Western Maine Health Menu
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| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 45 Minutes (434000022) | $366.45 |
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| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (434000019) | $366.45 |
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| Occupational Therapy - Evaluation Of Occupational Therapy Established Plan Of Care, Typically 60 Minutes (434000025) | $366.45 |
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| Occupational Therapy - Application Of Hot Wax Bath To 1 Or More Areas (430000022) | $107.10 |
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| Occupational Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Each 15 Minutes (431000001) | $107.10 |
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| Observation - Hospital Observation Care - Direct Admission Service(S) (762000027) | $160.65 |
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| Observation (762000001) | $105.00 |
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| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Radioactive Material Distribution (878803) | $1,239.00 |
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| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Liver (878205) | $1,789.20 |
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| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Heart, Single Study (878451) | $1,276.80 |
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| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Heart, Multiple Studies (878452) | $2,941.05 |
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| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Bones Or Joints (878320) | $1,239.00 |
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| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan At Site Of Inflammation (878807) | $1,239.00 |
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| Nuclear Medicine - Diagnostic Study Of Radioactive Material Distribution, Whole Body With Imaging Over 2 Or More Days (878804) | $3,473.40 |
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| Nuclear Medicine - Diagnostic Study Of Radioactive Material Distribution, Whole Body With Imaging On Single Day (878802) | $1,743.00 |
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| Nuclear Medicine - Diagnostic Stomach Emptying Study (878264) | $1,604.40 |
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| Nuclear Medicine - Diagnostic Scan Of Testicles With Blood Flow (878761) | $1,009.05 |
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| Nuclear Medicine - Diagnostic Scan Of Stomach Lining (878261) | $624.75 |
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| Nuclear Medicine - Diagnostic Scan Of Radioactive Material Distribution, Limited Area (878800) | $1,340.85 |
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| Nuclear Medicine - Diagnostic Scan Of Parathyroid (878070) | $1,102.50 |
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| Nuclear Medicine - Diagnostic Scan Of Lymphatic Tissue And Lymph Node (878195) | $1,795.50 |
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| Nuclear Medicine - Diagnostic Scan Of Lung Ventilation And Blood Circulation (878582) | $1,523.55 |
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| Nuclear Medicine - Diagnostic Scan Of Lung Ventilation (878579) | $1,964.55 |
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| Nuclear Medicine - Diagnostic Scan Of Liver And Spleen (878215) | $1,132.95 |
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| Nuclear Medicine - Diagnostic Scan Of Liver And Ducts With Drug Intervention (878227) | $1,954.05 |
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| Nuclear Medicine - Diagnostic Scan Of Liver And Ducts (878226) | $1,795.50 |
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| Nuclear Medicine - Diagnostic Scan Of Kidney Blood Flow And Function, Single Study Without Drug Intervention (878707) | $1,286.25 |
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| Nuclear Medicine - Diagnostic Scan Of Kidney Blood Flow And Function, Single Study With Drug Intervention (878708) | $1,495.20 |
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| Nuclear Medicine - Diagnostic Scan Of Kidney Blood Flow And Function, Multiple Studies With And Without Drug Intervention (878709) | $2,385.60 |
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| Nuclear Medicine - Diagnostic Scan Of Heart After Heart Attack With Ejection Fraction (878468) | $347.55 |
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| Nuclear Medicine - Diagnostic Scan Of Heart After Heart Attack With Ejection Fraction (341000045) | $347.55 |
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| Nuclear Medicine - Diagnostic Scan Of Heart After Heart Attack (878466) | $1,243.20 |
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| Nuclear Medicine - Diagnostic Scan Of Esophageal Motion (878258) | $624.75 |
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| Nuclear Medicine - Diagnostic Scan Of Bones Or Joints, Whole Body (878306) | $1,594.95 |
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| Nuclear Medicine - Diagnostic Scan Of Bones Or Joints, Multiple (878305) | $1,594.95 |
