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 |
|---|---|---|---|---|
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $56.67 – $116.42 | 3 |
| Gabapentin non-blood CPT 80355 | not published | not published | $9.18 – $50.16 | 3 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.31 – $0.54 | 7 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $234.97 | $234.97 | $1.50 – $220.87 | 8 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $406.43 | $406.43 | $0.12 – $191.03 | 8 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $573.52 | $573.52 | $14.73 – $539.11 | 8 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $21.07 – $44.07 | 6 |
| Galactokinase - sendout CPT 82759 | not published | not published | $21.48 – $44.74 | 6 |
| Galactose transferase test CPT 82776 | not published | not published | $11.74 – $24.39 | 6 |
| Galectin-3 CPT 82777 | not published | not published | $40.00 – $92.72 | 6 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,718.70 | $1,718.70 | $34.30 – $1,438.55 | 8 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $1,718.70 | $1,718.70 | $41.71 – $1,438.55 | 8 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $630.02 – $1,359.67 | 7 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $7.73 – $7,623.03 | 3 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $706.21 – $1,653.93 | 3 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $721.28 – $1,689.21 | 3 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $958.80 – $3,084.69 | 4 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $840.48 – $2,648.71 | 4 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $2.08 – $2.70 | 3 |
| Galsulfase injection HCPCS J1458 | not published | not published | $441.56 – $958.60 | 7 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $490.62 – $976.87 | 7 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $49.06 – $97.69 | 7 |
| Gammaglobulin iga CPT 82784 | $84.60 | $84.60 | $9.30 – $79.52 | 8 |
| Gammaglobulin ige CPT 82785 | $180.65 | $180.65 | $16.46 – $169.81 | 8 |
| Gamma glutamyltransferase CPT 82977 | $80.75 | $80.75 | $7.20 – $75.91 | 8 |
| Gammagraft HCPCS Q4111 | not published | not published | $7.14 – $14.48 | 7 |
| Gammaplex injection HCPCS J1557 | not published | not published | $54.57 – $112.21 | 7 |
| Gamunex-c/gammaked HCPCS J1561 | $17,761.78 | $17,761.78 | $48.65 – $4,174.02 | 8 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | not published | not published | $30.59 – $56.83 | 7 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $8,601.28 – $16,960.00 | 3 |
| Gardner vag dna amp probe CPT 87511 | $315.35 | $315.35 | $35.09 – $296.43 | 8 |
| Gardner vag dna quant CPT 87512 | not published | not published | $41.76 – $87.44 | 6 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $6.71 – $14.06 | 6 |
| Gastric emptying imag study CPT 78265 | $1,660.70 | $1,660.70 | $45.09 – $1,390.01 | 8 |
| Gastric emptying imag study CPT 78266 | not published | not published | $48.24 – $97.61 | 7 |
| Gastric motility studies CPT 91020 | not published | not published | $70.70 – $143.68 | 7 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $27.52 – $54.90 | 7 |
| Gastrin test CPT 82938 | not published | not published | $17.69 – $37.07 | 6 |
| Gastroduodenostomy CPT 43810 | not published | not published | $969.02 – $2,084.22 | 7 |
| Gastroesophageal reflux study CPT 78262 | $1,470.75 | $1,470.75 | $32.22 – $1,231.02 | 8 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $48.33 – $98.28 | 7 |
| Gastrointestinal repair CPT 43360 | not published | not published | $2,118.52 – $4,522.96 | 7 |
| Gastrointestinal repair CPT 43361 | not published | not published | $2,561.76 – $5,503.74 | 7 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $1,281.63 – $2,751.87 | 7 |
| Gastrojejunostomy w/vagotomy CPT 43825 | not published | not published | $1,249.43 – $2,685.45 | 7 |
| Gastro/jejuno tube, std HCPCS B4087 | not published | not published | $75.08 – $75.08 | 1 |
| Gastroplasty duodenal switch CPT 43845 | not published | not published | $1,865.52 – $4,010.54 | 7 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $582.56 – $1,256.63 | 7 |
| Gated heart multiple CPT 78473 | $2,032.85 | $2,032.85 | $67.35 – $1,701.50 | 8 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | not published | not published | $2.69 – $7.10 | 3 |
| Gauze >16 <=48 sq in w/bordr HCPCS A6220 | not published | not published | $2.88 – $7.59 | 3 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | not published | not published | $2.37 – $6.24 | 3 |
