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 |
|---|---|---|---|---|
| Tte w or without fol w/cont, com HCPCS C8921 | not published | not published | $691.75 – $3,429.96 | 2 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | not published | not published | $691.75 – $3,429.96 | 2 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $360.61 – $760.50 | 7 |
| Tube drain vert dev st 5-40f HCPCS A5200 | not published | not published | $12.57 – $33.11 | 3 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | not published | not published | $52.29 – $137.73 | 3 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | not published | not published | $7.28 – $19.19 | 3 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | not published | not published | $52.78 – $138.99 | 3 |
| Tubing (oxygen) per foot HCPCS A4616 | not published | not published | $0.06 – $0.17 | 3 |
| Tubular dressing HCPCS A6457 | not published | not published | $1.26 – $3.33 | 3 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $70.11 – $145.05 | 6 |
| Tvh >250 gms 58290 CPT 58290 | not published | not published | $1,117.29 – $2,343.83 | 7 |
| Tvh w/mmk 58267 CPT 58267 | not published | not published | $1,038.44 – $2,179.80 | 7 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $477.36 – $1,266.31 | 3 |
| Tx atrial fib pulm vein isol CPT 93656 | not published | not published | $898.82 – $1,878.85 | 7 |
| Tx closed distal humerus fx CPT 24999 | $3,038.35 | $3,038.35 | $468.78 – $2,302.77 | 8 |
| Tx closed hip disl traumatic without anes CPT 27250 | $1,585.20 | $1,585.20 | $93.83 – $293.99 | 8 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $9,684.15 | $9,684.15 | $560.52 – $1,225.82 | 8 |
| Tx closed tib shaft fx without manip CPT 27750 | $1,083.85 | $1,083.85 | $84.12 – $263.58 | 8 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $107.25 – $309.02 | 8 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | not published | not published | $69.86 – $210.09 | 8 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | not published | not published | $904.25 – $1,941.21 | 7 |
| Tx ectopic pregnancy ntrstl prtl rescj uter 59136 CPT 59136 | not published | not published | $857.51 – $1,842.94 | 7 |
| Tx l/r atrial fib addl CPT 93657 | not published | not published | $290.84 – $609.35 | 7 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $717.30 – $1,547.42 | 7 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | not published | not published | $487.56 – $1,058.72 | 7 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $530.99 – $1,153.62 | 7 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $428.66 – $909.61 | 7 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $613.15 – $1,302.73 | 7 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $575.63 – $1,247.16 | 7 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $443.22 – $950.95 | 7 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | not published | not published | $185.73 – $406.68 | 8 |
| Tympanic membrane repair CPT 69610 | not published | not published | $278.93 – $743.98 | 8 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $530.44 – $1,111.59 | 7 |
| Tympanometry & reflex thresh CPT 92550 | not published | not published | $21.71 – $44.07 | 7 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | not published | not published | $127.72 – $392.54 | 8 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $1,358.29 – $2,854.21 | 7 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $1,235.30 – $2,606.83 | 7 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $366.01 | 6 |
| Typhoid vaccine oral CPT 90690 | not published | not published | $66.43 – $169.29 | 3 |
| U2af1 gene common variants CPT 81357 | not published | not published | $109.62 – $404.65 | 6 |
| Ua w/micro/comp poc CPT 81000 | $36.40 | $36.40 | $3.26 – $15.00 | 8 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $67.23 – $136.45 | 7 |
| Ue triple control harness HCPCS L6677 | not published | not published | $276.10 – $732.42 | 3 |
| Ugt1a1 gene analy common variants CPT 81350 | $1,460.15 | $1,460.15 | $54.50 – $1,372.54 | 8 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $2.58 – $5.43 | 7 |
| Ultrasound breast complete CPT 76641 | $385.55 | $385.55 | $34.58 – $322.71 | 8 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $498.80 | $498.80 | $32.22 – $65.75 | 8 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $223.80 | $223.80 | $23.45 – $187.32 | 8 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $29.91 – $57.82 | 7 |
