Does Weeks Medical Center have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Weeks Medical Center. In a medical emergency, call 911.

Where is Weeks Medical Center?

173 Middle Street, Lancaster, NH 03584, in Coos County, New Hampshire.

What is the phone number of Weeks Medical Center?

(603) 788-4911, as listed by Medicare (CMS).

What is the Medicare star rating of Weeks Medical Center?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Weeks Medical Center — Phone, Address & ER

Quick answers

Does Weeks Medical Center have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Weeks Medical Center. In a medical emergency, call 911.
Where is Weeks Medical Center?: 173 Middle Street, Lancaster, NH 03584, in Coos County, New Hampshire.
What is the phone number of Weeks Medical Center?: (603) 788-4911, as listed by Medicare (CMS).
What is the Medicare star rating of Weeks Medical Center?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][5][9]

Addiction and recovery
Audiology
Ear, nose, throat/allergy
Behavioral health and psychiatry
Cardiac care
Dermatology
Diabetes care and education
General surgery
Home health and hospice
Hospitalist services
Imaging services
Infusion services
Neurology
OB/GYN
Oncology
Orthopaedics
Palliative care
Pediatrics
Podiatry
Primary care/family medicine
Pulmonary care
Rehabilitation (PT/OT/SLP)
Respiratory therapy
Sleep medicine
Urology
Wound care and healing
Emergency medicine
Rehabilitation (PT/OT/speech)

Conditions treated^[9][14]

Arthritis
Carpal tunnel syndrome
Swallowing disorders
Speech and language disorders
Voice disorders
Head injury
Degenerative neuromuscular disease
Brain tumor
Developmental delay

Treatments^[7][9][11]

MRI (open bore)
CT scan
Nuclear medicine
PET/CT
Ultrasound
3D mammography
Bone density testing
Physical therapy
Occupational therapy
Speech therapy
Lymphedema treatment
IV infusion therapy

Procedures^[13][14]

Laparoscopic appendectomy
Laparoscopic gallbladder removal
Breast biopsy
Colonoscopy
Colon resection
Hernia repair
Port insertion
Skin lesion removal and biopsy
Upper GI endoscopy
Total joint replacement
Hip replacement
Hip resurfacing
Knee replacement
Arthroscopic surgery

Programs and centers^[8][10][12]

Palliative care program
Hospitalist services
TeleICU (Dartmouth Health)

Emergency care (hospital website)^[5]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	Limited visitors allowed in the hospital; clinical discretion is used for visits^[15]
Parking	Park in the main lots behind the hospital near the main entrance; the Middle Street lot has no access to that entrance^[6]
Interpreters and languages	Free remote video interpretation 24 hours a day in many languages including ASL^[6]

Doctors and clinicians (152)

152 doctors and other clinicians list Weeks Medical Center as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (152)

Ajay K. Mishra, MDCardiovascular Disease (Cardiology)
Albert Alhatem, MDPathology
Alexander D. Fuld, MDMedical Oncology
Alexander Knapik, MDDiagnostic Radiology
Alexander Orfanos, MDOrthopedic Surgery
Alexandra PerreaultNurse Practitioner
Alexandra R. Ortengren, MDCardiovascular Disease (Cardiology)
Allen P. Hoang, MDCardiovascular Disease (Cardiology)
Amanda A. FernandezNurse Practitioner
Amanda Neider, MDDiagnostic Radiology
Amber R. Schmidt, DOFamily Practice
Amjad Farah, MDCardiovascular Disease (Cardiology)
Andrew L. Chen Jr., MDSports Medicine
Angelina Hubert, CNACertified Registered Nurse Anesthetist (CRNA)
Angelo C. VozzellaPhysician Assistant
Anna L. Ruelle, DPMPodiatry
Anna S. Lingelbach-LorenzPhysician Assistant
Ashley E. VittumNurse Practitioner
Augustin J. Delago, MDInternal Medicine
Brendon Kinsley, MDEmergency Medicine
Brianne Teaboldt, MDFamily Practice
Bruce Chung, MDGeneral Surgery
Calvin M. KnowlesPhysician Assistant
Carolyn Clark, MDDiagnostic Radiology

And 128 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Littleton Regional Healthcare18 mi · Littleton, NH · Critical Access Hospital
Androscoggin Valley Hospital20 mi · Berlin, NH · Critical Access Hospital
Northeastern Vermont Regional Hospital23 mi · Saint Johnsbury, VT · Critical Access Hospital
Upper Connecticut Valley Hospital29 mi · Colebrook, NH · Critical Access Hospital
Cottage Hospital34 mi · Woodsville, NH · Critical Access Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Lancaster

The Memorial Hospital36 mi · North Conway, NH · Critical Access Hospital

Hospitals in Coos County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Country Village Center, Genesis Healthcare1.4 mi · Lancaster, NH · 3 of 5 stars
Morrison Nursing Home8.3 mi · Whitefield, NH · 4 of 5 stars
Coos County Nursing Home19 mi · Berlin, NH · 3 of 5 stars

All nursing homes in the state →

Hospice providers

North Country Home Health & Hospice Agency15 mi · Littleton, NH · 4 of 5 stars
Caledonia Home Health Care22 mi · Saint Johnsbury, VT · 4 of 5 stars

All hospice providers in the state →

Home health agencies

North Country Home Health & Hospice Agency15 mi · Littleton, NH · 4 of 5 stars
Caledonia Home Health Care22 mi · Saint Johnsbury, VT · 3.5 of 5 stars

All home health agencies in the state →

Dialysis facilities

Fresenius Medical Care of Lancaster0.4 mi · Lancaster, NH · 3 of 5 stars
FMC of ST. Johnsbury Dialysis22 mi · Saint Johnsbury, VT · 2 of 5 stars

All dialysis facilities in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

ACHS - Whitefield8.3 mi · Whitefield, NH · Community health center
Concord Health Center16 mi · Concord, VT · Community health center
Mid-State Health Center - Littleton Dental Clinic17 mi · Littleton, NH · Community health center

Clinics and urgent care

Hartzler Health0.4 mi · Lancaster, NH · Rural health clinic
Weeks Medical Center7.7 mi · Groveton, NH · Rural health clinic
Weeks Medical Center8.3 mi · Whitefield, NH · Rural health clinic

Pharmacies

Cumulus Pharmacy LLC0.4 mi · Lancaster, NH · Pharmacy
Walgreen Co0.4 mi · Lancaster, NH · Pharmacy
Weeks Medical Center0.4 mi · Lancaster, NH · Community/retail pharmacy

