Franklin Memorial Hospital
111 Franklin Health Commons, Farmington, ME · MaineHealth · · NPI 1922791417
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Slp pure tone screening CPT 92551 | not published | not published | $11.17 – $25.75 | 6 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $39.67 – $81.34 | 7 |
| Slp ther svc non-spch gen CPT 92606 | $486.65 | $486.65 | $67.09 – $457.45 | 8 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $7,503.25 – $52,340.50 | 4 |
| Small animal inoculation CPT 87003 | not published | not published | $16.84 – $35.25 | 6 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $924.65 | $924.65 | $37.96 – $773.93 | 8 |
| Small bowel endoscopy CPT 44360 | not published | not published | $137.32 – $288.06 | 7 |
| Small bowel endoscopy CPT 44364 | not published | not published | $195.61 – $409.39 | 7 |
| Small bowel endoscopy CPT 44366 | not published | not published | $229.72 – $479.88 | 7 |
| Small bowel endoscopy CPT 44369 | not published | not published | $235.01 – $491.40 | 7 |
| Small bowel endoscopy CPT 44376 | not published | not published | $272.07 – $568.68 | 7 |
| Small bowel endoscopy CPT 44378 | not published | not published | $367.94 – $767.96 | 7 |
| Small bowel endoscopy CPT 44382 | not published | not published | $70.86 – $573.72 | 8 |
| Small bowel endoscopy CPT 44384 | not published | not published | $148.53 – $307.71 | 7 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $183.42 – $383.63 | 7 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $174.02 – $365.34 | 7 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $151.52 – $318.57 | 7 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $286.43 – $596.47 | 7 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $54.45 – $379.69 | 8 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $81.07 – $1,833.67 | 8 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $255.19 – $534.11 | 7 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.02 – $302.40 | 4 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $52.35 | $52.35 | $5.39 – $49.21 | 8 |
| Smear gram stain CPT 87205 | $49.85 | $49.85 | $3.46 – $8.82 | 8 |
| Smear nasal eosinophil CPT 89190 | $33.35 | $33.35 | $5.79 – $31.35 | 8 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $67.35 | $67.35 | $5.99 – $31.90 | 8 |
| Smear wet mount CPT 87210 | $48.35 | $48.35 | $4.71 – $26.25 | 8 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $301.35 – $631.46 | 6 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $185.20 – $388.07 | 6 |
| Smpd1 gene common variants CPT 81330 | $335.15 | $335.15 | $47.00 – $315.04 | 8 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $35.68 – $107.01 | 6 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $999.30 – $2,650.87 | 3 |
| So cap design without jnts cf HCPCS L3671 | not published | not published | $761.78 – $2,020.82 | 3 |
| Socket insert above knee HCPCS L5658 | not published | not published | $400.85 – $1,063.35 | 3 |
| Socket insert below knee HCPCS L5655 | not published | not published | $299.29 – $793.94 | 3 |
| Socket insert knee articulat HCPCS L5656 | not published | not published | $355.09 – $941.98 | 3 |
| Socket insert symes HCPCS L5654 | not published | not published | $419.24 – $1,112.13 | 3 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $623.27 – $1,653.38 | 3 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $747.96 – $1,984.13 | 3 |
| Sock fracture or equal each HCPCS L3995 | not published | not published | $37.96 – $100.71 | 3 |
| Sock wool above knee HCPCS L8430 | not published | not published | $23.09 – $61.23 | 3 |
| Sodium 24 hour urine CPT 84300 | $47.60 | $47.60 | $5.06 – $44.74 | 8 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $157.14 | $157.14 | $2.63 – $147.71 | 8 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $0.11 | $0.11 | $0.03 – $0.10 | 8 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $157.14 | $157.14 | $0.66 – $5.38 | 8 |
| Sodium chloride 3 % ivpb HCPCS J7131 | not published | not published | $0.12 – $0.27 | 3 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | not published | not published | $2.14 – $3.94 | 7 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | not published | not published | $73.10 – $144.35 | 7 |
| Sodium serum/plasma/whole blood CPT 84295 | $55.30 | $55.30 | $4.81 – $51.98 | 8 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $451.15 | $451.15 | $1.95 – $424.08 | 8 |
