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 |
|---|---|---|---|---|
| Aep hearing status deter i&r CPT 92651 | not published | not published | $82.07 – $160.64 | 7 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $81.75 – $164.70 | 7 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $109.96 – $220.29 | 7 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $3,031.69 – $8,713.37 | 4 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $849,762.67 – $849,762.67 | 1 |
| _afb id by dna probe rflx ast CPT 87149 | $180.25 | $180.25 | $20.05 – $169.44 | 8 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $7.31 – $15.32 | 6 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $115.36 – $241.73 | 6 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $137.00 – $287.07 | 6 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $274.83 – $575.89 | 6 |
| Aflibercept injection HCPCS J0178 | not published | not published | $835.40 – $1,583.56 | 7 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $11.89 – $23.72 | 3 |
| Afo molded ankle gauntlet HCPCS L1904 | not published | not published | $557.95 – $1,480.11 | 3 |
| Afo molded plas rig ant tib HCPCS L1945 | not published | not published | $1,098.36 – $2,913.70 | 3 |
| Afo molded to patient plasti HCPCS L1940 | not published | not published | $586.80 – $1,556.64 | 3 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | not published | not published | $828.92 – $2,198.95 | 3 |
| Afo sing bar clasp attach sh HCPCS L1910 | not published | not published | $282.15 – $748.47 | 3 |
| Afo sing solid stirrup calf HCPCS L1980 | not published | not published | $422.47 – $1,120.74 | 3 |
| Afo sing upright with adjust s HCPCS L1920 | not published | not published | $413.49 – $1,096.88 | 3 |
| Afo spiral molded to pt plas HCPCS L1950 | not published | not published | $848.69 – $2,251.38 | 3 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | not published | not published | $282.64 – $749.81 | 3 |
| Afo supramalleolar custom HCPCS L1907 | not published | not published | $522.69 – $1,386.59 | 3 |
| Afo tib fx cast molded to pt HCPCS L2108 | not published | not published | $1,225.55 – $3,251.07 | 3 |
| Afo tib fx cast plaster mold HCPCS L2106 | not published | not published | $806.75 – $2,140.11 | 3 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $607.60 – $1,611.83 | 3 |
| Afo tibial fracture rigid HCPCS L2116 | not published | not published | $780.32 – $2,070.00 | 3 |
| Afo tibial fracture soft HCPCS L2112 | not published | not published | $503.05 – $1,334.50 | 3 |
| Afo, walk boot type, cus fab HCPCS L4631 | not published | not published | $1,534.63 – $4,042.07 | 3 |
| Afo w/ankle joint, prefab HCPCS L1971 | not published | not published | $435.40 – $1,155.02 | 3 |
| After cataract laser surgery CPT 66821 | not published | not published | $296.51 – $626.28 | 8 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $210.26 – $441.86 | 7 |
| Ag detect nos ia single CPT 87450 | not published | not published | $13.90 – $13.90 | 1 |
| Air conduction bilat CPT 92552 | not published | not published | $33.07 – $81.34 | 7 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $87.31 – $285.90 | 8 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $12.03 – $24.39 | 7 |
| Ak 4 bar ling w/hydraul swig HCPCS L5613 | not published | not published | $3,097.94 – $8,218.11 | 3 |
| Ak 4 bar link w/fric swing HCPCS L5611 | not published | not published | $2,036.70 – $5,402.87 | 3 |
| Ak/bk self-aligning unit ea HCPCS L5617 | not published | not published | $547.04 – $1,451.17 | 3 |
| Ak flex inner socket ext fra HCPCS L5651 | not published | not published | $1,518.09 – $4,027.11 | 3 |
| Ak/knee disartic acrylic soc HCPCS L5631 | not published | not published | $555.42 – $1,473.41 | 3 |
| Ak/knee disartic pelvic band HCPCS L5697 | not published | not published | $101.48 – $269.20 | 3 |
| Ak/knee disartic pelvic join HCPCS L5696 | not published | not published | $224.80 – $596.32 | 3 |
| Ak/knee disartic silesian ba HCPCS L5698 | not published | not published | $113.91 – $302.18 | 3 |
| Ak open end sach HCPCS L5321 | not published | not published | $3,280.87 – $8,703.37 | 3 |
| Ak pelvic control belt light HCPCS L5692 | not published | not published | $149.00 – $395.24 | 3 |
| Ak pelvic control belt pad/l HCPCS L5694 | not published | not published | $229.33 – $608.35 | 3 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | not published | not published | $174.08 – $461.79 | 3 |