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Weeks Medical Center reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Rated the hospital 9 or 10 out of 10	75%National average: 72%
Would definitely recommend the hospital	70%National average: 71%
Nurses “always” communicated well	91%National average: 80%
Doctors “always” communicated well	85%National average: 80%
“Always” got help as soon as they wanted	80%National average: 64%
Staff “always” explained medicines before giving them	57%National average: 62%
Were given information about recovery at home	92%National average: 86%
Room and bathroom “always” clean	83%National average: 73%
Not reported to Medicare	Summary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys	67Response rate: 22%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: pneumonia patients	18.6%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90); Complications after hip or knee replacement
Too few cases to report	Deaths within 30 days: heart attack patients; Deaths within 30 days: heart failure patients; Deaths within 30 days: COPD patients; Deaths within 30 days: stroke patients

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	15%
Readmitted within 30 days: pneumonia	18.2%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery; Readmitted within 30 days: hip or knee replacement
Too few cases to report	Readmitted within 30 days: heart attack; Readmitted within 30 days: heart failure; Readmitted within 30 days: COPD

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	110 minutesNational average: 162 minutes
Not reported to Medicare	Patients who left the emergency room before being seen (OP-22); Sepsis patients who got all the recommended early care (SEP-1)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Not reported to Medicare: infections caught in the hospital. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in New Hampshire

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 55 common services exactly as Weeks Medical Center lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 55 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OV,NEW,LOW MDM,30-44MIN	$282	$157.92	$87.56 – $142.33
New patient office visit (about 30–44 minutes): rates for 8 insurance plans AETNA - Commercial-PPO — Aetna: $89.77 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $87.56 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $142.33 ANTHEM NH - Medicare Part A — Medicare Advantage: $89.73 HUMANA INC. - Medicare-HMO — Medicare Advantage: $89.57 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $87.56 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $91.40 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $91.40
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ONC OV,NEW,LOW MDM,30-44MIN	$282	$157.92	$87.56 – $142.33
New patient office visit (about 30–44 minutes): rates for 8 insurance plans AETNA - Commercial-PPO — Aetna: $89.77 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $87.56 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $142.33 ANTHEM NH - Medicare Part A — Medicare Advantage: $89.73 HUMANA INC. - Medicare-HMO — Medicare Advantage: $89.57 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $87.56 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $91.40 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $91.40
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WC OV,NEW,LOW MDM,30-44MIN	$282	$157.92	$87.56 – $142.33
New patient office visit (about 30–44 minutes): rates for 8 insurance plans AETNA - Commercial-PPO — Aetna: $89.77 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $87.56 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $142.33 ANTHEM NH - Medicare Part A — Medicare Advantage: $89.73 HUMANA INC. - Medicare-HMO — Medicare Advantage: $89.57 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $87.56 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $91.40 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $91.40
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ONC OV, NEW, MOD MDM,45-59MIN	$422	$236.32	$121.28 – $242.80
New patient office visit (about 45–59 minutes): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $146.11 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $215.16 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $242.80 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $121.28 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $148.97
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WC OV, NEW, MOD MDM,45-59MIN	$422	$236.32	$121.28 – $242.80
New patient office visit (about 45–59 minutes): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $146.11 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $215.16 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $242.80 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $121.28 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $148.97
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: SYNCH AUDIO-VIDEO NEW MOD 45	$330	$184.80	$121.28 – $242.80
New patient office visit (about 45–59 minutes): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $146.11 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $215.16 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $242.80 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $121.28 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $148.97
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ONC OV, NEW, HIGH MDM,60 MIN	$556	$311.36	$198.74 – $202.71
New patient office visit (about 60–74 minutes): rates for 2 insurance plans ANTHEM NH - Medicare Part A — Medicare Advantage: $198.74 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $202.71
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: WC OV, NEW, HIGH MDM,60 MIN	$556	$311.36	$198.74 – $202.71
New patient office visit (about 60–74 minutes): rates for 2 insurance plans ANTHEM NH - Medicare Part A — Medicare Advantage: $198.74 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $202.71
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: SYNCH AUDIO-VIDEO NEW HI 60	$437	$244.72	$198.74 – $202.71
New patient office visit (about 60–74 minutes): rates for 2 insurance plans ANTHEM NH - Medicare Part A — Medicare Advantage: $198.74 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $202.71
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient · Hospital (facility) fee In the file: WC OV, EST, LOW MDM,20 MIN	$224	$125.44	$77.62 – $198.91
Established patient office visit (about 20–29 minutes): 10 of 15 insurance plan rates AETNA - Commercial-POS — Aetna: $198.91 AETNA - Commercial-PPO — Aetna: $111.96 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $110.66 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $114.29 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $97.23 ANTHEM NH - Medicare Part A — Medicare Advantage: $110.66 BCBS FEP - Commercial-PPO — Anthem Health: $169.40 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $183.68 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $77.62 HUMANA INC. - Medicare-HMO — Medicare Advantage: $114.15
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OV,EST,LOW MDM,20 MIN	$230	$128.80	$70.52 – $117.18
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans AETNA - Commercial-PPO — Aetna: $73.05 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $70.52 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $117.18 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $116.08 ANTHEM NH - Medicare Part A — Medicare Advantage: $70.52 HUMANA INC. - Medicare-HMO — Medicare Advantage: $72.15 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $70.52 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $75.37 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $73.62
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ONC OV, EST, LOW MDM,20 MIN	$230	$128.80	$70.52 – $117.18
Established patient office visit (about 20–29 minutes): rates for 9 insurance plans AETNA - Commercial-PPO — Aetna: $73.05 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $70.52 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $117.18 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $116.08 ANTHEM NH - Medicare Part A — Medicare Advantage: $70.52 HUMANA INC. - Medicare-HMO — Medicare Advantage: $72.15 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $70.52 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $75.37 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $73.62
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient or outpatient · Hospital (facility) fee In the file: WC OV,EST,MOD MDM, 30-39MIN	$281	$157.36	$97.37 – $249.53
Established patient office visit (about 30–39 minutes): rates for 10 insurance plans AETNA - Commercial-POS — Aetna: $249.53 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $119.54 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $143.27 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $132.74 BCBS FEP - Commercial-PPO — Anthem Health: $211.75 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $230.42 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $97.37 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $119.54 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $214.12 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $120.83
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OV,EST,MOD MDM, 30 MIN	$324	$181.44	$88.22 – $164.62
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans AETNA - Commercial-PPO — Aetna: $108.94 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $103.80 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $164.62 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $163.52 ANTHEM NH - Medicare Part A — Medicare Advantage: $103.80 HUMANA INC. - Medicare-HMO — Medicare Advantage: $106.48 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $88.22 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $111.16 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $108.35
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ONC OV,EST,MOD MDM, 30 MIN	$324	$181.44	$88.22 – $164.62
Established patient office visit (about 30–39 minutes): rates for 9 insurance plans AETNA - Commercial-PPO — Aetna: $108.94 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $103.80 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $164.62 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $163.52 ANTHEM NH - Medicare Part A — Medicare Advantage: $103.80 HUMANA INC. - Medicare-HMO — Medicare Advantage: $106.48 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $88.22 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $111.16 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $108.35
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Hospital (facility) fee In the file: ED VISIT W/LOW MDM	$794	$444.64	$100 – $794
Emergency room visit (moderate): 10 of 29 insurance plan rates AETNA - Commercial-POS — Aetna: $705.07 AETNA - Commercial-PPO — Aetna: $396.84 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $337.77 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $491.88 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $606.38 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $606.38 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $606.38 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $606.38 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $606.38 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $400.73
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ED VISIT W/LOW MDM	$175	$98	$75.03 – $88.33
Emergency room visit (moderate): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $75.03 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $88.33 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $88.33 ANTHEM NH - Medicare Part A — Medicare Advantage: $75.03 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $75.03
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient · Doctor (professional) fee In the file: ED VISIT W/LOW MDM	$794	$444.64	$100 – $794
Emergency room visit (moderate): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $616.94
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Hospital (facility) fee In the file: ED VISIT W/MODERATE MDM	$1,249	$699.44	$110 – $1,230.52
Emergency room visit (moderately high): 10 of 21 insurance plan rates AETNA - Commercial-POS — Aetna: $1,109.11 AETNA - Commercial-PPO — Aetna: $624.25 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $531.32 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $773.76 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $953.86 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $953.87 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $986.80 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $953.87 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $630.38 ANTHEM HEALTH PLANS, INC (CT) - Commercial-HMO — Anthem Health: $953.87
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ED VISIT W/MODERATE MDM	$298	$166.88	$127.92 – $298
Emergency room visit (moderately high): rates for 8 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $127.92 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $150.40 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $150.40 ANTHEM NH - Medicare Part A — Medicare Advantage: $127.92 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $127.92 UNITED HEALTHCARE INSURANCE COMPANY - Commercial-HMO — UnitedHealthcare: $298 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $298 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $298
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient · Doctor (professional) fee In the file: ED VISIT W/MODERATE MDM	$1,249	$699.44	$110 – $1,230.52
Emergency room visit (moderately high): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $773.76
Emergency room visit (high) CPT 99285 · Inpatient or outpatient · Hospital (facility) fee In the file: ED VISIT W/HIGH MDM	$1,793	$1,004.08	$125 – $1,763.64
Emergency room visit (high): rates for 8 insurance plans ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,369.31 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,369.32 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $907.13 ANTHEM NH - Medicare Part A — Medicare Advantage: $829.92 BCBS FEP - Commercial-PPO — Anthem Health: $1,457.89 HUMANA INC. - Medicare-HMO — Medicare Advantage: $1,763.64 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $885.74 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $125
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ED VISIT W/HIGH MDM	$431	$241.36	$185.40 – $217.53
Emergency room visit (high): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $190.10 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $217.53 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $217.53 ANTHEM NH - Medicare Part A — Medicare Advantage: $185.40 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $185.40

