CMS Price Transparency Data

Drug screening test

Facility: Mainehealth Franklin Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $99
Cash Discount Price: $164
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Mainehealth Franklin Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 0.87x the Medicare baseline. Located in 111 Franklin Health Commons, Farmington, ME.

Cash / Self-Pay

$164

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $164 (143%)

Insurance Median: $99 (87%)

Cash: $164 (143% of Medicare)

Ins. Median: $99 (87% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Harvard Pilgrim Healthcare	$12 - $718	10%
Blue Cross Blue Shield	$17 - $379	15%
Aetna	$17 - $650	15%
UnitedHealthcare	$17 - $761	15%
Wellcare	$18 - $264	16%
Cigna	$29 - $714	25%
Community Health Options	$30 - $744	26%
Multiplan	$33 - $802	29%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $164.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mainehealth Franklin Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.