| Ak univ multiplex sys frict HCPCS L5616 | not published | not published | $1,453.66 – $3,856.19 | 3 |
| Albumin body fluid quantitative each specimen CPT 82042 | $57.95 | $57.95 | $7.78 – $54.47 | 8 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $293.25 | $293.25 | $45.90 – $275.66 | 8 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $20.98 – $41.97 | 7 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $47.49 – $104.92 | 7 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.49 – $33.45 | 7 |
| Albumin ischemia modified CPT 82045 | not published | not published | $33.94 – $71.12 | 6 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $62.00 | $62.00 | $5.78 – $58.28 | 8 |
| Albumin serum plasma or whole blood CPT 82040 | $33.75 | $33.75 | $4.95 – $31.73 | 8 |
| Albuterol comp con HCPCS J7610 | not published | not published | $0.49 – $1.23 | 2 |
| Albuterol comp unit HCPCS J7609 | not published | not published | $0.49 – $2.79 | 3 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.13 – $0.38 | 7 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.12 – $0.31 | 7 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.03 – $0.15 | 7 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $9.80 – $35.92 | 6 |
| Alcohols biomarkers 3/more CPT 80322 | not published | not published | $11.40 – $11.40 | 1 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $16.24 – $33.88 | 7 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | not published | not published | $30.88 – $66.18 | 7 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $63.59 – $128.49 | 7 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $1,246.98 – $11,957.15 | 4 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $125.50 – $262.98 | 6 |
| Alefacept HCPCS J0215 | not published | not published | $41.64 – $52.87 | 3 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $2,280.09 – $4,770.78 | 7 |
| Alginate dressing <=16 sq in HCPCS A6196 | not published | not published | $8.18 – $21.54 | 3 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | not published | not published | $18.27 – $48.15 | 3 |
| Alginate drsg wound filler HCPCS A6199 | not published | not published | $5.88 – $15.44 | 3 |
| Alglucerase injection HCPCS J0205 | not published | not published | $42.03 – $63.03 | 3 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $206.70 – $451.42 | 4 |
| Alkaline phosphatase CPT 84075 | $80.80 | $80.80 | $5.18 – $75.95 | 8 |
| Allergen alpha lactalbumin ige CPT 86008 | $107.60 | $107.60 | $17.93 – $101.14 | 8 |
| Allergen egg white ige CPT 86003 | $57.10 | $57.10 | $5.22 – $53.67 | 8 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $56.85 | $56.85 | $7.97 – $53.44 | 8 |
| Allergy injections; 2 or more 95117 CPT 95117 | $91.60 | $91.60 | $10.86 – $76.67 | 8 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $9.29 – $21.69 | 7 |
| Allergy Skin Testing CPT 95004 | not published | not published | $3.70 – $7.46 | 7 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $4.60 – $10.16 | 7 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $1,226.28 – $2,640.04 | 7 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | not published | not published | $17.05 – $33.72 | 7 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $77.66 – $171.39 | 7 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $97.32 – $230.67 | 7 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $1,704.75 | $1,704.75 | $511.43 – $1,602.47 | 8 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $30.73 – $60.47 | 7 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $1,144.00 | $1,144.00 | $151.60 – $1,075.36 | 8 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $85.96 – $147.77 | 3 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $129.93 – $252.06 | 3 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | not published | not published | $244.49 – $479.83 | 7 |
| Alloskin HCPCS Q4115 | not published | not published | $12.13 – $29.94 | 7 |
| Alloskin ac, 1 cm HCPCS Q4141 | not published | not published | $39.45 – $87.04 | 7 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $6.94 – $36.73 | 8 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $3.58 – $16.71 | 8 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $1,794.43 | $1,794.43 | $1.12 – $3.50 | 8 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $64.41 – $134.88 | 6 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $17.00 – $35.62 | 6 |
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.