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Hospital (facility) fee In the file: BASIC METABOLIC PANEL	$86	$48.16	$7.69 – $84.76
Basic metabolic panel (blood test): 10 of 28 insurance plan rates AETNA - Commercial-POS — Aetna: $70.18 AETNA - Commercial-PPO — Aetna: $42.98 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $42.14 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $7.69 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $71.89 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $71.89 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $71.89 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $71.89 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $71.89 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $43.40
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · Doctor (professional) fee In the file: BASIC METABOLIC PANEL	$86	$48.16	$7.69 – $84.76
Basic metabolic panel (blood test): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $7.69
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$153	$85.68	$9.59 – $150.42
Comprehensive metabolic panel (blood test): 10 of 34 insurance plan rates AETNA - Commercial-POS — Aetna: $124.85 AETNA - Commercial-PPO — Aetna: $76.47 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $74.97 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $9.59 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $89.73 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $89.73 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $89.73 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $89.73 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $89.73 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $77.22
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · Doctor (professional) fee In the file: COMPREHEN METABOLIC PANEL	$153	$85.68	$9.59 – $150.42
Comprehensive metabolic panel (blood test): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $9.59
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Hospital (facility) fee In the file: LIPID PANEL	$218	$122.08	$12.16 – $213.64
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates AETNA - Commercial-POS — Aetna: $177.89 AETNA - Commercial-PPO — Aetna: $108.96 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $106.82 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $12.16 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $113.78 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $113.78 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $113.78 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $113.78 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $113.78 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $110.02
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient · Doctor (professional) fee In the file: LIPID PANEL	$218	$122.08	$12.16 – $213.64
Cholesterol panel (lipid panel): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $12.16
Kidney function panel CPT 80069 · Inpatient or outpatient · Hospital (facility) fee In the file: RENAL FUNCTION	$103	$57.68	$7.89 – $83.75
Kidney function panel: rates for 7 insurance plans AETNA - Commercial-PPO — Aetna: $48.48 BCBS FEP - Commercial-PPO — Anthem Health: $83.75 Cigna Health and Life Insurance Company - Commercial-POS — Cigna: $77.60 HUMANA INC. - Medicare-HMO — Medicare Advantage: $40.74 NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $7.89 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $51.50 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $51.50
Liver function panel CPT 80076 · Inpatient or outpatient · Hospital (facility) fee In the file: HFP	$97	$54.32	$7.42 – $95.54
Liver function panel: 10 of 25 insurance plan rates AETNA - Commercial-POS — Aetna: $86.14 AETNA - Commercial-PPO — Aetna: $48.48 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $44.95 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $7.42 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $69.42 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $69.42 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $69.42 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $69.42 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $48.96 ANTHEM NH - Medicare Part A — Medicare Advantage: $40.88
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALYSIS AUTO W/ SCOPE	$69	$38.64	$2.88 – $69
Urine test (automated, with microscope): 10 of 29 insurance plan rates AETNA - Commercial-POS — Aetna: $56.30 AETNA - Commercial-PPO — Aetna: $34.49 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $29.08 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2.88 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $26.93 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $26.93 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $26.93 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $26.93 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $34.83 ANTHEM HEALTH PLANS, INC (CT) - Commercial-HMO — Anthem Health: $26.93
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS AUTO W/ SCOPE	$69	$38.64	$2.88 – $69
Urine test (automated, with microscope): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2.88
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Hospital (facility) fee In the file: URINALYSIS WO MICRO	$32	$17.92	$3.16 – $32
Urine test (manual, without microscope): 10 of 13 insurance plan rates AETNA - Commercial-PPO — Aetna: $15.99 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $14.70 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $32 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $16.15 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $16.15 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $31.58 HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $21.85 HARVARD PILGRIM HEALTH CARE - Commercial-POS — Harvard Pilgrim Healthcare: $25.73 HUMANA INC. - Medicare-HMO — Medicare Advantage: $31.36 NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $3.16
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient · Doctor (professional) fee In the file: URINALYSIS WO MICRO	$32	$17.92	$3.16 – $32
Urine test (manual, without microscope): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $30
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Hospital (facility) fee In the file: AUTOMATED URINALYSIS WO MICRO	$15	$8.40	$2.05 – $15
Urine test (automated, without microscope): 10 of 30 insurance plan rates AETNA - Commercial-PPO — Aetna: $7.50 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $7.35 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2.05 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $15 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $15 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $15 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $15 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $15 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $7.58 ANTHEM HEALTH PLANS, INC (CT) - Commercial-HMO — Anthem Health: $15
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient · Doctor (professional) fee In the file: AUTOMATED URINALYSIS WO MICRO	$15	$8.40	$2.05 – $15
Urine test (automated, without microscope): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2.05
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient · Hospital (facility) fee In the file: PROSTATE SPEC ANTIGEN TOTAL	$106	$59.36	$14.34 – $106
PSA (prostate specific antigen) blood test: 10 of 23 insurance plan rates AETNA - Commercial-PPO — Aetna: $52.98 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $48.51 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $16.71 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $106 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $106 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $106 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $106 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $53.50 ANTHEM HEALTH PLANS, INC (CT) - Commercial-HMO — Anthem Health: $106 BCBS FEP - Commercial-PPO — Anthem Health: $86.19
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Hospital (facility) fee In the file: THYROID STIMULATING HORMONE	$197	$110.32	$15.26 – $197
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates AETNA - Commercial-POS — Aetna: $160.75 AETNA - Commercial-PPO — Aetna: $98.46 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $83.02 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $15.26 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $142.76 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $142.76 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $142.76 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $142.76 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $142.76 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $99.43
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient · Doctor (professional) fee In the file: THYROID STIMULATING HORMONE	$197	$110.32	$15.26 – $197
Thyroid stimulating hormone (TSH) test: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $197
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC-DIFF-PLATELET CO	$70	$39.20	$7.06 – $70
Complete blood count (CBC) with differential: 10 of 34 insurance plan rates AETNA - Commercial-POS — Aetna: $62.16 AETNA - Commercial-PPO — Aetna: $34.99 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $34.30 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $7.06 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $66.03 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $66.03 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $66.03 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $66.03 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $66.03 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $35.33
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · Doctor (professional) fee In the file: CBC-DIFF-PLATELET CO	$70	$39.20	$7.06 – $70
Complete blood count (CBC) with differential: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $7.06
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Hospital (facility) fee In the file: CBC W PLT COMPL AUTOM	$73	$40.88	$5.88 – $73
Complete blood count (CBC), automated: 10 of 30 insurance plan rates AETNA - Commercial-PPO — Aetna: $36.49 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $35.77 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $5.88 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $54.98 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $54.98 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $54.98 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $54.98 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $54.98 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $36.85 ANTHEM HEALTH PLANS, INC (CT) - Commercial-HMO — Anthem Health: $54.98
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · Doctor (professional) fee In the file: CBC W PLT COMPL AUTOM	$73	$40.88	$5.88 – $73
Complete blood count (CBC), automated: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $73
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee In the file: PROTHROMBIN TIME	$64	$35.84	$3.90 – $58.05
Blood clotting time test (prothrombin time, PT): 10 of 28 insurance plan rates AETNA - Commercial-POS — Aetna: $53.40 AETNA - Commercial-PPO — Aetna: $31.99 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $26.97 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $3.90 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $36.04 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $36.45 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $36.45 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $36.45 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $36.45 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $27.78
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Doctor (professional) fee In the file: PROTHROMBIN TIME	$64	$35.84	$3.90 – $58.05
Blood clotting time test (prothrombin time, PT): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $3.90
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient · Hospital (facility) fee · modifier QW In the file: PROTHROMBIN TIME	$64	$35.84	$3.87 – $60.16
Blood clotting time test (prothrombin time, PT): rates for 10 insurance plans AETNA - Commercial-PPO — Aetna: $31.99 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $60.16 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $32.30 ANTHEM NH - Medicare Part A — Medicare Advantage: $29.40 HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $51.47 HUMANA INC. - Medicare-HMO — Medicare Advantage: $32.61 NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $3.87 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $29.40 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $32 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $27.52
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Hospital (facility) fee In the file: PTT PLASMA OR WHOLE BLOOD	$36	$20.16	$5.46 – $36
Blood clotting test (partial thromboplastin time, PTT): 10 of 25 insurance plan rates AETNA - Commercial-PPO — Aetna: $17.99 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $17.64 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $5.46 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $36 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $36 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $36 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $36 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $36 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $18.17 ANTHEM NH - Medicare Part A — Medicare Advantage: $17.64
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · Doctor (professional) fee In the file: PTT PLASMA OR WHOLE BLOOD	$36	$20.16	$5.46 – $36
Blood clotting test (partial thromboplastin time, PTT): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $5.46

