MaineHealth - Memorial Hospital — price list

← Hospital overviewVerified from MaineHealth - Memorial Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

1,500 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
ABLATOR ARTHROSCOPIC SABER 30 DEGREE (028733) Outpatient	0272 RC	$199	$199	$67.63 – $187	—
ADAPTER UROLOK II BALL FITTING TUBING INTRODUCER (531630) Outpatient	0272 RC	$14.03	$14.03	$4.77 – $13.19	—
ADHESIVE SKIN DERMABOND ADVANCED 0.7ML (935077) Outpatient	0272 RC	$16.74	$16.74	$5.69 – $15.74	—
ADHESIVE SKIN DERMABOND PRINEO SKIN CLOSURE SYSTEM 22CM MESH (945460) Outpatient	0272 RC	$73.98	$73.98	$25.15 – $69.54	—
AGENT LIFT 5ML SUBMUCOSAL EVERLIFT (988308) Outpatient	0272 RC	$36.00	$36.00	$12.24 – $33.84	—
AIRWAY LARYNGEAL MASK SIZE 2.5 AURAONCE DISPOSABLE (945149) Outpatient	0272 RC	$5.13	$5.13	$1.74 – $4.82	—
AIRWAY LARYNGEAL MASK SIZE 5 SUPREME DISP (940324) Outpatient	0272 RC	$11.95	$11.95	$4.06 – $11.23	—
ALLOGRAFT BONE CANCELLOUS CRUSHED 30ML (945289) Outpatient	C1713 HCPCS	$299	$299	$102 – $281	$6,227
ALLOGRAFT BONE DOWEL CANCELLOUS TISSUE 18MM FLEXIGRAFT (1002748) Outpatient	C1762 HCPCS	$1,216	$1,216	$414 – $1,143	—
ALLOGRAFT BONE PUTTY 1ML DEMINERALIZED MATRIX (005965) Outpatient	C1713 HCPCS	$173	$173	$58.72 – $162	$6,227
ALLOGRAFT BONE PUTTY 2.5ML DEMINERALIZED MATRIX (005966) Outpatient	C1713 HCPCS	$386	$386	$131 – $362	$6,227
ALLOGRAFT TENDON GRACILIS FLEXIGRAFT (960994) Outpatient	C1762 HCPCS	$1,242	$1,242	$422 – $1,168	—
ALLOGRAFT TENDON SEMITENDINOSUS 17.5 X 5.5CM SOFT TISSUE (807650) Outpatient	C1762 HCPCS	$846	$846	$288 – $796	—
ALLOGRAFT TISSUE DERMAL ARTHROFLEX 40 X 70MM THICK (945675) Outpatient	Q4125 HCPCS	$3,889	$3,889	$1,322 – $3,656	—
ALLOGRAFT TISSUE NERVE AVANCE 3 X 50MM (035700) Outpatient	C1762 HCPCS	$5,678	$5,678	$1,931 – $5,337	—
ALLOGRAFT TISSUE NERVE AXOGUARD 10 X 40MM (039656) Outpatient	C1762 HCPCS	$2,621	$2,621	$891 – $2,464	—
ALLOGRAFT TISSUE QUADLINK CONSTRUCT (806560) Outpatient	C1762 HCPCS	$2,470	$2,470	$840 – $2,322	—
ANCHOR SUTURE 4.75 PEEK EYELET SWIVELOCK SP BIOCOMPOSITE (805313) Outpatient	C1713 HCPCS	$549	$549	$187 – $516	$6,227
ANCHOR SUTURE BIO-SUTURE TAK 3 X 14.5MM W/FIBERWIRE (934871) Outpatient	C1713 HCPCS	$305	$305	$104 – $287	$6,227
ANCHOR SUTURE HEALIX 3.4MM PEEK W/ORTHOCORD (962565) Outpatient	C1713 HCPCS	$418	$418	$142 – $393	$6,227
ANCHOR SUTURE HEALIX ADVANCE 6.5MM WITH PERMACORD (961273) Outpatient	C1713 HCPCS	$300	$300	$102 – $282	$6,227
ANCHOR SUTURE JUGGERKNOT 1.0MM MINI 2-0 NEEDLE WITH DRILL (947897) Outpatient	C1713 HCPCS	$259	$259	$88.15 – $244	$6,227
ANCHOR SUTURE QUICKANCHOR+ 1.3MM W/ORTHOCORD (961179) Outpatient	C1713 HCPCS	$503	$503	$171 – $473	$6,227
ANCHOR SUTURE SWIVELOCK 5.5 X 24MM FIBERTAPE BIOCOMPOSITE (945672) Outpatient	C1713 HCPCS	$1,780	$1,780	$605 – $1,673	$6,227
ANCHOR SUTURE SWIVELOCK PEEK ACHILLES (038765) Outpatient	C1713 HCPCS	$1,740	$1,740	$592 – $1,636	$6,227
ANCHOR SUTURE TIGHTROPE 1.1MM SYNDESMOSIS KIT (944497) Outpatient	C1713 HCPCS	$695	$695	$236 – $653	$6,227
ANCHOR SUTURE TIGHTROPE SYNDESMOSIS REPAIR TITANIUM (970687) Outpatient	C1713 HCPCS	$1,258	$1,258	$428 – $1,183	$6,227
APPLICATOR ENDOSCOPIC FLOSEAL (023910) Outpatient	0272 RC	$60.89	$60.89	$20.70 – $57.24	—
ASMBLY SCHUHLI F/ SCR 4.5MM S (526738) Outpatient	C1713 HCPCS	$231	$231	$78.66 – $217	$6,227
ASMBLY SCHUHLI SCR SS 3.5MM S (526741) Outpatient	C1713 HCPCS	$252	$252	$85.52 – $236	$6,227