| Ultrasound elastography ea l target les CPT 76983 | $455.60 | $455.60 | $24.44 – $381.34 | 8 |
| Ultrasound elastography parenchyma CPT 76981 | $455.60 | $455.60 | $28.17 – $381.34 | 8 |
| Ultrasound encephalogram CPT 76506 | $356.15 | $356.15 | $29.87 – $298.10 | 8 |
| Ultrasound exam follow-up CPT 76970 | not published | not published | $40.22 – $40.22 | 1 |
| Ultrasound exam k transpl w/doppler CPT 76776 | not published | not published | $35.62 – $72.52 | 7 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $409.80 | $409.80 | $34.00 – $73.19 | 8 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | $900.50 | $900.50 | $30.00 – $58.97 | 8 |
| Ultrasound guidance for vascular access CPT 76937 | $157.70 | $157.70 | $11.50 – $27.11 | 8 |
| Ultrasound guide intraoperative CPT 76998 | $972.45 | $972.45 | $20.00 – $94.21 | 8 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $96.47 – $190.17 | 7 |
| Ultrasound hips infant dynamic CPT 76885 | $461.00 | $461.00 | $34.92 – $385.86 | 8 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $29.53 – $59.64 | 7 |
| Ultrasound joint complete left CPT 76881 | $429.00 | $429.00 | $18.89 – $82.23 | 8 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $24.66 – $109.87 | 7 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $393.65 | $393.65 | $36.50 – $88.66 | 8 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $244.00 | $244.00 | $36.39 – $204.23 | 8 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | not published | not published | $89.72 – $179.62 | 7 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $461.00 | $461.00 | $35.00 – $81.34 | 8 |
| Ultrasound prostate/transrectal CPT 76872 | $363.40 | $363.40 | $31.80 – $65.06 | 8 |
| Ultrasound spinal canal and contents CPT 76800 | $505.50 | $505.50 | $58.44 – $423.10 | 8 |
| Ultrasound transabd ea addl gest CPT 76812 | not published | not published | $84.01 – $170.13 | 7 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $76.26 – $154.54 | 7 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $39.97 – $81.34 | 7 |
| Ultraviolet therapy CPT 97028 | not published | not published | $8.00 – $16.95 | 7 |
| Umbilical artery cath newborn 36660 CPT 36660 | not published | not published | $66.60 – $136.25 | 7 |
| Umbilical cord occlud w/us CPT 59072 | not published | not published | $273.00 – $1,058.72 | 7 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $851.06 – $1,003.82 | 3 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $11,206.70 – $29,517.41 | 3 |
| Unlistd noninvas vasc dx std CPT 93998 | not published | not published | $17.17 – $106.34 | 2 |
| Unlisted all/immlg svc/px CPT 95199 | not published | not published | $106.34 – $106.34 | 1 |
| Unlisted chemotherapy px CPT 96549 | $404.30 | $404.30 | $0.67 – $380.04 | 8 |
| Unlisted cranfcl&maxlfcl px CPT 21299 | not published | not published | $1,008.18 – $1,008.18 | 1 |
| Unlisted CT procedure CPT 76497 | not published | not published | $44.07 – $382.24 | 3 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $1,744.52 – $1,744.52 | 1 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $231.96 – $231.96 | 1 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $231.96 – $231.96 | 1 |
| Unlisted dx gi procedure CPT 91299 | not published | not published | $679.24 – $679.24 | 1 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $1,744.52 – $1,744.52 | 1 |
| Unlisted fetal invas px w/us CPT 59897 | not published | not published | $873.38 – $873.38 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $62.30 – $382.24 | 3 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $1,744.52 – $1,744.52 | 1 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $1,744.52 – $1,744.52 | 1 |
| Unlisted hystsc px uterus CPT 58579 | not published | not published | $873.38 – $873.38 | 1 |
| Unlisted laparoscopic liver biopy 47379 CPT 47379 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laparoscopic reduction intestine 44238 CPT 44238 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laparoscopy procedure biliary tract 47579 CPT 47579 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laps px appendix CPT 44979 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laps px bladder CPT 51999 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laps px endoc sys CPT 60659 | not published | not published | $25,329.42 – $25,329.42 | 1 |
| Unlisted laps px esoph CPT 43289 | not published | not published | $25,329.42 – $25,329.42 | 1 |
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.