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee In the file: CT HEAD/BRAIN WO CONTRAST	$2,336	$1,308.16	$369.01 – $2,336
CT scan of the head or brain, without contrast: 10 of 23 insurance plan rates AETNA - Commercial-POS — Aetna: $1,037.18 AETNA - Commercial-PPO — Aetna: $2,074.37 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,153.98 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $1,447.15 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $738.01 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $738.01 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $369.01 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $369.01 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $369.01 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,178.98
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Doctor (professional) fee In the file: CT HEAD/BRAIN WO CONTRAST	$2,336	$1,308.16	$369.01 – $2,336
CT scan of the head or brain, without contrast: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $1,447.15
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: CT HEAD/BRAIN WO CONTRAST	$2,336	$1,308.16	$369.01 – $2,336
CT scan of the head or brain, without contrast: rates for 1 insurance plan HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $1,595.25
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI BRAIN W & WO CONTRAST	$6,054	$3,390.24	$2,097.71 – $6,054
MRI of the brain, before and after contrast: 10 of 18 insurance plan rates AETNA - Commercial-PPO — Aetna: $3,025.79 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $3,750.45 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $2,409.05 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $2,409.05 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $2,409.05 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $3,067.92 ANTHEM NH - Medicare Part A — Medicare Advantage: $2,575.37 BCBS FEP - Commercial-PPO — Anthem Health: $4,922.51 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $4,964.28 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $2,097.71
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: MRI BRAIN W & WO CONTRAST	$6,054	$3,390.24	$2,097.71 – $6,054
MRI of the brain, before and after contrast: rates for 1 insurance plan HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $4,134.28
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$378	$211.68	$130.98 – $335.66
Chest X-ray, 2 views: 10 of 29 insurance plan rates AETNA - Commercial-POS — Aetna: $335.66 AETNA - Commercial-PPO — Aetna: $188.92 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $186.73 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $234.17 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $244.52 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $244.52 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $244.52 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $244.52 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $244.52 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $190.78
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Doctor (professional) fee In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$378	$211.68	$130.98 – $335.66
Chest X-ray, 2 views: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $219.30
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: RADIOLOGIC EXAM CHEST 2 VIEWS	$378	$211.68	$130.98 – $335.66
Chest X-ray, 2 views: rates for 2 insurance plans HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $258.14 HARVARD PILGRIM HEALTH CARE - Commercial-POS — Harvard Pilgrim Healthcare: $303.99
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee In the file: X-RAY LOWER SPINE (MIN 4 VIEW)	$639	$357.84	$221.41 – $513.88
X-ray of the lower spine, at least 4 views: 10 of 18 insurance plan rates AETNA - Commercial-PPO — Aetna: $319.37 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $271.83 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $395.86 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $411.45 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $411.45 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $411.45 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $399.47 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $322.51 ANTHEM NH - Medicare Part A — Medicare Advantage: $315.67 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $491.18
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: X-RAY LOWER SPINE (MIN 4 VIEW)	$639	$357.84	$221.41 – $513.88
X-ray of the lower spine, at least 4 views: rates for 1 insurance plan HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $436.37
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI LUMBAR SPINE WO CONTRAST	$4,371	$2,447.76	$1,383.81 – $3,710.98
MRI of the lower back (lumbar spine), without contrast: 10 of 19 insurance plan rates AETNA - Commercial-PPO — Aetna: $1,879.53 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,859.42 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,707.83 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,383.81 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,383.81 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $1,383.81 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,383.81 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,904.95 ANTHEM NH - Medicare Part A — Medicare Advantage: $2,159.27 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $3,584.22
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI LUMBAR SPINE WO CONTRAST	$4,371	$2,447.76	$1,383.81 – $3,710.98
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $3,396.27
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: MRI LUMBAR SPINE WO CONTRAST	$4,371	$2,447.76	$1,383.81 – $3,710.98
MRI of the lower back (lumbar spine), without contrast: rates for 1 insurance plan HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $2,984.96
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee In the file: CT PELVIS W CONTRAST	$2,644	$1,480.64	$1,805.59 – $1,870.58
CT scan of the pelvis, with contrast: rates for 1 insurance plan ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,870.58
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: CT PELVIS W CONTRAST	$2,644	$1,480.64	$1,805.59 – $1,870.58
CT scan of the pelvis, with contrast: rates for 1 insurance plan HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $1,805.59
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI LT LOW EXT JNT WO CONTRAST	$3,676	$2,058.56	$1,273.73 – $3,264.29
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates AETNA - Commercial-POS — Aetna: $3,264.29 AETNA - Commercial-PPO — Aetna: $1,837.26 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,563.77 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,277.28 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,855.28 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,563.77
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Hospital (facility) fee In the file: MRI RT LOW EXTR JNT WO CONTR	$3,676	$2,058.56	$1,273.73 – $3,264.29
MRI of a leg joint (such as the knee), without contrast: 10 of 23 insurance plan rates AETNA - Commercial-POS — Aetna: $3,264.29 AETNA - Commercial-PPO — Aetna: $1,837.26 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,563.77 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,277.28 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,561.32 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,855.28 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,563.77
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · Doctor (professional) fee In the file: MRI LT LOW EXT JNT WO CONTRAST	$3,676	$2,058.56	$1,273.73 – $3,264.29
MRI of a leg joint (such as the knee), without contrast: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,134.18
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee In the file: CT ABDOMEN & PELVIS W CONTRST	$4,745	$2,657.20	$1,644.14 – $4,213.56
