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 |
|---|---|---|---|---|
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $103.80 | $103.80 | $10.15 – $24.39 | 8 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $162.85 | $162.85 | $31.14 – $97.57 | 8 |
| Ghs musc test done w/n test comp CPT 95886 | not published | not published | $44.07 – $90.15 | 7 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | not published | not published | $17.64 – $36.61 | 7 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $36.08 – $73.89 | 7 |
| Ghs myocardial strain img spckl track CPT 93356 | $639.70 | $639.70 | $11.25 – $71.31 | 8 |
| Ghs nailbed repair/nail removal CPT 11760 | $655.15 | $655.15 | $106.60 – $341.22 | 8 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $2,740.75 | $2,740.75 | $23.82 – $64.25 | 8 |
| Ghs nerve blk intercostal, single level CPT 64420 | $2,114.10 | $2,114.10 | $56.78 – $188.88 | 8 |
| Ghs nerve block axillary nerve CPT 64417 | $2,781.90 | $2,781.90 | $61.74 – $309.02 | 8 |
| Ghs nerve block brachial plexus CPT 64415 | $2,871.20 | $2,871.20 | $68.00 – $258.28 | 8 |
| Ghs nerve block celiac plexus CPT 64530 | $2,615.05 | $2,615.05 | $91.28 – $440.73 | 8 |
| Ghs nerve block interscaline CPT 64510 | $2,740.75 | $2,740.75 | $74.05 – $282.69 | 8 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $2,740.75 | $2,740.75 | $81.27 – $444.59 | 8 |
| Ghs nerve block sciatic nerve CPT 64445 | $2,211.20 | $2,211.20 | $70.25 – $305.81 | 8 |
| Ghs nerve block suprascapular CPT 64418 | $1,977.25 | $1,977.25 | $54.17 – $166.40 | 8 |
| Ghs ng placement w fluoro guidance CPT 43752 | $86.65 | $86.65 | $39.00 – $80.65 | 8 |
| Ghs o2 saturation CPT 82810 | not published | not published | $9.77 – $20.33 | 6 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $12.25 – $25.08 | 7 |
| Ghs o2 uptake rest & indirect CPT 94690 | not published | not published | $3.58 – $7.46 | 7 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $37.88 – $200.30 | 3 |
| Ghs opcc repair cvp without subq port CPT 36575 | $2,134.50 | $2,134.50 | $32.24 – $274.97 | 8 |
| Ghs opcc repair cvp w subq port CPT 36576 | not published | not published | $174.53 – $656.59 | 8 |
| Ghs optokenetic CPT 92544 | not published | not published | $6.19 – $26.98 | 7 |
| Ghs oscillating trac CPT 92545 | not published | not published | $6.19 – $25.05 | 7 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $86.70 | $86.70 | $22.75 – $56.33 | 8 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $92.65 | $92.65 | $24.78 – $72.57 | 8 |
| Ghs ot dds rom CPT 95851 | not published | not published | $7.63 – $38.57 | 8 |
| Ghs ot group caregiver training CPT 97552 | $32.15 | $32.15 | $9.65 – $26.91 | 8 |
| Ghs ot prosthetic training/15 min CPT 97761 | $180.65 | $180.65 | $40.66 – $151.20 | 8 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $167.20 | $167.20 | $41.65 – $139.95 | 8 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $76.19 – $134.21 | 3 |
| Ghs pacing - transcutaneous CPT 92953 | not published | not published | $0.89 – $2.03 | 7 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $896.50 | $896.50 | $58.44 – $188.24 | 8 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $545.55 | $545.55 | $50.27 – $175.39 | 8 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | not published | not published | $22.04 – $50.84 | 7 |
| Ghs peritonsillar abscess i andd CPT 42700 | $715.70 | $715.70 | $131.23 – $353.48 | 8 |
| Ghs phenylketonurid CPT 84030 | $183.25 | $183.25 | $5.50 – $172.26 | 8 |
| Ghs picc line insert < 5 CPT 36568 | $2,553.20 | $2,553.20 | $89.50 – $2,137.03 | 8 |
| Ghs plngl fx pm cl CPT 26725 | $1,091.90 | $1,091.90 | $83.73 – $262.35 | 8 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $4.31 – $8.82 | 6 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | not published | not published | $121.07 – $244.68 | 7 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $7.33 – $46.90 | 7 |
| Ghs ppd (tb intradermal) CPT 86580 | $50.29 | $50.29 | $9.29 – $20.33 | 8 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $93.90 | $93.90 | $9.66 – $88.27 | 8 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $5.61 – $11.52 | 6 |
| Ghs protoporphyrins fract CPT 84202 | $145.65 | $145.65 | $14.35 – $136.91 | 8 |
