 $27.00 66%
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK $9.18 $27.00 66%
Urinalysis without microscope exam, manual CPT 81002 URINE SUGAR/LAB $9.18 $27.00 66%
Urinalysis without microscope exam, manual inpatient CPT 81002 RH UA NONAUTO W/O SCOPE $4.76 $14.00 66%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK $9.18 $27.00 66%
Urinalysis without microscope exam, manual inpatient CPT 81002 RH URINALYSIS, MANUAL TEST $9.18 $27.00 66%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE SUGAR/LAB $9.18 $27.00 66%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS MANUAL TEST $9.18 $27.00 66%

Surgery and procedures

ProcedureCash price List priceOff list
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/SNARE $356.66 $1,049.00 66%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/SNARE $356.66 $1,049.00 66%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY $332.52 $978.00 66%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY $332.52 $978.00 66%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC $297.84 $876.00 66%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAGNOSTIC $297.84 $876.00 66%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPYCHOLECYSTECTOMY $503.54 $1,481.00 66%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPYCHOLECYSTECTOMY $503.54 $1,481.00 66%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 INGUINAL HERNIA INITIAL $399.84 $1,176.00 66%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 INGUINAL HERNIA INITIAL $399.84 $1,176.00 66%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MENISCEC $565.08 $1,662.00 66%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MENISCEC $565.08 $1,662.00 66%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ INTERLAMINAR LUMBAR/SAC $941.80 $2,770.00 66%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ INTERLAMINAR LUMBAR/SAC $941.80 $2,770.00 66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 XR INJ FORAMEN EPIDURAL L/S $171.36 $504.00 66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PF XR INJ FORAMEN EPIDURAL L/S $187.68 $552.00 66%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S $187.68 $552.00 66%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 XR INJ FORAMEN EPIDURAL L/S $171.36 $504.00 66%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PF XR INJ FORAMEN EPIDURAL L/S $187.68 $552.00 66%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S $187.68 $552.00 66%
Prostate biopsy CPT 55700 BX PROSTATE FACILITY $187.68 $552.00 66%
Prostate biopsy inpatient CPT 55700 BX PROSTATE FACILITY $187.68 $552.00 66%
Removal of a breast lump, open surgery CPT 19120 REMOVAL BREAST LESION $397.80 $1,170.00 66%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL BREAST LESION $397.80 $1,170.00 66%
Total knee replacement CPT 27447 PF ARTHROPLASTY KNEE MED & LAT $989.74 $2,911.00 66%
Total knee replacement inpatient CPT 27447 PF ARTHROPLASTY KNEE MED & LAT $989.74 $2,911.00 66%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY W/BX $342.04 $1,006.00 66%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY W/BX GSTR $342.04 $1,006.00 66%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY W/BX GSTR $342.04 $1,006.00 66%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY W/BX $342.04 $1,006.00 66%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY DX $220.66 $649.00 66%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY DX $220.66 $649.00 66%

Doctor visits and therapy

ProcedureCash price List priceOff list
Family therapy with the patient, 50 minutes CPT 90847 PF FAMILY PSYTX W/PT 50 MIN $64.94 $191.00 66%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PF FAMILY PSYTX W/PT 50 MIN $64.94 $191.00 66%
New patient office visit, about 30 minutes CPT 99203 HC NEW PT OV LEVEL III $63.58 $187.00 66%
New patient office visit, about 30 minutes CPT 99203 HC INITIAL VISIT LEVEL III $63.58 $187.00 66%
New patient office visit, about 30 minutes CPT 99203 PF NEW PT OV LEVEL III $85.68 $252.00 66%