| Gauze <= 16 sq in w/border HCPCS A6219 | not published | not published | $1.06 – $2.79 | 3 |
| Gauze > 48 in no w/sal without b HCPCS A6224 | not published | not published | $4.00 – $10.54 | 3 |
| Gba gene CPT 81251 | $336.95 | $336.95 | $47.25 – $316.73 | 8 |
| Gc stocking full lngth 18-30 HCPCS A6536 | not published | not published | $75.03 – $150.89 | 2 |
| Gc stocking full lngth 30-40 HCPCS A6537 | not published | not published | $75.03 – $178.89 | 2 |
| Gc stocking full lngth 40+ HCPCS A6538 | not published | not published | $75.03 – $209.44 | 2 |
| Gc stocking thighlngth 18-30 HCPCS A6533 | not published | not published | $67.52 – $111.94 | 2 |
| Gc stocking thighlngth 30-40 HCPCS A6534 | not published | not published | $67.52 – $127.82 | 2 |
| Gc stocking thighlngth 40+ HCPCS A6535 | not published | not published | $58.52 – $147.16 | 2 |
| Gc stocking waistlngth 18-30 HCPCS A6539 | not published | not published | $151.92 – $199.67 | 2 |
| Gc stocking waistlngth 30-40 HCPCS A6540 | not published | not published | $151.92 – $238.06 | 2 |
| Gc stocking waistlngth 40+ HCPCS A6541 | not published | not published | $151.92 – $282.00 | 2 |
| Gefitinib oral HCPCS J8565 | not published | not published | $108.44 – $143.01 | 3 |
| Gel cap app device for trach HCPCS L8515 | not published | not published | $58.74 – $155.80 | 3 |
| Gel cap for trach voice pros HCPCS L8512 | not published | not published | $2.01 – $5.32 | 3 |
| Gel-one HCPCS J7326 | not published | not published | $497.29 – $1,040.55 | 7 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $0.49 – $1.11 | 7 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $248.39 | $248.39 | $3.30 – $55.18 | 8 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $30,550.87 | $30,550.87 | $221.84 – $28,717.82 | 8 |
| General health panel CPT 80050 | $400.45 | $400.45 | $47.21 – $376.42 | 8 |
| Genetic counseling 30 min CPT 96040 | not published | not published | $45.32 – $52.12 | 5 |
| Genetic tstg severe inh cond CPT 81443 | $2,910.00 | $2,910.00 | $873.00 – $2,735.40 | 8 |
| Genioplasty augmentation CPT 21120 | not published | not published | $486.42 – $1,281.07 | 8 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $820.61 – $1,717.54 | 7 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $514.02 – $1,220.68 | 8 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $718.11 – $1,530.46 | 7 |
| Genome re-evaluation CPT 81427 | not published | not published | $1,909.97 – $4,898.39 | 6 |
| Genome sequence analysis CPT 81425 | not published | not published | $3,819.94 – $10,542.49 | 6 |
| Genome sequence analysis CPT 81426 | not published | not published | $2,709.95 – $5,678.53 | 6 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $168.90 | $168.90 | $2.07 – $20.59 | 8 |
| Gentamicin peak therapeutic drug level CPT 80170 | $180.65 | $180.65 | $16.38 – $169.81 | 8 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $5.13 – $12.20 | 7 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $78.93 – $162.67 | 7 |
| Gfrg autol fat lipo ea addl CPT 15774 | not published | not published | $137.93 – $359.14 | 8 |
| Ghs abscess perianal iandd CPT 46050 | $1,922.30 | $1,922.30 | $96.97 – $457.43 | 8 |
| Ghs abscess postoperative iandd complex CPT 10180 | not published | not published | $170.12 – $508.84 | 8 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $9.81 – $20.33 | 6 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $176.65 | $176.65 | $17.11 – $166.05 | 8 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $729.20 | $729.20 | $102.26 – $685.45 | 8 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $374.25 | $374.25 | $18.00 – $37.28 | 8 |
| Ghs antibodies (torch) igm CPT 86694 | not published | not published | $14.39 – $29.82 | 6 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $37.66 – $142.62 | 8 |
| Ghs bladder cath - complex-foley CPT 51703 | $194.10 | $194.10 | $58.23 – $162.46 | 8 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $4.82 – $10.10 | 6 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $2,211.20 | $2,211.20 | $53.08 – $213.29 | 8 |
| Ghs central line insert < age 5, failed CPT 36555 | not published | not published | $82.73 – $359.77 | 8 |
| Ghs change cysto/gastrost CPT 43762 | $868.70 | $868.70 | $35.51 – $419.44 | 8 |
| Ghs chemo >8 hrs CPT 96416 | $466.40 | $466.40 | $119.88 – $390.38 | 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.