CT scan of the abdomen and pelvis, with contrast: 10 of 28 insurance plan rates AETNA - Commercial-POS — Aetna: $4,213.56 AETNA - Commercial-PPO — Aetna: $2,371.55 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $2,018.52 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,939.53 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $2,432.72 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $2,505.71 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $2,505.71 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $2,505.71 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $2,505.71 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $2,394.81
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Doctor (professional) fee In the file: CT ABDOMEN & PELVIS W CONTRST	$4,745	$2,657.20	$1,644.14 – $4,213.56
CT scan of the abdomen and pelvis, with contrast: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,754.92
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: CT ABDOMEN & PELVIS W CONTRST	$4,745	$2,657.20	$1,644.14 – $4,213.56
CT scan of the abdomen and pelvis, with contrast: rates for 2 insurance plans HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $3,240.36 HARVARD PILGRIM HEALTH CARE - Commercial-POS — Harvard Pilgrim Healthcare: $3,814.51
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee In the file: US EXAM ABDOMEN COMPLETE	$1,001	$560.56	$346.85 – $888.89
Ultrasound of the abdomen, complete: 10 of 20 insurance plan rates AETNA - Commercial-POS — Aetna: $888.89 AETNA - Commercial-PPO — Aetna: $430.43 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $425.83 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $620.12 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $848.12 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $848.12 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $848.12 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $565.83 ANTHEM NH - Medicare Part A — Medicare Advantage: $425.83 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $820.82
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: US EXAM ABDOMEN COMPLETE	$1,001	$560.56	$346.85 – $888.89
Ultrasound of the abdomen, complete: rates for 2 insurance plans HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $683.58 HARVARD PILGRIM HEALTH CARE - Commercial-POS — Harvard Pilgrim Healthcare: $805
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient · Hospital (facility) fee In the file: OB US >/= 14 WKS SINGLE FETUS	$984	$551.04	$572.50
Pregnancy ultrasound (after the first trimester): rates for 1 insurance plan NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $572.50
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee In the file: NON-OB TRANSVAGINAL US	$936	$524.16	$324.32 – $933.31
Transvaginal ultrasound: 10 of 20 insurance plan rates AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $398.17 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $579.85 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $933.31 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $933.31 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $933.31 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $933.31 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $933.31 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $407.92 ANTHEM NH - Medicare Part A — Medicare Advantage: $398.17 BCBS FEP - Commercial-PPO — Anthem Health: $761.06
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: NON-OB TRANSVAGINAL US	$936	$524.16	$324.32 – $933.31
Transvaginal ultrasound: rates for 1 insurance plan HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $639.19
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO DX UNILAT LT INC CAD	$1,037	$580.72	$336.80 – $1,026.06
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates AETNA - Commercial-PPO — Aetna: $518.29 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $441.14 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $642.42 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $534.06 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $929.75 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $929.75 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $929.75 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $523.38 ANTHEM NH - Medicare Part A — Medicare Advantage: $515.54 BCBS FEP - Commercial-PPO — Anthem Health: $843.18
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO DX UNILAT RT INC CAD	$1,037	$580.72	$336.80 – $1,026.06
Diagnostic mammogram, one breast: 10 of 22 insurance plan rates AETNA - Commercial-PPO — Aetna: $518.29 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $441.14 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $642.42 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $534.06 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $929.75 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $929.75 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $929.75 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $523.38 ANTHEM NH - Medicare Part A — Medicare Advantage: $515.54 BCBS FEP - Commercial-PPO — Anthem Health: $843.18
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · Doctor (professional) fee In the file: MAMMO DX UNILAT LT INC CAD	$1,037	$580.72	$336.80 – $1,026.06
Diagnostic mammogram, one breast: rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $602.15
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO DX BILAT INC CAD	$1,241	$694.96	$430.01 – $1,217.98
Diagnostic mammogram, both breasts: 10 of 18 insurance plan rates AETNA - Commercial-PPO — Aetna: $620.25 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $768.80 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $639.12 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,185.45 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $1,185.45 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,185.45 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $538.65 ANTHEM NH - Medicare Part A — Medicare Advantage: $613.05 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $1,017.62 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $430.01
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · Hospital (facility) fee · modifier TC In the file: MAMMO DX BILAT INC CAD	$1,241	$694.96	$430.01 – $1,217.98
Diagnostic mammogram, both breasts: rates for 2 insurance plans HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $847.48 HARVARD PILGRIM HEALTH CARE - Commercial-POS — Harvard Pilgrim Healthcare: $824.80
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO SCREEN BILAT INC CAD	$1,027	$575.12	$90.75 – $1,027
Screening mammogram, both breasts: 10 of 29 insurance plan rates AETNA - Commercial-POS — Aetna: $785.81 AETNA - Commercial-PPO — Aetna: $513.29 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $93.39 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $636.23 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $518.33
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO SCREEN UNILAT LT INC CAD	$841	$470.96	$90.75 – $1,027
Screening mammogram, both breasts: 10 of 29 insurance plan rates AETNA - Commercial-POS — Aetna: $785.81 AETNA - Commercial-PPO — Aetna: $513.29 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $93.39 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $636.23 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $518.33
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · Hospital (facility) fee In the file: MAMMO SCREEN UNILAT RT INC CAD	$841	$470.96	$90.75 – $1,027
Screening mammogram, both breasts: 10 of 29 insurance plan rates AETNA - Commercial-POS — Aetna: $785.81 AETNA - Commercial-PPO — Aetna: $513.29 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $93.39 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $636.23 ANTHEM HEALTH PLANS OF NH - Commercial-EPO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $979.47 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $518.33

