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 |
|---|---|---|---|---|
| Inj cefazolin sodium, hikma HCPCS J0688 | $53.38 | $53.38 | $1.04 – $50.18 | 8 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $2.20 – $3.28 | 2 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $5.47 – $11.34 | 7 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | $166.45 | $166.45 | $5.13 – $103.16 | 8 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.17 – $4.51 | 7 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $6.84 – $16.11 | 7 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $105.77 – $232.30 | 3 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $14.96 – $31.10 | 7 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $204.57 – $333.57 | 7 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $86.70 – $267.28 | 3 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $3.49 – $7.17 | 3 |
| Inj, clindamycin (baxter) HCPCS J0737 | $59.67 | $59.67 | $1.75 – $56.09 | 8 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $680.20 | $680.20 | $39.19 – $352.71 | 8 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $87.56 – $270.38 | 4 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $441.85 – $2,030.54 | 7 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $1,090.23 – $1,090.23 | 1 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $13.80 – $28.69 | 7 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $15.21 – $32.84 | 7 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $10.14 – $10.14 | 1 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $3.72 – $18.34 | 3 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $1.25 – $4.54 | 7 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.98 – $4.32 | 3 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $8.59 – $8.59 | 1 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.07 – $0.13 | 3 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.06 – $0.08 | 7 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.05 – $0.06 | 2 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $4.28 – $9.28 | 3 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $0.78 – $4.44 | 7 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $0.03 – $6,968,275.51 | 3 |
| Inj diclofenac sodium 0.5mg HCPCS J1130 | not published | not published | $0.21 – $0.21 | 2 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $142.18 – $594.28 | 8 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $8.09 – $8.09 | 1 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $62.92 – $169.62 | 8 |
| Inj, durolane 1 mg HCPCS J7318 | not published | not published | $6.14 – $13.24 | 7 |
| Inj dx for sinogram CPT 20501 | $320.90 | $320.90 | $35.67 – $265.17 | 8 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,977.25 | $1,977.25 | $79.46 – $427.88 | 8 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $1,214.55 | $1,214.55 | $66.28 – $443.30 | 8 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $48.06 – $99.39 | 7 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $423.00 – $928.57 | 7 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $19.47 – $55.59 | 4 |
| Injection, caplacizumab-yhdp HCPCS C9047 | not published | not published | $764.26 – $2,329.63 | 4 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $1,714.20 | $1,714.20 | $54.68 – $159.33 | 8 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $163.20 – $504.09 | 4 |
| Injection, cimetidine hydroc HCPCS S0023 | not published | not published | $2.44 – $4.07 | 2 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $61.13 – $129.12 | 7 |
| Injection, delafloxacin HCPCS C9462 | not published | not published | $0.48 – $0.98 | 3 |
| Injection, doxercalciferol HCPCS J1270 | not published | not published | $0.33 – $0.75 | 7 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $35.53 – $74.56 | 7 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $21.82 – $42.85 | 7 |
| Injection epidural blood patch or clot CPT 62273 | $946.40 | $946.40 | $109.61 – $323.80 | 8 |
| Injection estrone per 1 mg HCPCS J1435 | not published | not published | $0.24 – $0.67 | 3 |
| Injection eye drug CPT 67028 | not published | not published | $87.91 – $216.52 | 8 |
| Injection, famotidine, 20 mg HCPCS S0028 | not published | not published | $0.92 – $3.39 | 2 |
| Injection for arthrography wrist (both sides) CPT 25246 | $125.40 | $125.40 | $37.62 – $117.88 | 8 |
| Injection for bladder x-ray CPT 51600 | $884.30 | $884.30 | $42.36 – $404.10 | 8 |
| Injection for hip x-ray CPT 27095 | not published | not published | $79.01 – $588.50 | 8 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $632.25 | $632.25 | $48.70 – $311.60 | 8 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $126.46 – $260.27 | 7 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $49.87 – $111.78 | 8 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $48.54 – $245.43 | 8 |
| Injection for ureter x-ray CPT 50690 | $1,159.15 | $1,159.15 | $67.20 – $228.08 | 8 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $38.25 – $266.37 | 2 |
| Injection, fulvestrant HCPCS J9395 | $2,948.72 | $2,948.72 | $8.17 – $2,771.80 | 8 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $58.65 – $3,253.44 | 4 |
| Injection, glucarpidase HCPCS C9293 | not published | not published | $392.50 – $862.77 | 3 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $12.12 – $24.27 | 7 |
| Injection into brain canal CPT 61026 | not published | not published | $101.83 – $231.82 | 7 |
| Injection into brain canal CPT 61055 | $1,366.90 | $1,366.90 | $113.62 – $1,144.10 | 8 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $177.04 – $602.63 | 8 |
| Injection into spinal artery CPT 62294 | not published | not published | $764.84 – $1,993.41 | 7 |
| Injection into vocal cord CPT 31513 | not published | not published | $126.03 – $267.06 | 7 |
| Injection intraop add-on CPT 48400 | not published | not published | $101.27 – $215.54 | 7 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $1.00 – $2.97 | 4 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $43.56 – $408.60 | 8 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.08 – $2.66 | 7 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.74 – $11.34 | 7 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $25.59 – $309.00 | 5 |
| Injection of sinus tract CPT 20500 | not published | not published | $85.91 – $239.64 | 8 |
| Injection,onabotulinumtoxina HCPCS J0585 | $3,929.49 | $3,929.49 | $6.13 – $1,846.87 | 8 |
| Injection, pentamidine iseth HCPCS S0080 | not published | not published | $99.65 – $103.70 | 2 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.62 – $5.09 | 4 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $1.78 – $2.70 | 2 |
| Injection px peyronie ds CPT 54200 | not published | not published | $82.80 – $226.78 | 8 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $529.80 | $529.80 | $31.47 – $158.69 | 8 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $29.91 – $51.92 | 7 |
| Injection, ruconest HCPCS J0596 | not published | not published | $32.24 – $68.52 | 7 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | not published | not published | $316.74 – $316.74 | 1 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $2,421.70 | $2,421.70 | $61.62 – $223.58 | 8 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $558.05 | $558.05 | $40.54 – $145.20 | 8 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,615.05 | $2,615.05 | $106.95 – $475.43 | 8 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $896.50 | $896.50 | $57.50 – $187.60 | 8 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,527.50 | $2,527.50 | $101.37 – $371.99 | 8 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $545.55 | $545.55 | $49.64 – $175.39 | 8 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,615.05 | $2,615.05 | $87.02 – $342.44 | 8 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,114.10 | $2,114.10 | $103.28 – $506.91 | 8 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,114.10 | $2,114.10 | $95.68 – $498.55 | 8 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $142.01 – $308.32 | 7 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $208.95 | $208.95 | $37.87 – $111.78 | 8 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $412.50 | $412.50 | $35.87 – $101.51 | 8 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $412.50 | $412.50 | $41.00 – $116.93 | 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.