MaineHealth
MaineHealth in Farmington, ME publishes cash prices for 40 common procedures listed here, from its own machine-readable price file updated Sep 9, 2025. Click a procedure to compare it with other hospitals nearby.
111 Franklin Health Commons, Farmington, ME 04938 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELVIS W/ CONTRAST | $1,961.30 | $1,961.30 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELVIS W/ CONTRAST | $1,961.30 | $1,961.30 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST | $1,287.30 | $1,287.30 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST | $1,287.30 | $1,287.30 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST | $1,949.20 | $1,949.20 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST | $1,949.20 | $1,949.20 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $521.70 | $521.70 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $521.70 | $521.70 | — |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $370.75 | $370.75 | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $370.75 | $370.75 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JOINT LOWER EXTREM W/O CONTRAST | $2,554.55 | $2,554.55 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JOINT LOWER EXTREM W/O CONTRAST | $2,554.55 | $2,554.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST | $3,955.10 | $3,955.10 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT LOWER EXTREM W/O & W/CONTRAST | $3,955.10 | $3,955.10 | — |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O CONTRAST | $2,559.90 | $2,559.90 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O CONTRAST | $2,559.90 | $2,559.90 | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN STEM W/O & W/ CONTRAST | $3,955.10 | $3,955.10 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN STEM W/O & W/ CONTRAST | $3,955.10 | $3,955.10 | — |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $2,554.55 | $2,554.55 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $2,554.55 | $2,554.55 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME | $139.00 | $139.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $304.00 | $304.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME | $707.70 | $707.70 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME | $139.00 | $139.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $304.00 | $304.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US SINGLE FETUS >/= 14 WKS REAL TIME | $707.70 | $707.70 | — |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $399.00 | $399.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $399.00 | $399.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL | $56.00 | $56.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB | $625.50 | $625.50 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL | $56.00 | $56.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB | $625.50 | $625.50 | — |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE REAL TIME | $699.65 | $699.65 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMINAL COMPLETE REAL TIME | $699.65 | $699.65 | — |
| X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $77.00 | $77.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC XRAY EXAM L-2 SPINE 4/> VIEWS | $461.00 | $461.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $77.00 | $77.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XRAY EXAM L-2 SPINE 4/> VIEWS | $461.00 | $461.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC METAPANEL CALCIUM TOTAL | $95.70 | $95.70 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC METAPANEL CALCIUM TOTAL | $95.70 | $95.70 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL | $76.00 | $76.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $146.95 | $146.95 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL | $76.00 | $76.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $146.95 | $146.95 | — |
| Complete blood count (CBC) with differential CPT 85025 HC COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $87.55 | $87.55 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $87.55 | $87.55 | — |
| Complete blood count (CBC), no differential CPT 85027 HC COUNT COMPLETE AUTOMATED | $71.50 | $71.50 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COUNT COMPLETE AUTOMATED | $71.50 | $71.50 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METAPANEL | $118.65 | $118.65 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METAPANEL | $118.65 | $118.65 | — |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $97.05 | $97.05 | — |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $97.05 | $97.05 | — |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $92.85 | $92.85 | — |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL | $92.85 | $92.85 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $199.50 | $199.50 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $199.50 | $199.50 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $102.00 | $102.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $199.50 | $199.50 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $199.50 | $199.50 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $102.00 | $102.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $199.50 | $199.50 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING | $199.50 | $199.50 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMTIME PARTIAL PLASMA/WHOLE BLOOD | $67.35 | $67.35 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMTIME PARTIAL PLASMA/WHOLE BLOOD | $67.35 | $67.35 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME | $27.00 | $27.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $46.50 | $46.50 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMTIME | $46.50 | $46.50 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME | $27.00 | $27.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMTIME | $46.50 | $46.50 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $46.50 | $46.50 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH | $183.25 | $183.25 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH | $183.25 | $183.25 | — |
| Urinalysis with microscope exam, automated CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $20.00 | $20.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TAREAGENT AUTO MICROSCOPY | $36.35 | $36.35 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $20.00 | $20.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TAREAGENT AUTO MICROSCOPY | $36.35 | $36.35 | — |
| Urinalysis with microscope exam, manual CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $20.00 | $20.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 HC URINLS DIP STICK/TAREAGNT NON-AUTO MICRSCPY | $36.40 | $36.40 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $20.00 | $20.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINLS DIP STICK/TAREAGNT NON-AUTO MICRSCPY | $36.40 | $36.40 | — |
| Urinalysis without microscope exam, automated CPT 81003 B* HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY POC | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 B* HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TARGNT AUTO W/O MICROSCOPY | $24.35 | $24.35 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 B* HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 B* HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY POC | $14.00 | $14.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TARGNT AUTO W/O MICROSCOPY | $24.35 | $24.35 | — |
| Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $17.00 | $17.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIP STICK | $20.45 | $20.45 | — |
| Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TARGNT NON-AUTO W/O MICRSCP | $20.45 | $20.45 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $17.00 | $17.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TARGNT NON-AUTO W/O MICRSCP | $20.45 | $20.45 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIP STICK | $20.45 | $20.45 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $227.05 | $227.05 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ INTERLAMINAR LMBR/SAC W/ IMG GUIDE | $2,114.10 | $2,114.10 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $227.05 | $227.05 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ INTERLAMINAR LMBR/SAC W/ IMG GUIDE | $2,114.10 | $2,114.10 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ INTERLAMINAR LMBR/SAC W/O IMG GUIDE | $2,114.10 | $2,114.10 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ INTERLAMINAR LMBR/SAC W/O IMG GUIDE | $2,114.10 | $2,114.10 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $254.25 | $254.25 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC TRANSFORAM L/S SGL | $2,615.05 | $2,615.05 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $254.25 | $254.25 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC TRANSFORAM L/S SGL | $2,615.05 | $2,615.05 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE/OUTPT NEW LEV 3 | $347.80 | $347.80 | — |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $354.55 | $354.55 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE/OUTPT NEW LEV 3 | $347.80 | $347.80 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $354.55 | $354.55 | — |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE/OUTPT NEW LEV 4 | $510.95 | $510.95 | — |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $540.60 | $540.60 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE/OUTPT NEW LEV 4 | $510.95 | $510.95 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $540.60 | $540.60 | — |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $611.95 | $611.95 | — |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE/OUTPT NEW LEV 5 | $655.15 | $655.15 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $611.95 | $611.95 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE/OUTPT NEW LEV 5 | $655.15 | $655.15 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES 1/> AREAS EA 15 MIN | $199.50 | $199.50 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES 1/> AREAS EA 15 MIN | $199.50 | $199.50 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $547.25 | $547.25 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $547.25 | $547.25 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $741.40 | $741.40 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $741.40 | $741.40 | — |