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient · Hospital (facility) fee In the file: POLYSOMNOGRAPHY 4 > W TECH	$3,361	$1,882.16	$1,955.45 – $2,756.02
Sleep study (overnight, in a sleep lab): rates for 3 insurance plans ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $2,566.80 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $2,756.02 NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $1,955.45

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES 15 MIN	$189	$105.84	$3.44 – $455.98
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 27 insurance plan rates AETNA - Commercial-PPO — Aetna: $94.46 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $80.40 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $117.09 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $95.39 ANTHEM NH - Medicare Part A — Medicare Advantage: $80.40 BCBS FEP - Commercial-PPO — Anthem Health: $167.59
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: THERAPEUT EXCERCISE 15MIN PTA	$178	$99.68	$65.49 – $320.92
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 26 insurance plan rates AETNA - Commercial-PPO — Aetna: $94.46 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $80.40 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $117.09 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $95.39 ANTHEM NH - Medicare Part A — Medicare Advantage: $80.40 BCBS FEP - Commercial-PPO — Anthem Health: $167.59
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · Hospital (facility) fee In the file: PRH EXERCISE (15 MIN UNIT)	$177	$99.12	$65.49 – $320.92
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 26 insurance plan rates AETNA - Commercial-PPO — Aetna: $94.46 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $80.40 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $117.09 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $144.34 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $95.39 ANTHEM NH - Medicare Part A — Medicare Advantage: $80.40 BCBS FEP - Commercial-PPO — Anthem Health: $167.59
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	$385	$215.60	$137.45 – $349.20
Physical therapy evaluation (low complexity): 10 of 14 insurance plan rates AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $216.60 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $320.82 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $320.83 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $152.83 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $221.51 ANTHEM NH - Medicare Part A — Medicare Advantage: $216.60 BCBS FEP - Commercial-PPO — Anthem Health: $341.38 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $137.45 HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $263.19 HUMANA INC. - Medicare-HMO — Medicare Advantage: $218.29
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Hospital (facility) fee In the file: PRH EVAL LOW COMPLEX 20 MIN	$361	$202.16	$137.45 – $349.20
Physical therapy evaluation (low complexity): 10 of 14 insurance plan rates AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $216.60 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $320.82 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $320.83 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $152.83 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $221.51 ANTHEM NH - Medicare Part A — Medicare Advantage: $216.60 BCBS FEP - Commercial-PPO — Anthem Health: $341.38 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $137.45 HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $263.19 HUMANA INC. - Medicare-HMO — Medicare Advantage: $218.29
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL LOW COMPLEX 20 MIN	$385	$215.60	$137.45 – $349.20
Physical therapy evaluation (low complexity): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $299.15
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	$434	$243.04	$150.38 – $368.47
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates AETNA - Commercial-PPO — Aetna: $216.91 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $184.62 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $268.86 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $219.04 ANTHEM NH - Medicare Part A — Medicare Advantage: $184.62 BCBS FEP - Commercial-PPO — Anthem Health: $352.89
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Hospital (facility) fee In the file: PRH EVAL MOD COMPLEX 30 MIN	$407	$227.92	$150.38 – $368.47
Physical therapy evaluation (moderate complexity): 10 of 25 insurance plan rates AETNA - Commercial-PPO — Aetna: $216.91 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $184.62 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $268.86 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $331.45 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $219.04 ANTHEM NH - Medicare Part A — Medicare Advantage: $184.62 BCBS FEP - Commercial-PPO — Anthem Health: $352.89
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · Doctor (professional) fee In the file: PT EVAL MOD COMPLEX 30 MIN	$434	$243.04	$150.38 – $368.47
Physical therapy evaluation (moderate complexity): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $337.22
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	$491	$274.96	$360.32 – $409.15
Physical therapy evaluation (high complexity): rates for 2 insurance plans ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $409.15 NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $360.32
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · Hospital (facility) fee In the file: PRH EVAL HIGH COMPLEX 45 MIN	$460	$257.60	$360.32 – $409.15
Physical therapy evaluation (high complexity): rates for 2 insurance plans ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $409.15 NEW HAMPSHIRE HEALTHY FAMILIES - Medicaid — Medicaid Managed Care: $360.32