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| Nuclear Medicine - Diagnostic Scan Of Bones Or Joints, Limited (878300) | $594.30 |
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| Nuclear Medicine - Diagnostic Scan Of Bones Or Joints, 3 Phase Study (878315) | $1,992.90 |
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| Nuclear Medicine - Diagnostic Scan Of Blood Circulation In The Lungs (878580) | $919.80 |
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| Nuclear Medicine - Diagnostic Scan For Reflux Of Urine Into Kidney (878740) | $1,460.55 |
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| Nuclear Medicine - Diagnostic Scan For Acute Blood Loss (878278) | $946.05 |
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| Nuclear Medicine - Diagnostic Scan At Site Of Inflammation, Whole Body (878806) | $1,743.00 |
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| Nuclear Medicine - Diagnostic Scan At Site Of Inflammation, Limited Area (878805) | $1,340.85 |
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| Nuclear Medicine - Diagnostic Regurgitation Study (878262) | $624.75 |
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| Non-Sterile Supplies (271000001) | $855.04 |
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| Labor & Delivery - Turning Of Fetus From Breech To Presenting Position (720000016) | $919.80 |
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| Labor & Delivery - Insertion Dilator Device Into Cervix (721000026) | $226.80 |
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| Labor & Delivery (720000035) | $1,270.50 |
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| Labor & Delivery (720000037) | $263.55 |
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| Labor & Delivery (720000036) | $144.90 |
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| Lab - Zonisamide Level (301000079) | $336.00 |
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| Lab - Zinc Level (301000384) | $206.00 |
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| Lab - Zinc Level (301000550) | $116.00 |
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| Lab - White Blood Cell Function Test (Nitroblue Tetrazolium Dye) (302000078) | $327.60 |
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| Lab - White Blood Cell Examination Without Manual White Cell Differential Count (301000393) | $75.60 |
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| Lab - White Blood Cell Examination With Manual White Cell Differential Count (301000392) | $75.60 |
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| Lab - White Blood Cell Enzyme Assay And Count (305000024) | $116.55 |
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| Lab - White Blood Cell Count (Automated) (301000401) | $67.20 |
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| Lab - White Blood Cell Count (Automated) (301000400) | $47.25 |
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| Lab - White Blood Cell Antibodies Identification (302000020) | $256.00 |
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| Lab - White Blood Cell Antibodies Identification (302000022) | $182.00 |
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| Lab - White Blood Cell Antibodies Identification (302000021) | $95.00 |
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| Lab - White Blood Cell Analysis Of Stool Specimen (300000082) | $43.05 |
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| Lab - Volatile Chemicals Identification In Specimen (301000382) | $396.90 |
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| Lab - Volatile Chemicals Identification In Specimen (301000383) | $323.40 |
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| Lab - Vitamin E Level (301000366) | $186.00 |
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| Lab - Vitamin D-3 Level (301000150) | $176.40 |
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| Lab - Vitamin D-3 Level (301000115) | $160.00 |
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| Lab - Vitamin D Level (1,25-Dihydroxy) (301000165) | $184.00 |
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| Lab - Vitamin B-6 Level (301000342) | $338.00 |
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| Lab - Vitamin B-6 Level (301000598) | $63.00 |
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| Lab - Vitamin B-2 Level (302000190) | $75.00 |
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| Lab - Vitamin B-12 Level (Cyanocobalamin Level) (301000160) | $257.25 |
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| Lab - Vitamin B-1 Level (301000357) | $75.00 |
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| Lab - Vitamin B-1 Level (301000597) | $53.00 |
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| Lab - Vitamin A Level (301000381) | $221.00 |
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| Lab - Viral Antibody Analysis (301000574) | $32.00 |
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| Lab - Viral Antibody Analysis (302000254) | $27.00 |
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| Lab - Very Long Chain Fatty Acids Level (301000472) | $134.00 |