| Soft interface below knee se HCPCS L2820 | not published | not published | $102.62 – $272.26 | 3 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $382.24 – $382.24 | 1 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $2,819.01 – $4,450.42 | 2 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $2,505.78 – $3,955.93 | 2 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $6,890.86 – $10,878.72 | 2 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $2,192.56 – $3,461.43 | 2 |
| Solid skin barrier HCPCS A4362 | not published | not published | $3.29 – $9.26 | 3 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $8.22 – $21.67 | 3 |
| Somatosensory testing CPT 95927 | not published | not published | $26.31 – $54.23 | 7 |
| Somatropin injection HCPCS J2941 | not published | not published | $90.82 – $495.97 | 4 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $6,264.41 – $9,889.73 | 2 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $1,879.33 – $2,966.94 | 2 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $22.41 – $69.11 | 4 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $148.36 – $393.56 | 3 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $15.59 – $23.05 | 2 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $157.78 – $340.26 | 7 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $172.01 – $372.11 | 7 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $214.46 – $239.95 | 3 |
| Special casting material HCPCS A4590 | not published | not published | $52.87 – $52.87 | 1 |
| Special physics consult CPT 77370 | not published | not published | $123.77 – $305.01 | 7 |
| Special pump services CPT 99190 | not published | not published | $832.00 – $870.06 | 3 |
| Special pump services CPT 99191 | not published | not published | $582.72 – $609.33 | 3 |
| Special pump services CPT 99192 | not published | not published | $416.32 – $435.31 | 3 |
| Special radiation dosimetry CPT 77331 | not published | not published | $33.33 – $88.02 | 7 |
| Special radiation treatment CPT 77470 | not published | not published | $62.04 – $204.30 | 7 |
| Special teletx port plan CPT 77321 | not published | not published | $49.38 – $95.72 | 7 |
| Specific gravity body fluid CPT 84315 | $25.10 | $25.10 | $3.28 – $23.59 | 8 |
| Specimen fat stain CPT 89125 | not published | not published | $5.88 – $12.20 | 6 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $436.85 | $436.85 | $131.06 – $410.64 | 8 |
| Speech audiometry complete CPT 92556 | not published | not published | $32.12 – $95.57 | 7 |
| Speech evaluation complex CPT 70371 | not published | not published | $40.57 – $84.72 | 7 |
| Speech recep thresh CPT 92555 | not published | not published | $25.56 – $61.69 | 7 |
| Speech Therapy Session (one-on-one) CPT 92507 | $334.30 | $334.30 | $75.24 – $279.81 | 8 |
| Sperm antibody test CPT 89325 | not published | not published | $10.67 – $22.36 | 6 |
| Sperm evaluation test CPT 89329 | not published | not published | $19.59 – $41.05 | 6 |
| Sperm identification CPT 89257 | not published | not published | $50.98 – $231.96 | 2 |
| Sperm isolation complex CPT 89261 | not published | not published | $14.88 – $231.96 | 2 |
| Sperm isolation simple CPT 89260 | not published | not published | $14.88 – $231.96 | 2 |
| Sperm washing 58323 CPT 58323 | not published | not published | $11.67 – $28.91 | 8 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $673.86 – $1,408.47 | 7 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $723.03 – $1,528.43 | 7 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $103.76 – $225.70 | 7 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $226.34 – $255.54 | 3 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $932.85 | $932.85 | $83.78 – $426.60 | 8 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $9,642.49 – $55,860.25 | 2 |
| Spine X-ray (single view, one level) CPT 72020 | $191.35 | $191.35 | $7.63 – $160.16 | 8 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $135.01 – $276.53 | 7 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $83.21 – $170.13 | 7 |
| Spleen imaging CPT 78185 | not published | not published | $16.24 – $32.54 | 7 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $1,097.30 – $2,347.89 | 7 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.