Franklin Memorial Hospital — price list
← Hospital overviewVerified from Franklin Memorial Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ACETAMINOPHEN 10 MG/ML IV SOLN Outpatient | J0134 HCPCS | $58.40 | $58.40 | $0.15 – $54.90 | — | |
| ACTIDOSE WITH SORBITOL 25 GM/120ML PO SUSP Outpatient | 0637 RC | $30.39 | $30.39 | $9.12 – $28.57 | — | |
| ALBUTEROL SULFATE (5 MG/ML) 0.5% IN NEBU Outpatient | 0250 RC | $0.58 | $0.58 | $0.17 – $0.55 | — | |
| AMIODARONE HCL IN DEXTROSE 360-4.14 MG/200ML-% IV SOLN Outpatient | J0283 HCPCS | $234 | $234 | $70.26 – $220 | — | |
| AMPICILLIN SODIUM 1 G IV SOLR Outpatient | J0290 HCPCS | $73.05 | $73.05 | $21.92 – $68.67 | — | |
| AMPICILLIN SODIUM 250 MG IJ SOLR Outpatient | J0290 HCPCS | $20.37 | $20.37 | $6.11 – $19.15 | — | |
| ARGATROBAN 250 MG/2.5ML IV SOLN Outpatient | J0883 HCPCS | $867 | $867 | $2.49 – $815 | — | |
| ARIPIPRAZOLE ER 300 MG IM SUSR (COMBINED) Outpatient | J0401 HCPCS | $6,625 | $6,625 | $6.81 – $6,228 | — | |
| ATORVASTATIN CALCIUM 10 MG PO TABS Outpatient | 0637 RC | $0.71 | $0.71 | $0.21 – $0.67 | — | |
| ATORVASTATIN CALCIUM 80 MG PO TABS Outpatient | 0637 RC | $0.99 | $0.99 | $0.30 – $0.93 | — | |
| BENZOCAINE-MENTHOL 15-10 MG MT LOZG Outpatient | 0637 RC | $0.41 | $0.41 | $0.12 – $0.39 | — | |
| BUPIVACAINE HCL (PF) 0.25 % IJ SOLN Outpatient | J0665 HCPCS | $13.93 | $13.93 | $0.03 – $13.09 | — | |
| BUPRENORPHINE HCL-NALOXONE HCL 8-2 MG SL FILM Outpatient | 0637 RC | $20.49 | $20.49 | $6.15 – $19.26 | — | |
| CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN Outpatient | 0637 RC | $91.25 | $91.25 | $27.38 – $85.78 | — | |
| CALCIUM GLUCONATE-NACL 1-0.675 GM/50ML-% IV SOLN Outpatient | J0613 HCPCS | $110 | $110 | $0.27 – $104 | — | |
| CEFDINIR 125 MG/5ML PO SUSR Outpatient | 0637 RC | $57.03 | $57.03 | $17.11 – $53.61 | — | |
| CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC Outpatient | 82272 CPT | $36.30 | $36.30 | $4.23 – $34.12 | — | |
| CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE Outpatient | 80305 CPT | $46.65 | $46.65 | $12.60 – $43.85 | — | |
| CHOLESTYRAMINE 4 G PO PACK Outpatient | 0637 RC | $4.68 | $4.68 | $1.40 – $4.40 | — | |
| CLOBAZAM 10 MG PARTIAL TABS Outpatient | 0637 RC | $2.04 | $2.04 | $0.61 – $1.92 | — | |
| DARBEPOETIN ALFA 40 MCG/ML IJ SOLN Outpatient | J0881 HCPCS | $2,825 | $2,825 | $2.90 – $2,655 | — | |
| DEXTROSE-SODIUM CHLORIDE 5-0.45 % IV SOLN Outpatient | J7042 HCPCS | $157 | $157 | $47.14 – $148 | — | |
| DILTIAZEM HCL ER 300 MG PO TB24 Outpatient | 0637 RC | $7.92 | $7.92 | $2.38 – $7.44 | — | |
| ELOTUZUMAB 400 MG/16ML IV (WET SOLR VIAL) Outpatient | J9176 HCPCS | $9,228 | $9,228 | $7.40 – $8,674 | — | |
| EMPAGLIFLOZIN 10 MG PO TABS Outpatient | 0637 RC | $47.86 | $47.86 | $14.36 – $44.99 | — | |
| ENOXAPARIN SODIUM 120 MG/0.8ML IJ SOSY Outpatient | J1650 HCPCS | $133 | $133 | $39.90 – $125 | — | |
| ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY Outpatient | J1650 HCPCS | $61.06 | $61.06 | $18.32 – $57.40 | — | |
| FLUPHENAZINE HCL 1 MG PO TABS Outpatient | 0637 RC | $1.37 | $1.37 | $0.41 – $1.29 | — | |
| GASTROGRAFIN 66-10 % PO SOLN Outpatient | Q9963 HCPCS | $607 | $607 | $182 – $570 | — | |
| HALOPERIDOL DECANOATE 100 MG/ML IM SOLN Outpatient | J1631 HCPCS | $53.23 | $53.23 | $15.97 – $50.04 | — |