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| Lab - Vasoactive Intestinal Peptide Level (301000380) | $470.00 |
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| Lab - Varicella-Zoster Antibody Analysis (302000137) | $94.50 |
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| Lab - Varicella-Zoster Antibody Analysis (302000138) | $86.00 |
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| Lab - Vanillylmandelic Acid Level In Urine (301000379) | $57.00 |
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| Lab - Vancomycin Level (301000068) | $213.15 |
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| Lab - Valproic Acid Level (Total) (301000045) | $55.65 |
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| Lab - Valproic Acid Level (Free) (301000475) | $55.65 |
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| Lab - Urine Pregnancy Test (307000035) | $144.90 |
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| Lab - Urine Pregnancy Test (300000005) | $23.10 |
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| Lab - Urine Concentration Measurement (301000309) | $53.55 |
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| Lab - Urine Concentration Measurement (301000581) | $17.00 |
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| Lab - Uric Acid Level In Specimen Other Than Blood (301000378) | $23.10 |
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| Lab - Uric Acid Level In Specimen Other Than Blood (301000586) | $12.00 |
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| Lab - Uric Acid Level In Blood (301000377) | $75.60 |
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| Lab - Urea Nitrogen Level In Urine (Bun Only) (301000376) | $78.75 |
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| Lab - Urea Nitrogen Level In Urine (Bun Only) (301000588) | $12.00 |
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| Lab - Urea Nitrogen Level In Urine (24 Hour Clearance) (301000528) | $78.75 |
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| Lab - Urea Nitrogen Level In Blood (Quantitative) (301000375) | $75.60 |
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| Lab - Tuberculosis Antigen Analysis (Gamma Interferon-Producing T-Cell Quantification) (301000541) | $128.00 |
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| Lab - Tuberculosis Antigen Analysis (Gamma Interferon Secretion Test) (302000189) | $123.00 |
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| Lab - Troponin Protein Level (301000374) | $151.20 |
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| Lab - Triglycerides Level (301000370) | $153.30 |
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| Lab - Triglycerides Level (301000442) | $41.00 |
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| Lab - Treponema Pallidum Antibody Analysis (302000213) | $151.20 |
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| Lab - Treponema Pallidum Antibody Analysis (300000197) | $106.00 |
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| Lab - Treponema Pallidum Antibody Analysis (302000188) | $44.00 |
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| Lab - Transplant Antibodies Measurement (Standard Method) (302000143) | $699.30 |
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| Lab - Transplant Antibodies Measurement (Standard Method) (302000142) | $179.55 |
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| Lab - Transcortin Protein Level (302000183) | $93.00 |
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| Lab - Toxoplasma Antibody Analysis (Igm) (302000136) | $182.00 |
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| Lab - Toxoplasma Antibody Analysis (Except Igm Only) (302000135) | $195.00 |
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| Lab - Total Protein Level In Urine (301000335) | $202.65 |
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| Lab - Total Protein Level In Body Fluid (301000336) | $75.60 |
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| Lab - Total Protein Level In Blood (301000334) | $47.25 |
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| Lab - Total Cell Count For Natural Killer Cells (302000068) | $308.70 |
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| Lab - Total Cell Count For Natural Killer Cells (302000069) | $44.10 |
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| Lab - Total Cell Count For Natural Killer Cells (300000137) | $44.10 |
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| Lab - Total Cell Count For B Cells (302000065) | $234.15 |
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| Lab - Total Cell Count For B Cells (302000066) | $184.80 |
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| Lab - Total Cell Count For B Cells (302000067) | $50.40 |
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| Lab - Total Cell Count For B Cells (302000064) | $37.80 |
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| Lab - Topiramate Level (301000067) | $345.00 |
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| Lab - Tobramycin Level (301000066) | $240.45 |
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| Lab - Tissue Culture Inoculation For Virus Isolation And Identification (300000075) | $754.95 |
