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Special medical report or form completion cost in Maine
Compare cash prices for special medical report or form completion at hospitals, clinics and other providers.
Typical cash price
In Maine
From 16 hospital and 0 clinic prices in Maine.
Nationwide typical: $24 (most listed prices $5.40–$95.20).
Cheapest in Maine
- $2.10
Doctor fees are billed separately.
Source: Northern Light AR Gould Hospital price file · checked Oct 2026 - $4.81
Doctor fees are billed separately.
Source: Northern Light Blue Hill Hospital price file · checked Oct 2026 - $15.75
Doctor fees are billed separately.
Source: Northern Light Maine Coast Hospital price file · checked Oct 2026 - $18.75
Doctor fees are billed separately.
Source: Redington-Fairview General Hospital price file · checked Oct 2026 - $20.89
Doctor fees are billed separately.
Source: Penobscot Valley Hospital price file · checked Oct 2026 - $21.78
Doctor fees are billed separately.
Source: Northern Light Mayo Hospital price file · checked Oct 2026 - Northern Light Sebasticook Valley HospitalSpecial medical report or form completionFacility fee only$22.44
Doctor fees are billed separately.
Source: Northern Light Sebasticook Valley Hospital price file · checked Oct 2026 - $23.40
Doctor fees are billed separately. Location not independently confirmed.
Source: Alfond Center for Health price file · checked Oct 2026 - $29
Doctor fees are billed separately.
Source: Down East Community Hospital price file · checked Oct 2026 - $29.70
Doctor fees are billed separately.
Source: Millinocket Regional Hospital price file · checked Oct 2026 - $30
Doctor fees are billed separately.
Source: Northern Maine Medical Center price file · checked Oct 2026 - $36.10
Doctor fees are billed separately.
Source: Houlton Regional Hospital price file · checked Oct 2026
See all prices for Special medical report or form completion
Common questions
Do I need a referral?
It depends on the service and the provider. Many clinics see self-pay patients directly; call ahead to check.
Why are prices so different?
Each hospital and clinic sets its own cash price. Hospitals publish prices because federal rules require it; clinics and booking sites set prices to compete. The same service can cost several times more at one place than at another nearby.
Can I pay cash if I have insurance?
Yes. You can choose to self-pay. A cash price is often lower than what you would pay before meeting your deductible. Cash payments may not count toward your deductible, so check with your plan. Our cash vs. insurance tool can help you decide.
What is a Good Faith Estimate?
If you are uninsured or paying cash, providers must give you a Good Faith Estimate of the cost on request. If your final bill is $400 or more above the estimate, you can dispute it.