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PROSTHETIC REPLACEMENT HIP	$3,223	$1,804.88	$1,391.28 – $1,626.65
Total hip replacement: rates for 4 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,420.17 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,626.65 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,391.28 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $1,391.28
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ASSIST HIP ARTHROPLASTY	$967	$541.52	$1,391.28 – $1,626.65
Total hip replacement: rates for 4 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,420.17 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,626.65 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,391.28 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $1,391.28
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: TOTAL KNEE REPLACEMENT	$3,218	$1,802.08	$1,389.48 – $1,418.11
Total knee replacement: rates for 3 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,418.11 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,397.74 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,389.48
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ASSIST TOTAL KNEE REPLACEMENT	$965	$540.40	$1,389.48 – $1,418.11
Total knee replacement: rates for 3 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,418.11 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,397.74 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,389.48
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHROSCOPY SHOULDER SURGERY	$424	$237.44	$183.25
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan ANTHEM NH - Medicare Part A — Medicare Advantage: $183.25
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ASSIST SHOULDER ARTHROSCOPY	$127	$71.12	$183.25
Shoulder arthroscopy: shaving of shoulder bone: rates for 1 insurance plan ANTHEM NH - Medicare Part A — Medicare Advantage: $183.25
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ARTHROSCOPY KNEE SURGERY	$1,384	$775.04	$609.87
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans ANTHEM NH - Medicare Part A — Medicare Advantage: $609.87 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $609.87
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: ASSIST KNEE ARTHROSCOPY	$415	$232.40	$609.87
Knee arthroscopy: removal of torn cartilage (meniscus): rates for 2 insurance plans ANTHEM NH - Medicare Part A — Medicare Advantage: $609.87 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $609.87
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient · Hospital (facility) fee In the file: GASTROSCOPY	$3,921	$2,195.76	$90.05 – $3,862.18
Upper GI endoscopy (diagnostic): 10 of 14 insurance plan rates AETNA - Commercial-PPO — Aetna: $1,959.72 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,667.99 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,429.06 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $2,744.70 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $2,994.47 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $908.97 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,936.97 BCBS FEP - Commercial-PPO — Anthem Health: $3,188.17 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $3,215.22 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $1,358.63
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EGD ENDOSCOPY DIAGNOSIC	$734	$411.04	$130.64 – $364.39
Upper GI endoscopy (diagnostic): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $130.64 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $318.59 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $364.39 ANTHEM NH - Medicare Part A — Medicare Advantage: $130.64 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $133.75
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: EGD w Colonoscopy	$2,444	$1,368.64	$395 – $3,542.92
Upper GI endoscopy with biopsy: 10 of 18 insurance plan rates AETNA - Commercial-PPO — Aetna: $1,282.49 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,091.58 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $1,589.64 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,321.49 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,959.65 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $1,959.65 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,959.66 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,295.06 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,091.58 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $889.12
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient · Hospital (facility) fee In the file: GASTROSCOPY WITH BIOPSY	$2,566	$1,436.96	$395 – $3,542.92
Upper GI endoscopy with biopsy: 10 of 18 insurance plan rates AETNA - Commercial-PPO — Aetna: $1,282.49 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,091.58 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $1,589.64 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,321.49 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,959.65 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $1,959.65 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,959.66 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,295.06 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,091.58 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $889.12
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: EGD ENDOSCOPY BIOPSY	$960	$537.60	$146.77 – $484.51
Upper GI endoscopy with biopsy: rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $146.77 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $484.51 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $484.51 ANTHEM NH - Medicare Part A — Medicare Advantage: $146.77 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $146.77
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient · Hospital (facility) fee In the file: Colo brushing/washing	$2,474	$1,385.44	$123.70 – $2,028.68
Colonoscopy (diagnostic): 10 of 12 insurance plan rates AETNA - Commercial-PPO — Aetna: $1,063.82 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,274.11 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $1,839.57 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $1,889.39 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $1,253.72 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,222.16 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $2,028.68 HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $1,720.91 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $1,219.68 UNITED HEALTHCARE INSURANCE COMPANY - Commercial-POS — UnitedHealthcare: $1,989.59
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: DIAGNOSTIC COLONOSCOPY	$863	$483.28	$195.88 – $435.56
Colonoscopy (diagnostic): rates for 4 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $195.88 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $435.56 ANTHEM NH - Medicare Part A — Medicare Advantage: $200.50 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $197
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient · Hospital (facility) fee In the file: Colo w/biopsy	$3,308	$1,852.48	$1,146.22 – $4,418.85
Colonoscopy with biopsy: 10 of 17 insurance plan rates AETNA - Commercial-PPO — Aetna: $2,054.28 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,630.84 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $2,526.32 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $2,526.32 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $2,526.32 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $2,073.59 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,403.92 BOSTON MEDICAL HEALTH PLAN - Medicaid — Medicaid Managed Care: $1,146.22 Cigna Health and Life Insurance Company - Commercial-POS — Cigna: $2,742.33 HARVARD PILGRIM HEALTH CARE - Commercial-HMO — Harvard Pilgrim Healthcare: $2,259.03
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOSCOPY AND BIOPSY	$1,103	$617.68	$214.23 – $634.62
Colonoscopy with biopsy: rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $214.23 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $556.69 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $634.62 ANTHEM NH - Medicare Part A — Medicare Advantage: $214.23 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $214.23
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Hospital (facility) fee In the file: Colon W/Polyp Snare Technique	$7,104	$3,978.24	$1,468.75 – $7,104
Colonoscopy with removal of polyps (snare): 10 of 23 insurance plan rates AETNA - Commercial-POS — Aetna: $1,468.75 AETNA - Commercial-PPO — Aetna: $3,327.67 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $3,014.94 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $4,400.93 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $5,425.32 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $5,425.33 ANTHEM HEALTH PLANS OF NH - Commercial-POS — Anthem Health: $5,425.32 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $5,425.33 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $3,585.39 ANTHEM NH - Medicare Part A — Medicare Advantage: $3,014.94
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLON FLEX W REM LES SNARE	$1,151	$644.56	$270 – $1,151
Colonoscopy with removal of polyps (snare): rates for 6 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $270 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $580.91 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $580.91 ANTHEM NH - Medicare Part A — Medicare Advantage: $270 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $270 UNITEDHEALTHCARE SERVICES INC AND ITS AFFILIATES - Medicare- — Medicare Advantage: $1,151
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient · Doctor (professional) fee In the file: Colon W/Polyp Snare Technique	$7,104	$3,978.24	$1,468.75 – $7,104
Colonoscopy with removal of polyps (snare): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $4,400.93
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Hospital (facility) fee In the file: Colo Screening	$3,725	$2,086	$931.25 – $3,725
Screening colonoscopy (not high risk): 10 of 18 insurance plan rates AETNA - Commercial-POS — Aetna: $3,039.60 AETNA - Commercial-PPO — Aetna: $3,725 AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,825.25 AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,307.64 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $2,844.78 ANTHEM HEALTH PLANS OF NH - Commercial-Indemnity — Anthem Health: $2,844.79 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $2,844.79 ANTHEM NH - Medicare Part A — Medicare Advantage: $1,569.71 BCBS FEP - Commercial-PPO — Anthem Health: $3,028.80 BLUE CROSS BLUE SHIELD OF VERMONT - Commercial-POS — Anthem Health: $3,054.50
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: COLONOS SCREEN NOT HI RISK	$864	$483.84	$200.72 – $436.06
Screening colonoscopy (not high risk): rates for 5 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $200.72 ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $436.06 ANTHEM NH - Medicare Part A — Medicare Advantage: $200.72 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $205.46 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $326.95
Screening colonoscopy (not high risk) HCPCS G0121 · Inpatient or outpatient · Doctor (professional) fee In the file: Colo Screening	$3,725	$2,086	$931.25 – $3,725
Screening colonoscopy (not high risk): rates for 1 insurance plan AmeriHealth Caritas New Hampshire - Medicaid — Medicaid Managed Care: $2,894.33
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: INGUINAL HERNIA	$1,316	$736.96	$579.93 – $664.19
Groin (inguinal) hernia repair, age 5 or older: rates for 3 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $579.93 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $664.19 ANTHEM NH - Medicare Part A — Medicare Advantage: $579.93
Prostate biopsy CPT 55700 · Inpatient or outpatient · Hospital (facility) fee In the file: PROSTATE NEEDLE PUNCH BX	$2,376	$1,330.56	$1,010.75 – $1,931.93
Prostate biopsy: rates for 4 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $1,010.75 ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,582.61 BCBS FEP - Commercial-PPO — Anthem Health: $1,931.93 HARVARD PILGRIM HEALTH CARE - Commercial-POS — Harvard Pilgrim Healthcare: $1,910.78
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PROSTATE NEEDLE PUNCH BX	$612	$342.72	$68.89 – $137.79
Prostate biopsy: rates for 2 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $137.79 ANTHEM NH - Medicare Part A — Medicare Advantage: $68.89
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: CT ESI INTERLAMINAR	$1,617	$905.52	$922.38 – $1,340.49
Spinal injection, lower back (epidural), with imaging guidance: rates for 3 insurance plans ANTHEM HEALTH PLANS OF NH - Commercial-HMO — Anthem Health: $1,234.90 Cigna Health and Life Insurance Company - Commercial-POS — Cigna: $1,340.49 UNITED HEALTHCARE INSURANCE COMPANY - Medicare-HMO — Medicare Advantage: $922.38
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient · Hospital (facility) fee In the file: INJECT EPID/SUBARA LUMB W/IMAG	$1,568	$878.08	$903.06
Spinal injection, lower back (epidural), with imaging guidance: rates for 1 insurance plan ANTHEM HEALTH PLANS OF NH - Medicare-HMO — Medicare Advantage: $903.06
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: CARPAL TUNNEL SYNDROME	$1,145	$641.20	$247.86 – $577.89
Carpal tunnel release: rates for 4 insurance plans AMERICAN CONTINENTAL INSU. - Medicare Part A — Medicare Advantage: $496.24 ANTHEM HEALTH PLANS OF NH - Commercial-PPO — Anthem Health: $577.89 ANTHEM NH - Medicare Part A — Medicare Advantage: $495.75 NH DEPT HEALTH & HUMAN SERVICES - Medicare Part A — Medicare Advantage: $247.86

