SOUTHERN MAINE HEALTH CARE
Hospital
Procedure Prices at SOUTHERN MAINE HEALTH CARE
Blood Draw From Vein Using Needle
CPT 36415
$3.11
Lab Test - Complete Blood Cell Count
CPT 85025
$7.05
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$9.69
EKG
CPT 93000
$28.15
EKG Tracing
CPT 93005
$28.15
Individual Psychotherapy Session
CPT 90837
$55.46
Therapeutic Exercises
CPT 97110
$57.11
Therapeutic Activities
CPT 97530
$57.11
Mechanical Traction
CPT 97012
$59.1
Outpatient Clinic Visit
CPT 99213
$59.57
Chest X-Ray (1 view)
CPT 71045
$61.88
Chest X-Ray (2 views)
CPT 71046
$61.88
ER Visit — Low-Moderate Complexity
CPT 99283
$92.16
ER Visit — Moderate Complexity
CPT 99284
$92.16
ER Visit — High Complexity
CPT 99285
$92.16
Diagnostic Mammogram (unilateral)
CPT 77065
$97.92
Screening Mammogram (bilateral)
CPT 77067
$102.8
Echocardiogram w/ Doppler
CPT 93306
$105.46
CT Chest
CPT 71250
$118.86
Thoracic Spine X-Ray
CPT 72072
$118.86
Abdominal Ultrasound
CPT 76700
$118.86
Abdominal Ultrasound — Limited
CPT 76705
$118.86
Retroperitoneal Ultrasound
CPT 76770
$118.86
OB Ultrasound
CPT 76805
$118.86
Diagnostic Mammogram (bilateral)
CPT 77066
$124.88
Injection of Drug Into Spinal Nerve Root With Imaging Guidance
CPT 64483
$127.49
Colonoscopy
CPT 45378
$198.16
MRI Brain w/o Contrast
CPT 70551
$247.15
MRI Brain w/ Contrast
CPT 70553
$408.11
CT Abdomen & Pelvis
CPT 74177
$409.01
MRI Joint of Lower Extremity
CPT 73721
$423.45
Colonoscopy w/ Biopsy
CPT 45380
$472.16
Upper GI Endoscopy w/ Biopsy
CPT 43239
$812.15
Laparoscopic Hernia Repair
CPT 49650
$1,096.35
Cataract Surgery
CPT 66984
$1,898.8
Knee Arthroscopy
CPT 29881
$2,774.45
Inguinal Hernia Repair
CPT 49505
$3,212.17
Laparoscopic Cholecystectomy
CPT 47562
$5,126.26
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$5,693.7
Repair of Shoulder Rotator Cuff Using Arthroscope
CPT 29827
$8,542.19
Knee Replacement
CPT 27447
$11,506.42
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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.