| Ghs pr without cont pulse ox CPT 94625 | $181.95 | $181.95 | $16.47 – $105.67 | 8 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | not published | not published | $12.25 – $25.67 | 6 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | not published | not published | $190.51 – $338.22 | 3 |
| Ghs quinidine CPT 80194 | $141.45 | $141.45 | $14.60 – $132.96 | 8 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $83.49 – $176.90 | 7 |
| Ghs removal intranasal foreign body CPT 30300 | $723.90 | $723.90 | $32.76 – $102.65 | 8 |
| Ghs removal pharyngeal foreign body CPT 42809 | $602.60 | $602.60 | $34.79 – $108.99 | 8 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $2,936.00 | $2,936.00 | $582.18 – $1,231.57 | 8 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $9,428.65 | $9,428.65 | $479.47 – $1,038.39 | 8 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $113.30 | $113.30 | $15.89 – $106.50 | 8 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $4.31 – $8.82 | 6 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $163.65 | $163.65 | $13.91 – $153.83 | 8 |
| Ghs sedimentation rate CPT 85651 | $21.00 | $21.00 | $3.46 – $15.75 | 8 |
| Ghs semen analysis fert CPT 89320 | $133.40 | $133.40 | $12.31 – $125.40 | 8 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $9.84 – $20.33 | 6 |
| Ghs sensitivity (per antimicro) CPT 87184 | $78.15 | $78.15 | $7.48 – $73.46 | 8 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $833.05 | $833.05 | $76.85 – $214.40 | 8 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $316.95 | $316.95 | $33.96 – $106.41 | 8 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $846.60 | $846.60 | $72.00 – $209.23 | 8 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $113.20 | $113.20 | $33.96 – $106.41 | 8 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $734.65 | $734.65 | $71.96 – $241.43 | 8 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $668.60 | $668.60 | $70.24 – $238.08 | 8 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $708.95 | $708.95 | $73.61 – $205.36 | 8 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $704.95 | $704.95 | $64.29 – $201.44 | 8 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $113.20 | $113.20 | $33.96 – $106.41 | 8 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $39.67 – $77.95 | 7 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $26.62 – $52.87 | 7 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $43.77 – $90.15 | 7 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $227.85 | $227.85 | $47.48 – $190.71 | 8 |
| Ghs sphenopalatine ganglion block CPT 64505 | $834.35 | $834.35 | $98.59 – $256.90 | 8 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $7.33 – $39.83 | 7 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $241.25 | $241.25 | $72.38 – $210.32 | 8 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $10.58 – $31.48 | 8 |
| Ghs strapping shoulder - 29240 CPT 29240 | $372.10 | $372.10 | $17.99 – $57.18 | 8 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $70.73 – $149.11 | 7 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $14.89 – $33.21 | 7 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $131.09 – $281.29 | 7 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $1,711.25 | $1,711.25 | $180.80 – $546.56 | 8 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $508.20 | $508.20 | $135.26 – $320.90 | 8 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $307.53 – $644.60 | 7 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $7.30 – $15.30 | 6 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $904.60 | $904.60 | $81.69 – $255.96 | 8 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $225.09 – $563.68 | 8 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $24.30 – $50.84 | 6 |
| Ghs urine, porphyrins quant CPT 84120 | $141.45 | $141.45 | $14.71 – $132.96 | 8 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $763.06 – $1,626.04 | 7 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $455.27 – $2,303.56 | 5 |
| Ghs windowing of cast CPT 29730 | not published | not published | $42.70 – $127.20 | 8 |
| Giardia ag if CPT 87269 | not published | not published | $13.61 – $28.48 | 6 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $14.72 – $30.84 | 6 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $40.16 – $81.34 | 7 |
| Gi inhouse confirmation CPT 87045 | $103.80 | $103.80 | $9.44 – $97.57 | 8 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $290.03 – $912.94 | 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.