New patient office visit, about 30 minutes CPT 99203 DETAILED VISIT LEVEL III NEW C $85.68 $252.00 66%
New patient office visit, about 30 minutes CPT 99203 CLINIC VISITPROFLEV IIINP $85.68 $252.00 66%
New patient office visit, about 30 minutes CPT 99203 PF INITIAL VISIT LEVL III GSTR $85.68 $252.00 66%
New patient office visit, about 30 minutes CPT 99203 PF INITIAL VISIT LEVEL III $85.68 $252.00 66%
New patient office visit, about 30 minutes CPT 99203 PF OFFIC/OUTPT VISIT LVL 3 NEW $85.68 $252.00 66%
New patient office visit, about 30 minutes CPT 99203 RH BH NEW PT OV LEVEL III $149.26 $439.00 66%
New patient office visit, about 30 minutes CPT 99203 RH NEW PT OV LEVEL III $149.26 $439.00 66%
New patient office visit, about 30 minutes CPT 99203 RH OFFIC/OUTPT VISIT LVL 3 NEW $149.26 $439.00 66%
New patient office visit, about 30 minutes inpatient CPT 99203 PF INITIAL VISIT LEVEL III $85.68 $252.00 66%
New patient office visit, about 30 minutes inpatient CPT 99203 PF OFFIC/OUTPT VISIT LVL 3 NEW $85.68 $252.00 66%
New patient office visit, about 30 minutes inpatient CPT 99203 DETAILED VISIT LEVEL III NEW C $85.68 $252.00 66%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC VISITPROFLEV IIINP $85.68 $252.00 66%
New patient office visit, about 30 minutes inpatient CPT 99203 PF INITIAL VISIT LEVL III GSTR $85.68 $252.00 66%
New patient office visit, about 30 minutes inpatient CPT 99203 PF NEW PT OV LEVEL III $85.68 $252.00 66%
New patient office visit, about 45 minutes CPT 99204 HC INITIAL VISIT LEVEL IV $86.70 $255.00 66%
New patient office visit, about 45 minutes CPT 99204 HC NEW PT OV LEVEL IV $86.70 $255.00 66%
New patient office visit, about 45 minutes CPT 99204 PF NEW PT OV LEVEL IV $128.86 $379.00 66%
New patient office visit, about 45 minutes CPT 99204 COMP VISIT LEVEL IV NEW COMM $128.86 $379.00 66%
New patient office visit, about 45 minutes CPT 99204 INITIAL VISIT LEVEL IV PROF $128.86 $379.00 66%
New patient office visit, about 45 minutes CPT 99204 PF INITIAL VISIT LEVEL IV GSTR $128.86 $379.00 66%
New patient office visit, about 45 minutes CPT 99204 PF INITIAL VISIT LEVEL IV $128.86 $379.00 66%
New patient office visit, about 45 minutes CPT 99204 PF OFFIC/OUTPT VISIT LVL 4 NEW $128.86 $379.00 66%
New patient office visit, about 45 minutes CPT 99204 RH BH NEW PT OV LEVEL IV $215.56 $634.00 66%
New patient office visit, about 45 minutes CPT 99204 RH NEW PT OV LEVEL IV $215.56 $634.00 66%
New patient office visit, about 45 minutes CPT 99204 RH OFFIC/OUTPT VISIT LVL 4 NEW $215.56 $634.00 66%
New patient office visit, about 45 minutes inpatient CPT 99204 PF INITIAL VISIT LEVEL IV $128.86 $379.00 66%
New patient office visit, about 45 minutes inpatient CPT 99204 COMP VISIT LEVEL IV NEW COMM $128.86 $379.00 66%
New patient office visit, about 45 minutes inpatient CPT 99204 INITIAL VISIT LEVEL IV PROF $128.86 $379.00 66%
New patient office visit, about 45 minutes inpatient CPT 99204 PF INITIAL VISIT LEVEL IV GSTR $128.86 $379.00 66%
New patient office visit, about 45 minutes inpatient CPT 99204 PF NEW PT OV LEVEL IV $128.86 $379.00 66%
New patient office visit, about 45 minutes inpatient CPT 99204 PF OFFIC/OUTPT VISIT LVL 4 NEW $128.86 $379.00 66%
New patient office visit, about 60 minutes CPT 99205 HC INITIAL VISIT LEVEL V $152.66 $449.00 66%
New patient office visit, about 60 minutes CPT 99205 HC NEW PT OV LEVEL V $152.66 $449.00 66%
New patient office visit, about 60 minutes CPT 99205 PF NEW PT OV LEVEL V $169.32 $498.00 66%
New patient office visit, about 60 minutes CPT 99205 PF INITIAL VISIT LEVEL V $169.32 $498.00 66%
New patient office visit, about 60 minutes CPT 99205 PF OFFIC/OUTPT VISIT LVL 5 NEW $169.32 $498.00 66%
New patient office visit, about 60 minutes CPT 99205 COMP VISIT LEVEL V NEW COMM $169.32 $498.00 66%
New patient office visit, about 60 minutes CPT 99205 INITIAL VISIT LEVEL V PROF $169.32 $498.00 66%