Source: Weeks Medical Center’s standard charges file (hospitalpricetransparencyfiles.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on November 12, 2025; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Critical Access Hospital
Address	173 Middle Street, Lancaster, NH 03584
County	Coos County
State	New Hampshire
Phone	(603) 788‑4911
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	Not rated by CMS
CMS Certification Number	301303
Name in Medicare records	WEEKS MEDICAL CENTER
Profile level	Medicare data + hospital website
Official website	weeksmedical.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Weeks Medical Center — weeksmedical.org
Emergency Care — weeksmedical.org
Visitor Information — weeksmedical.org
Imaging Services - Weeks Medical Center — weeksmedical.org
Inpatient Services - Weeks Medical Center — weeksmedical.org
Rehabilitation Services (PT/OT/SLP) - Weeks Medical Center — weeksmedical.org
Hospitalist Services - Weeks Medical Center — weeksmedical.org
Infusion Services - Weeks Medical Center — weeksmedical.org
Palliative Care Services - Weeks Medical Center — weeksmedical.org
General Surgery - Weeks Medical Center — weeksmedical.org
Orthopaedics - Weeks Medical Center — weeksmedical.org
Patients & Visitors - Weeks Medical Center — weeksmedical.org

Weeks Medical Center

Summary

Profile from official sources

At a glance