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 |
|---|---|---|---|---|
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $232.63 – $489.37 | 7 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $204.04 – $427.70 | 7 |
| Laryngoscopy w/fb removal CPT 31530 | not published | not published | $191.49 – $403.98 | 7 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $114.66 – $522.97 | 8 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $116.86 – $417.61 | 8 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | not published | not published | $107.57 – $393.51 | 8 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $328.78 – $689.31 | 7 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $253.76 – $532.74 | 7 |
| Laser surgery eye strands CPT 67031 | not published | not published | $337.56 – $711.69 | 8 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $141.94 – $400.26 | 8 |
| Laser surgery of prostate CPT 52647 | not published | not published | $625.40 – $3,003.53 | 8 |
| Laser surgery of prostate CPT 52648 | not published | not published | $666.56 – $3,097.32 | 8 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $94.08 – $276.90 | 8 |
| Laser treatment of retina CPT 67039 | not published | not published | $915.36 – $1,924.28 | 7 |
| Laser treatment of retina CPT 67040 | not published | not published | $988.42 – $2,077.46 | 7 |
| Lateral canthopexy CPT 21282 | not published | not published | $381.93 – $820.82 | 7 |
| Lateral thoracic extension HCPCS L1210 | not published | not published | $232.85 – $617.69 | 3 |
| Lateral trochanteric pad HCPCS L1290 | not published | not published | $75.12 – $199.25 | 3 |
| Latex suspension sleeve each HCPCS L6632 | not published | not published | $66.21 – $175.60 | 3 |
| Lat retinacular release open CPT 27425 | not published | not published | $439.45 – $955.02 | 7 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $106.21 – $341.57 | 8 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $1,086.61 – $2,280.80 | 7 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $710.50 – $1,728.87 | 8 |
| Lead capillary CPT 83655 | $113.90 | $113.90 | $9.81 – $50.25 | 8 |
| Leads any type vad, rep only HCPCS Q0487 | not published | not published | $319.99 – $842.81 | 3 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $1,291.33 – $2,715.27 | 7 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $1,325.67 – $2,786.43 | 7 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $1,653.20 – $3,464.24 | 7 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $1,366.07 – $2,871.84 | 7 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $1,591.58 – $3,337.48 | 7 |
| Left compres band >=3" <5"/yd HCPCS A6449 | not published | not published | $1.96 – $5.13 | 3 |
| Left compres band <3"/yd HCPCS A6448 | not published | not published | $1.28 – $3.37 | 3 |
| Left compres band >=5"/yd HCPCS A6450 | not published | not published | $1.96 – $5.13 | 3 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $837.10 | $837.10 | $36.51 – $700.65 | 8 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,960.00 | $1,960.00 | $54.58 – $1,640.52 | 8 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $1,430.20 | $1,430.20 | $46.73 – $1,197.08 | 8 |
| Legg perthes orth newington HCPCS L1710 | not published | not published | $2,121.11 – $5,626.79 | 3 |
| Legg perthes orthosis trilat HCPCS L1720 | not published | not published | $1,199.51 – $3,182.00 | 3 |
| Legg perthes orth scottish r HCPCS L1730 | not published | not published | $1,261.11 – $3,345.40 | 3 |
| Legg perthes patten bottom t HCPCS L1755 | not published | not published | $1,878.58 – $4,983.43 | 3 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $20.05 – $42.01 | 6 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $41.76 – $87.44 | 6 |
| Leg perthes orth toronto typ HCPCS L1700 | not published | not published | $1,726.86 – $4,580.96 | 3 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $881.55 – $1,880.21 | 7 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,056.85 | $1,056.85 | $32.43 – $884.58 | 8 |
| Leishmania antibody CPT 86717 | not published | not published | $12.25 – $25.67 | 6 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $642.91 – $1,354.93 | 7 |
| Lengthening of palate CPT 42227 | not published | not published | $815.16 – $1,728.40 | 7 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $874.66 – $1,855.82 | 7 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $1,136.68 – $2,442.10 | 7 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $486.05 – $1,050.59 | 7 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $631.53 – $1,367.12 | 7 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $849.11 – $1,828.71 | 7 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $1,029.51 – $2,211.67 | 7 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $899.19 – $1,903.93 | 7 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $957.94 – $2,060.50 | 7 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $1,084.32 – $2,328.93 | 7 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $595.00 | $595.00 | $38.40 – $120.32 | 8 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $134.00 | $134.00 | $40.20 – $125.96 | 8 |
| Lepirudin HCPCS J1945 | not published | not published | $304.34 – $570.54 | 3 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $105.67 | $105.67 | $3.48 – $99.33 | 8 |
| Leukacyte transfusion CPT 86950 | not published | not published | $78.26 – $111.16 | 3 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $10.39 – $21.69 | 6 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $39,167.12 | $39,167.12 | $170.02 – $3,874.03 | 8 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $39,531.24 | $39,531.24 | $1,510.51 – $5,149.23 | 8 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $4,819.82 – $4,819.82 | 2 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $4.65 – $17.62 | 7 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $281.57 – $465.10 | 7 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $55.64 – $110.51 | 7 |
| Lev 1 hosp type b ed visit HCPCS G0380 | not published | not published | $364.98 – $364.98 | 1 |
| Lev 2 hosp type b ed visit HCPCS G0381 | not published | not published | $480.42 – $480.42 | 1 |
| Lev 3 hosp type b ed visit HCPCS G0382 | not published | not published | $810.05 – $810.05 | 1 |
| Lev 4 hosp type b ed visit HCPCS G0383 | not published | not published | $1,239.67 – $1,239.67 | 1 |
| Lev 5 hosp type b ed visit HCPCS G0384 | not published | not published | $1,753.46 – $1,753.46 | 1 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $1.44 – $4.07 | 2 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.23 – $0.59 | 7 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.04 – $0.17 | 7 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $202.76 | $202.76 | $0.06 – $55.04 | 8 |
| Levetiracetam therapeutic drug level CPT 80177 | $173.45 | $173.45 | $13.25 – $163.04 | 8 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $38.33 | $38.33 | $0.86 – $36.03 | 8 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $323.41 – $787.61 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $549.10 | $549.10 | $10.64 – $516.15 | 8 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $259.12 – $514.45 | 7 |
| Lidocaine injection HCPCS J2001 | not published | not published | $0.03 – $0.08 | 7 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $40.21 | $40.21 | $0.02 – $0.24 | 8 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $176.40 | $176.40 | $0.01 – $165.82 | 8 |
| Lidocaine therapeutic drug level CPT 80176 | not published | not published | $14.69 – $30.51 | 6 |
| Lift assist for elbow HCPCS L6635 | not published | not published | $170.85 – $453.22 | 3 |
| Lift heel adj small gl60404sm HCPCS L3332 | $53.10 | $53.10 | $15.93 – $49.91 | 8 |
| Lift heel adjustable med HCPCS L3334 | not published | not published | $35.45 – $94.04 | 3 |
| Lifts elevation metal extens HCPCS L3330 | not published | not published | $525.72 – $1,394.62 | 3 |
| Ligate esophagus veins CPT 43400 | not published | not published | $1,449.57 – $3,110.42 | 7 |
| Ligate leg veins open CPT 37761 | not published | not published | $509.33 – $1,069.57 | 7 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $541.27 – $1,155.65 | 7 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $73.27 – $152.51 | 7 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $1,376.70 – $2,949.79 | 7 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $437.56 – $920.46 | 7 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $369.53 – $791.68 | 7 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $359.99 – $759.13 | 7 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $195.13 – $600.06 | 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.