New patient office visit, about 60 minutes CPT 99205 PF INITIAL VISIT LEVEL V GSTR $169.32 $498.00 66%
New patient office visit, about 60 minutes CPT 99205 RH OFFIC/OUTPT VISIT LVL 5 NEW $321.98 $947.00 66%
New patient office visit, about 60 minutes CPT 99205 RH BH NEW PT OV LEVEL V $321.98 $947.00 66%
New patient office visit, about 60 minutes CPT 99205 RH NEW PT OV LEVEL V $321.98 $947.00 66%
New patient office visit, about 60 minutes inpatient CPT 99205 COMP VISIT LEVEL V NEW COMM $169.32 $498.00 66%
New patient office visit, about 60 minutes inpatient CPT 99205 PF OFFIC/OUTPT VISIT LVL 5 NEW $169.32 $498.00 66%
New patient office visit, about 60 minutes inpatient CPT 99205 PF INITIAL VISIT LEVEL V $169.32 $498.00 66%
New patient office visit, about 60 minutes inpatient CPT 99205 PF NEW PT OV LEVEL V $169.32 $498.00 66%
New patient office visit, about 60 minutes inpatient CPT 99205 PF INITIAL VISIT LEVEL V GSTR $169.32 $498.00 66%
New patient office visit, about 60 minutes inpatient CPT 99205 INITIAL VISIT LEVEL V PROF $169.32 $498.00 66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 SP THERAPEUTIC EXER 15 MINS $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LYMPHEDEMA THERPUTC EXRCSE .25 $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPUTIC EXERCISE .25 HR $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THERAPUTIC EXERCISE .25 HR $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE .25 $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OTA THERAPEUTIC EXERCISE .25 $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPUTIC EXERCISE .25 HR $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THERAPUTIC EXERCISE .25 HR $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE .25 $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OTA THERAPEUTIC EXERCISE .25 $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 SP THERAPEUTIC EXER 15 MINS $44.88 $132.00 66%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 LYMPHEDEMA THERPUTC EXRCSE .25 $44.88 $132.00 66%
Preventive checkup, new patient aged 18–39 CPT 99385 HC NP PREV 18-39YR $20.74 $61.00 66%
Preventive checkup, new patient aged 18–39 CPT 99385 HC NP PREV 18-39 YR $20.74 $61.00 66%
Preventive checkup, new patient aged 18–39 CPT 99385 PF NP PREV 18-39 YR $94.86 $279.00 66%
Preventive checkup, new patient aged 18–39 CPT 99385 PF NP PREV 18-39YR $94.86 $279.00 66%
Preventive checkup, new patient aged 18–39 CPT 99385 RH NEW PREV 18-39 YRS $115.60 $340.00 66%
Preventive checkup, new patient aged 18–39 CPT 99385 RH PREV VISIT NEW AGE 18-39 $211.82 $623.00 66%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC NP PREV 18-39 YR $20.74 $61.00 66%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC NP PREV 18-39YR $20.74 $61.00 66%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PF NP PREV 18-39YR $94.86 $279.00 66%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PF NP PREV 18-39 YR $94.86 $279.00 66%
Preventive checkup, new patient aged 40–64 CPT 99386 HC NP PREV 40-64 YR $24.48 $72.00 66%
Preventive checkup, new patient aged 40–64 CPT 99386 HC NP PREV 40-64YR $24.48 $72.00 66%
Preventive checkup, new patient aged 40–64 CPT 99386 PF NP PREV 40-64 YR $115.26 $339.00 66%
Preventive checkup, new patient aged 40–64 CPT 99386 PF NP PREV 40-64YR $115.26 $339.00 66%
Preventive checkup, new patient aged 40–64 CPT 99386 RH NEW PREV 40-64 YRS $140.08 $412.00 66%
Preventive checkup, new patient aged 40–64 CPT 99386 RH PREV VISIT NEW AGE 40-64 $277.78 $817.00 66%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC NP PREV 40-64YR $24.48 $72.00 66%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC NP PREV 40-64 YR $24.48 $72.00 66%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PF NP PREV 40-64YR $115.26 $339.00 66%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PF NP PREV 40-64 YR $115.26 $339.00 66%
Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W/PATIENT 30 MINUTES $52.70 $155.00 66%