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| Lab - Tissue Culture Inoculation For Virus Isolation And Identification (300000074) | $279.30 |
N/A
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| Lab - Tissue Culture Inoculation For Virus Isolation And Identification (300000076) | $124.95 |
N/A
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| Lab - Thyroxine Level (Total) (301000359) | $116.55 |
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| Lab - Thyroxine Level (Free) (301000361) | $75.60 |
N/A
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| Lab - Thyroxine Level (Free) (301000571) | $53.00 |
N/A
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| Lab - Thyroxine Binding Globulin Level (301000362) | $363.00 |
N/A
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| Lab - Thyroid Stimulating Immune Globulin Level (301000365) | $434.00 |
N/A
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| Lab - Thyroid Stimulating Hormone Level (301000364) | $267.00 |
N/A
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| Lab - Thyroid Stimulating Hormone Level (301000363) | $218.40 |
N/A
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| Lab - Thyroid Stimulating Hormone Level (300000185) | $34.00 |
N/A
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| Lab - Thyroid Hormone Level (T3 Total) (301000372) | $240.45 |
N/A
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| Lab - Thyroid Hormone Level (T3 Reverse) (301000424) | $102.00 |
N/A
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| Lab - Thyroid Hormone Level (T3 Free) (301000373) | $357.00 |
N/A
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| Lab - Thyroid Hormone Level (Calcitonin) (301000116) | $260.00 |
N/A
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| Lab - Thyroid Hormone Analysis (301000371) | $46.20 |
N/A
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| Lab - Thyroglobulin Hormone Level (300000189) | $276.00 |
N/A
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| Lab - Thyroglobulin Hormone Level (301000358) | $226.00 |
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| Lab - Thyroglobulin Hormone Level (300000221) | $40.00 |
N/A
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| Lab - Thyroglobulin Antibody Measurement (302000139) | $169.05 |
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| Lab - Thyroglobulin Antibody Measurement (302000140) | $165.00 |
N/A
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| Lab - Thyroglobulin Antibody Measurement (300000188) | $46.00 |
N/A
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| Lab - Thyroglobulin Antibody Measurement (300000223) | $38.00 |
N/A
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| Lab - Thyroglobulin Antibody Measurement (300000184) | $27.00 |
N/A
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| Lab - Thiocyanate Level (301000439) | $185.00 |
N/A
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| Lab - Theophylline Level (301000065) | $240.45 |
N/A
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| Lab - Thawing Of Fresh Frozen Plasma (300000031) | $24.15 |
N/A
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| Lab - Tetanus Antibody Analysis (302000134) | $21.00 |
N/A
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| Lab - Testosterone Level (Total) (301000356) | $344.00 |
N/A
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| Lab - Testosterone Level (Total) (301000354) | $289.80 |
N/A
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| Lab - Testosterone Level (Total) (301000355) | $263.00 |
N/A
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| Lab - Testosterone Level (Total) (301000557) | $77.00 |
N/A
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| Lab - Testosterone Level (Total) (301000613) | $57.00 |
N/A
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| Lab - Testosterone Level (Free) (301000352) | $190.00 |
N/A
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| Lab - Testosterone Level (Free) (301000353) | $163.00 |
N/A
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| Lab - Testosterone Level (Free) (301000612) | $57.00 |
N/A
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| Lab - Testosterone Level (Free) (301000611) | $57.00 |
N/A
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| Lab - Testosterone Level (Bioavailable) (301000556) | $156.00 |
N/A
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| Lab - Tacrolimus Level (301000064) | $429.00 |
N/A
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| Lab - Tacrolimus Level (301000063) | $353.85 |
N/A
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| Lab - Syphyilis Antigen Measurement (302000215) | $72.45 |
N/A
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| Lab - Syphyilis Antigen Measurement (302000084) | $37.00 |
N/A
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| Lab - Syphilis Antibody Identification (302000082) | $86.10 |
N/A
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| Lab - Syphilis Antibody Identification (302000083) | $79.80 |
N/A
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| Lab - Sweat Collection (300000085) | $203.70 |
N/A
