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 |
|---|---|---|---|---|
| Close tear duct opening CPT 68761 | not published | not published | $112.16 – $280.11 | 8 |
| Close tear system fistula CPT 68770 | not published | not published | $598.34 – $1,263.42 | 7 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $16.00 – $33.21 | 6 |
| Clos txnose fx without stablz 21315 CPT 21315 | $5,354.35 | $5,354.35 | $57.97 – $295.53 | 8 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $826.59 – $1,760.92 | 7 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $1,517.48 – $3,224.98 | 7 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $966.27 – $2,053.07 | 7 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $1,329.76 – $2,835.23 | 7 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | not published | not published | $194.21 – $543.44 | 8 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $90.96 – $349.50 | 8 |
| Closure of salivary fistula CPT 42600 | not published | not published | $345.64 – $1,060.71 | 8 |
| Closure of valve CPT 33600 | not published | not published | $1,616.49 – $3,454.07 | 7 |
| Closure of valve CPT 33602 | not published | not published | $1,569.33 – $3,355.11 | 7 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $321.19 – $864.12 | 8 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $2,684.14 – $2,684.14 | 1 |
| Closure ureter/bowel fistula CPT 50930 | not published | not published | $1,058.65 – $2,233.36 | 7 |
| Closure ureter/skin fistula CPT 50920 | not published | not published | $848.10 – $1,794.82 | 7 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $18.93 – $39.67 | 6 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $20.42 – $42.70 | 6 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $18.93 – $39.67 | 6 |
| Clot factor xii hageman CPT 85280 | $210.35 | $210.35 | $19.35 – $197.73 | 8 |
| Clot factor xiii fibrin scrn CPT 85291 | $56.85 | $56.85 | $9.11 – $53.44 | 8 |
| Clot factor xiii fibrin stab CPT 85290 | not published | not published | $16.34 – $34.24 | 6 |
| Clotting assay whole blood CPT 85396 | not published | not published | $18.87 – $38.64 | 7 |
| Clozapine, 25 mg HCPCS S0136 | not published | not published | $0.66 – $2.03 | 2 |
| Clsd ostomy pouch w/flange HCPCS A5054 | not published | not published | $2.00 – $5.26 | 3 |
| Clsd ostomy pouch without barr HCPCS A5052 | not published | not published | $1.65 – $4.36 | 3 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $1,043.45 | $1,043.45 | $91.79 – $287.59 | 8 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $1,033.90 | $1,033.90 | $225.09 – $655.43 | 8 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $886.95 | $886.95 | $95.46 – $299.11 | 8 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $233.26 – $516.48 | 8 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $225.09 – $507.68 | 8 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $4,637.30 | $4,637.30 | $326.00 – $722.13 | 8 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | not published | not published | $223.93 – $494.80 | 8 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | not published | not published | $183.55 – $411.42 | 8 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $186.15 – $413.45 | 8 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $1,376.30 | $1,376.30 | $98.27 – $307.90 | 8 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $977.30 | $977.30 | $84.93 – $266.11 | 8 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $357.20 | $357.20 | $75.23 – $190.40 | 8 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $4,930.15 | $4,930.15 | $728.85 – $1,560.97 | 8 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $527.11 – $1,119.72 | 7 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | $225.09 – $557.16 | 8 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | not published | not published | $121.22 – $266.37 | 8 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $469.10 | $469.10 | $84.12 – $262.71 | 8 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | not published | not published | $225.09 – $700.17 | 8 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $2,911.75 | $2,911.75 | $498.47 – $1,079.74 | 8 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | not published | not published | $225.09 – $559.86 | 8 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $2,911.75 | $2,911.75 | $455.24 – $1,036.94 | 8 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | $225.09 – $559.19 | 8 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $1,325.05 | $1,325.05 | $75.23 – $235.71 | 8 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | $225.09 – $751.00 | 8 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | not published | not published | $225.09 – $716.43 | 8 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $4,830.00 | $4,830.00 | $235.58 – $757.77 | 8 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | not published | not published | $461.44 – $1,088.56 | 8 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | not published | not published | $216.26 – $477.84 | 8 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | not published | not published | $225.09 – $620.19 | 8 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $1,005.65 | $1,005.65 | $98.27 – $307.90 | 8 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | not published | not published | $493.11 – $1,056.69 | 7 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $672.15 | $672.15 | $201.65 – $483.94 | 8 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | not published | not published | $199.18 – $435.83 | 8 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | not published | not published | $91.73 – $418.89 | 8 |
| Clsd tx nose fx without manip 21310 CPT 21310 | not published | not published | $49.46 – $49.46 | 1 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $4,930.10 | $4,930.10 | $319.06 – $739.48 | 8 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $1,139.10 | $1,139.10 | $84.12 – $263.58 | 8 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | not published | not published | $225.09 – $645.94 | 8 |
| Clsd tx pelvic ring fx CPT 27197 | not published | not published | $128.14 – $273.16 | 7 |
| Clsd tx pelvic ring fx CPT 27198 | not published | not published | $225.09 – $650.70 | 7 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $4,930.15 | $4,930.15 | $393.40 – $876.33 | 8 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | not published | not published | $185.16 – $410.08 | 8 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | not published | not published | $225.09 – $533.43 | 8 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,618.95 | $1,618.95 | $394.76 – $903.31 | 8 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | not published | not published | $225.09 – $524.61 | 8 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $700.95 | $700.95 | $173.91 – $544.92 | 8 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $4,709.90 | $4,709.90 | $486.38 – $1,103.11 | 8 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $2,235.05 | $2,235.05 | $396.38 – $1,117.53 | 8 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | not published | not published | $329.61 – $755.54 | 8 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $475.90 | $475.90 | $30.04 – $261.06 | 8 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $283.10 | $283.10 | $84.93 – $226.65 | 8 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | not published | not published | $225.09 – $630.35 | 8 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,300.85 | $1,300.85 | $158.12 – $495.43 | 8 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $285.80 | $285.80 | $85.74 – $268.65 | 8 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | not published | not published | $225.09 – $622.22 | 8 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | not published | not published | $225.09 – $612.73 | 8 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | not published | not published | $225.09 – $612.06 | 8 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | not published | not published | $225.09 – $1,121.75 | 7 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | not published | not published | $225.09 – $656.79 | 8 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $900.50 | $900.50 | $84.93 – $266.11 | 8 |
| Clsr 1 vsd w/wo patch w/vlvt CPT 33684 | not published | not published | $1,772.21 – $3,776.71 | 7 |
| Clsr 1vsd w/wo ptch rmvl bnd CPT 33688 | not published | not published | $1,766.18 – $3,757.05 | 7 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | not published | not published | $225.09 – $862.17 | 8 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $993.45 | $993.45 | $298.04 – $866.09 | 8 |
| Cltx craniofacial separation CPT 21431 | not published | not published | $669.78 – $1,419.32 | 7 |
| Cltx gr hmrl tbrs fx w/mnpj CPT 23625 | not published | not published | $347.54 – $774.82 | 8 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | not published | not published | $225.09 – $633.07 | 8 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | not published | not published | $494.06 – $1,109.54 | 8 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | not published | not published | $225.09 – $673.72 | 8 |
| Cltx lunate dislc w/mnpj CPT 25690 | $4,794.90 | $4,794.90 | $477.68 – $4,013.33 | 8 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $16,932.90 | $16,932.90 | $891.11 – $2,108.58 | 8 |
| Cltx mndblr fx w/mnpj CPT 21451 | not published | not published | $617.54 – $1,412.43 | 8 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $9,108.10 | $9,108.10 | $528.26 – $1,466.11 | 8 |
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.