Psychotherapy session, 30 minutes CPT 90832 PF PSYTX W/PATIENT 30 MINUTES $85.68 $252.00 66%
Psychotherapy session, 30 minutes CPT 90832 PF PSYTX W PT 30 MIN $85.68 $252.00 66%
Psychotherapy session, 30 minutes CPT 90832 RH PSYTX PT&/FAMILY 30 MINUTES $138.38 $407.00 66%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W/PATIENT 30 MINUTES $52.70 $155.00 66%
Psychotherapy session, 30 minutes inpatient CPT 90832 PF PSYTX W/PATIENT 30 MINUTES $85.68 $252.00 66%
Psychotherapy session, 30 minutes inpatient CPT 90832 PF PSYTX W PT 30 MIN $85.68 $252.00 66%
Psychotherapy session, 30 minutes inpatient CPT 90832 RH PSYTX PT&/FAMILY 30 MINUTES $138.38 $407.00 66%
Psychotherapy session, 45 minutes CPT 90834 RH PSYTX PT&/FAMILY 45 MINUTES $170.34 $501.00 66%
Psychotherapy session, 45 minutes CPT 90834 PF PSYTX W PT 45 MIN $170.34 $501.00 66%
Psychotherapy session, 45 minutes inpatient CPT 90834 RH PSYTX PT&/FAMILY 45 MINUTES $170.34 $501.00 66%
Psychotherapy session, 45 minutes inpatient CPT 90834 PF PSYTX W PT 45 MIN $170.34 $501.00 66%
Psychotherapy session, 60 minutes CPT 90837 RH PSYTX PT&/FAMILY 60 MINUTES $254.32 $748.00 66%
Psychotherapy session, 60 minutes CPT 90837 PF PSYTX W PT 60 MIN $255.68 $752.00 66%
Psychotherapy session, 60 minutes inpatient CPT 90837 RH PSYTX PT&/FAMILY 60 MINUTES $254.32 $748.00 66%
Psychotherapy session, 60 minutes inpatient CPT 90837 PF PSYTX W PT 60 MIN $255.68 $752.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT LVL 3 NEW $25.84 $76.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT LVL 3 EST $25.84 $76.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OFFICE CONSULT LVL 3 EST $66.64 $196.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OFFICE CONSULT LVL 3 NEW $66.64 $196.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 RH OFFICE CONSULT LVL 3 NEW $96.56 $284.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 RH OFFICE CONSULT LVL 3 EST $96.56 $284.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OFFICE CONSULT NEW LVL 3 $158.44 $466.00 66%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OFFICE CONSULT EST LVL 3 $158.44 $466.00 66%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OFFICE CONSULT LVL 3 NEW $66.64 $196.00 66%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OFFICE CONSULT LVL 3 EST $66.64 $196.00 66%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OFFICE CONSULT EST LVL 3 $158.44 $466.00 66%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OFFICE CONSULT NEW LVL 3 $158.44 $466.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT LVL 4 NEW $34.68 $102.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT LVL 4 EST $34.68 $102.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF OFFICE CONSULT LVL 4 EST $133.62 $393.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF OFFICE CONSULT LVL 4 NEW $133.62 $393.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 RH OFFICE CONSULT LVL 4 NEW $173.40 $510.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 RH BH OFFICE CONSULT LVL 4 EST $173.40 $510.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 RH BH OFFICE CONSULT LVL 4 NEW $173.40 $510.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 RH OFFICE CONSULT LVL 4 EST $173.40 $510.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF OFFICE CONSULT EST LVL 4 $235.96 $694.00 66%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF OFFICE CONSULT NEW LVL 4 $235.96 $694.00 66%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF OFFICE CONSULT LVL 4 NEW $133.62 $393.00 66%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF OFFICE CONSULT LVL 4 EST $133.62 $393.00 66%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF OFFICE CONSULT EST LVL 4 $235.96 $694.00 66%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF OFFICE CONSULT NEW LVL 4 $235.96 $694.00 66%

Source file: https://northernlighthealth.org/NLH/media/Price-Transparency/010263628_Sebasticook-Valley-hospital_standardcharges.csv