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| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Mic Or Breakpoint, Per Plate, Each Multi-Antimicrobial Agent) (306000108) | $132.30 |
N/A
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| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Mic Or Breakpoint, Per Plate, Each Multi-Antimicrobial Agent) (300000064) | $132.30 |
N/A
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| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Disk Method, Per Plate With 12 Or Fewer Drugs) (300000063) | $96.60 |
N/A
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| Lab - Susceptibility Study Of Specific Antimicrobial Agent (Agar Dilution Method, Per Drug) (306000091) | $132.30 |
N/A
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| Lab - Sulfate Level In Urine (301000585) | $12.00 |
N/A
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| Lab - Sugars Identification In Specimen (Single Qualitative Each Specimen) (301000351) | $144.90 |
N/A
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| Lab - Sugars Identification In Specimen (Single Qualitative Each Specimen) (300000213) | $16.00 |
N/A
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| Lab - Strep Antibody Measurement (302000027) | $109.00 |
N/A
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| Lab - Stool Specimen Analysis For Helicobacter Pylori Bacteria (Immunoassay Technique) (306000004) | $315.00 |
N/A
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| Lab - Stone Analysis By Infrared Absorption (301000120) | $72.00 |
N/A
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| Lab - Steroid Hormone Level (Dehydroepiandrosterone-Sulfate) (301000163) | $267.00 |
N/A
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| Lab - Steroid Hormone Level (Dehydroepiandrosterone-Sulfate) (301000162) | $55.00 |
N/A
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| Lab - Steroid Hormone Level (Dehydroepiandrosterone) (302000182) | $312.00 |
N/A
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| Lab - Steroid Hormone Level (Dehydroepiandrosterone) (301000161) | $261.00 |
N/A
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| Lab - Steroid And Sex Hormone Level (Dihydrotestosterone) (301000595) | $382.00 |
N/A
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| Lab - Steroid And Sex Hormone Level (Androstenedione) (301000430) | $271.00 |
N/A
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| Lab - Steroid And Sex Hormone Level (Androstenedione) (301000096) | $111.00 |
N/A
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| Lab - Specimen Analysis Using Light Refraction (301000252) | $384.00 |
N/A
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| Lab - Specimen Analysis Using Light Refraction (301000437) | $384.00 |
N/A
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| Lab - Specimen Analysis For Strep Group A Bacteria (Immunoassay With Direct Optical Observation) (300000103) | $118.65 |
N/A
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| Lab - Specimen Analysis For Strep Group A (Immunoassay Technique) (306000010) | $118.65 |
N/A
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| Lab - Specimen Analysis For Shiga-Like Bacterial Toxin (Immunoassay Technique) (300000142) | $211.05 |
N/A
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| Lab - Specimen Analysis For Rotavirus (Immunoassay Technique) (306000009) | $183.75 |
N/A
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| Lab - Specimen Analysis For Respiratory Syncytial Virus (Immunoassay Technique) (306000008) | $349.65 |
N/A
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| Lab - Specimen Analysis For Legionella Pneumophila Bacteria (Immunofluorescent Technique) (300000079) | $78.75 |
N/A
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| Lab - Specimen Analysis For Influenza Virus A Or B (Immunoassay Technique Each Type) (306000047) | $58.80 |
N/A
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| Lab - Specimen Analysis For Identification Of Organism (Immunoassay With Direct Optical Observation) (306000011) | $51.00 |
N/A
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| Lab - Specimen Analysis For Identification Of Organism (Immunoassay With Direct Optical Observation) (306000057) | $33.60 |
N/A
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| Lab - Specimen Analysis For Hiv-1 And Hiv-2 (Immunoassay Technique) (302000114) | $174.30 |
N/A
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| Lab - Specimen Analysis For Hepatitis C Virus Genotype (306000036) | $321.30 |
N/A
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| Lab - Specimen Analysis For Hepatitis Be Surface Antigen (Immunoassay Technique) (306000007) | $123.00 |
N/A
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| Lab - Specimen Analysis For Hepatitis B Surface Antigen (Neutralization By Immunoassay Technique) (306000006) | $431.55 |
N/A
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| Lab - Specimen Analysis For Hepatitis B Surface Antigen (Immunoassay Technique) (306000005) | $130.20 |
N/A
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| Lab - Specimen Analysis For Giardia Parasite (Immunoassay Technique) (306000003) | $107.10 |
N/A
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