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 |
|---|---|---|---|---|
| Pulse ox multiple CPT 94761 | $113.20 | $113.20 | $3.36 – $8.13 | 8 |
| Pulse ox single CPT 94760 | $51.20 | $51.20 | $2.10 – $42.85 | 8 |
| Punc of shunt for asp or inj CPT 61070 | not published | not published | $53.98 – $114.56 | 7 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $226.50 | $226.50 | $14.64 – $52.69 | 8 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $675.40 | $675.40 | $92.70 – $251.20 | 8 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $46.85 – $179.89 | 8 |
| Puncture spinal lumbar diagnostic CPT 62270 | $2,422.40 | $2,422.40 | $60.17 – $282.04 | 8 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $71.23 – $203.19 | 7 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $94.44 – $173.68 | 7 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $1,517.65 | $1,517.65 | $47.78 – $136.85 | 8 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $80.45 – $438.80 | 8 |
| Pvb thoracic single inj site CPT 64461 | $2,114.10 | $2,114.10 | $76.51 – $258.28 | 8 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $643.23 – $1,694.18 | 3 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $15,237.10 – $40,133.08 | 3 |
| Pyelotomy complicated CPT 50135 | not published | not published | $1,077.75 – $2,141.34 | 6 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $944.10 – $1,996.11 | 7 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $912.60 – $1,930.38 | 7 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $992.68 – $2,097.11 | 7 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $886.25 – $1,903.93 | 7 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $121.17 | $121.17 | $5.73 – $113.90 | 8 |
| Pyruvate CPT 84210 | not published | not published | $14.48 – $30.34 | 6 |
| Pyruvate kinase CPT 84220 | $74.85 | $74.85 | $9.44 – $70.36 | 8 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $334.38 – $887.04 | 3 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $9.58 – $18.63 | 7 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $2,911.75 | $2,911.75 | $38.73 – $2,437.13 | 8 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,473.40 | $1,473.40 | $33.70 – $1,233.24 | 8 |
| Quest t3 uptake CPT 84479 | $67.75 | $67.75 | $6.47 – $63.69 | 8 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $539.31 – $1,430.66 | 3 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $18.89 – $503.85 | 5 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $174.32 – $506.88 | 7 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $236.67 – $495.24 | 7 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $10,348.28 | $10,348.28 | $283.29 – $1,945.50 | 8 |
| Rabies vaccine id CPT 90676 | not published | not published | $119.86 – $846.52 | 3 |
| Radial keratotomy CPT 65771 | not published | not published | $1,156.05 – $1,292.57 | 3 |
| Radiation handling CPT 77790 | not published | not published | $15.59 – $30.86 | 7 |
| Radiation physics consult CPT 77336 | not published | not published | $80.00 – $185.72 | 7 |
| Radiation therapy dose plan CPT 77300 | not published | not published | $32.34 – $67.10 | 7 |
| Radiation therapy management CPT 77431 | not published | not published | $104.50 – $222.33 | 7 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $23.51 – $45.62 | 7 |
| Radiation treatment aid(s) CPT 77333 | $212.00 | $212.00 | $32.00 – $81.34 | 8 |
| Radiation treatment aid(s) CPT 77334 | not published | not published | $59.42 – $123.36 | 7 |
| Radiation treatment delivery CPT 77401 | not published | not published | $38.39 – $83.38 | 7 |
| Radiation treatment delivery CPT 77402 | not published | not published | $116.99 – $288.94 | 3 |
| Radiation treatment delivery CPT 77412 | not published | not published | $224.46 – $498.07 | 3 |
| Radiation tx management x5 CPT 77427 | not published | not published | $186.77 – $393.80 | 7 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $1,758.65 – $3,719.77 | 7 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $1,441.17 – $3,092.80 | 7 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $1,852.67 – $3,966.49 | 7 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $1,690.29 – $3,623.51 | 7 |
| Radical resection of elbow CPT 24149 | not published | not published | $1,135.28 – $2,444.83 | 7 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $1,261.95 – $2,696.28 | 7 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $1,003.54 – $2,141.18 | 7 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $1,370.37 – $2,957.25 | 7 |
| Radiesse injection HCPCS Q2026 | not published | not published | $367.66 – $625.97 | 2 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $4,884.12 – $12,956.39 | 3 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $645.58 – $1,712.58 | 3 |
| Radiology port images(s) CPT 77417 | not published | not published | $12.74 – $33.21 | 7 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $413.96 – $861.48 | 7 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $159.32 – $500.91 | 4 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $2,000.40 | $2,000.40 | $36.69 – $1,674.33 | 8 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $3,667.90 | $3,667.90 | $46.13 – $3,070.03 | 8 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $4,500.10 | $4,500.10 | $83.16 – $3,766.58 | 8 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $2,152.75 | $2,152.75 | $49.52 – $1,801.85 | 8 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,083.85 | $1,083.85 | $29.91 – $907.18 | 8 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $21.07 – $42.70 | 7 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $1,478.38 – $3,171.42 | 7 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $1,077.93 – $2,324.17 | 7 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $1,266.26 – $2,725.43 | 7 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $989.57 – $2,109.31 | 7 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $690.05 – $1,454.57 | 7 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $1,267.82 – $2,732.22 | 7 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $715.14 – $1,553.51 | 7 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $1,013.94 – $2,181.16 | 7 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $1,286.61 – $2,764.74 | 7 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $915.58 – $1,956.13 | 7 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $68.19 – $144.12 | 7 |
| Range of motion measurements CPT 95852 | not published | not published | $5.27 – $31.81 | 8 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $137.63 – $245.08 | 7 |
| Rapid desensitization CPT 95180 | not published | not published | $100.05 – $266.62 | 8 |
| Rapid Strep Test CPT 87880 | $104.75 | $104.75 | $13.39 – $59.25 | 8 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $3,317.06 | $3,317.06 | $349.73 – $3,118.04 | 8 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $221.21 – $436.06 | 7 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $389.10 – $141,809.99 | 6 |
| Rbc count only automated CPT 85041 | not published | not published | $3.02 – $6.10 | 6 |
| Rbc deglycerolized each unit HCPCS P9039 | not published | not published | $197.62 – $2,838.17 | 2 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $46.00 – $95.57 | 6 |
| Rbc irradiated each unit HCPCS P9038 | not published | not published | $117.05 – $647.81 | 2 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.60 – $18.02 | 6 |
| Rbc o2 co2 reduced HCPCS P9027 | not published | not published | $529.06 – $2,114.72 | 2 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $7.47 – $15.59 | 6 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $32.12 – $46.10 | 3 |
| Rcm img acquisj&i&r 1st les CPT 96931 | not published | not published | $78.08 – $338.89 | 7 |
| Rcm img acquisj&i&r ea addl CPT 96934 | not published | not published | $39.04 – $239.26 | 7 |
| Rcm img acquisj only 1st les CPT 96932 | not published | not published | $17.17 – $251.47 | 7 |
| Rcm img acquisj only ea addl CPT 96935 | not published | not published | $23.43 – $154.54 | 7 |
| Rcm i&r only 1st lesion CPT 96933 | not published | not published | $31.23 – $87.44 | 7 |
| Rcm i&r only ea addl lesion CPT 96936 | not published | not published | $15.61 – $84.72 | 7 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $2,121.65 – $4,502.63 | 7 |
| Rcnstj forehead w/autograft CPT 21180 | not published | not published | $1,630.19 – $3,468.30 | 7 |
| Rcnstj forehead with grafts CPT 21179 | not published | not published | $1,459.44 – $3,106.36 | 7 |
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.