Mt Ascutney Hospital — procedure prices

Published prices for 211 procedures at Mt Ascutney Hospital (Windsor, VT), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $146 $182 $168 $51
Abdominal fluid drain (paracentesis) $1,959 $2,449 $2,254 $284
Abdominal ultrasound $854 $1,068 $1,000 $100
Albumin blood test $71 $89 $82 $5
Aldosterone test $699 $874 $804 $41
Alkaline phosphatase test $90 $112 $103 $5
Allergy shots $57 $71 $57 $11
Alpha-fetoprotein (AFP) test $244 $305 $281 $17
ALT liver enzyme test $79 $99 $91 $5
Ammonia blood test $250 $313 $288 $15
Amylase test $97 $121 $112 $6
Annual physical (new patient) $322 $403 $354
Antinuclear antibody (ANA) test $209 $261 $241 $12
Arterial blood gas (ABG) $526 $657 $531 $26
AST liver enzyme test $90 $113 $104 $5
Barium swallow study $1,606 $2,008 $1,622 $107
Basic metabolic panel $145 $181 $167 $8
Bilirubin blood test $87 $109 $100 $5
Bladder scope (cystoscopy) $1,194 $1,493 $1,374 $216
Blood clotting test (PT/INR) $59 $74 $69 $4
Blood crossmatch $195 $244 $225
Blood glucose test $62 $77 $71 $5
Blood transfusion $631 $789 $718 $47
Blood type and screen $182 $227 $209 $10
Blood type test $52 $65 $60 $3
BNP (heart failure) test $582 $728 $670 $39
Bone density scan (DEXA) $793 $991 $912 $39
Botox for migraine $494 $617 $568 $157
Breast biopsy $2,902 $3,627 $3,337 $478
Breast ultrasound $1,648 $2,060 $1,833 $92
Breathing tube insertion (intubation) $587 $734 $676 $133
C-reactive protein (CRP) $59 $74 $68 $5
CA 19-9 tumor marker test $356 $445 $410 $21
CA-125 ovarian marker test $356 $445 $410 $21
Calcium blood test $70 $88 $81 $5
Cardiac event monitor $424 $530 $482 $170
Cardiac rehabilitation $330 $412 $379 $26
Carotid artery ultrasound $844 $1,055 $971 $156
Cataract surgery $3,962 $4,953 $4,557 $547
CEA tumor marker test $250 $313 $288 $19
Celiac disease test $196 $245 $226 $12
Chemotherapy infusion $164 $205 $167 $81
Chest fluid drain (thoracentesis) $1,905 $2,381 $2,191 $311
Chest tube insertion $1,444 $1,805 $1,661 $143
Chest X-ray $598 $748 $671 $37
Clotting time test (PTT) $102 $128 $118 $6
Colonoscopy $1,210 $1,512 $1,319 $480
Complete blood count (CBC) $108 $135 $114 $7
Comprehensive metabolic panel $170 $213 $196 $11
Copper blood test $212 $265 $244 $12
Cortisol test $286 $358 $330 $16
COVID-19 PCR test $125 $156 $144 $51
CPAP titration study $562 $703 $647 $69
Creatine kinase (CK) test $112 $140 $129 $7
CT angiography of the chest $6,647 $8,308 $6,612 $281
CT angiography of the head $5,498 $6,873 $6,323 $274
CT scan of the abdomen $3,943 $4,929 $4,022 $230
CT scan of the abdomen and pelvis $4,038 $5,048 $4,284 $300
CT scan of the arm $3,521 $4,401 $4,005 $199
CT scan of the chest $3,157 $3,946 $3,384 $167
CT scan of the head $2,769 $3,462 $3,016 $148
CT scan of the leg $3,562 $4,453 $4,052 $166
CT scan of the lower back (lumbar spine) $3,222 $4,028 $3,503 $169
CT scan of the neck $3,360 $4,200 $3,683 $183
CT scan of the neck (cervical spine) $2,935 $3,669 $3,296 $168
CT scan of the pelvis $3,446 $4,307 $3,963 $226
CT scan of the sinuses $3,406 $4,257 $3,559 $152
D-dimer test $174 $218 $201 $10
DHEA-sulfate test $312 $390 $359 $22
Diagnostic mammogram $619 $774 $712 $140
Drug screen (urine) $39 $49 $46 $17
Ear tubes (myringotomy) $2,419 $3,024 $2,782 $174
Echocardiogram $1,785 $2,231 $2,053 $138
Electrocardiogram (EKG) $339 $424 $390 $8
Electroencephalogram (EEG) $964 $1,205 $1,109 $448
Electrolyte panel $120 $150 $139 $7
Electromyography (EMG) $765 $956 $880 $141
Emergency department visit $491 $614 $565 $69
Epidural steroid injection $2,250 $2,813 $2,588 $275
Estradiol (estrogen) test $472 $590 $543 $28
Facet joint injection (spine) $1,778 $2,223 $2,030 $99
Fallopian tube X-ray (HSG) $1,444 $1,805 $1,458 $164
Family therapy session $308 $385 $354 $110
Fecal occult blood (stool) test $38 $48 $46 $10
Ferritin (iron) test $218 $272 $251 $14
Fibrinogen test $145 $181 $167 $10
Flexible sigmoidoscopy $786 $982 $904 $323
Flu test $85 $106 $98 $17
Flu vaccine $35 $44 $41
Folate (folic acid) test $233 $291 $268 $15
Foreign body removal (skin) $685 $856 $788 $157
Free T4 thyroid test $157 $196 $180 $9
FSH hormone test $321 $401 $369 $19
Gallbladder removal (laparoscopic) $3,628 $4,535 $4,173 $658
GGT liver test $81 $101 $78 $7
Glucose tolerance test $174 $217 $175 $8
Group therapy session $67 $84 $77 $30
H. pylori test $909 $1,136 $1,045 $67
Hematocrit test $42 $52 $48 $2
Hemoglobin A1c (diabetes test) $166 $208 $191 $10
Hemorrhoid removal $2,786 $3,482 $3,204 $338
Hepatitis A vaccine $68 $85 $78
Hepatitis B test $178 $223 $205 $10
Hepatitis B vaccine $55 $69 $64
Hepatitis C test $183 $229 $211 $14
HIV test $182 $228 $210 $19
Holter heart monitor $227 $283 $227 $26
Inguinal hernia repair $2,532 $3,165 $2,912 $538
Iron blood test $112 $140 $129 $6
IV infusion therapy $143 $179 $159 $44
Joint aspiration (small/intermediate) $586 $733 $660 $57
Kidney ultrasound $985 $1,231 $1,064 $84
Knee arthroscopy $1,701 $2,126 $1,956 $524
Knee joint injection $254 $318 $293 $69
Lactate test $184 $230 $212 $12
LDH test $103 $129 $119 $6
LDL cholesterol test $137 $171 $158 $11
Leg vein ultrasound (Doppler) $678 $848 $789 $150
LH hormone test $304 $380 $350 $19
Lipase test $79 $99 $91 $7
Lipid (cholesterol) panel $160 $200 $184 $13
Liver biopsy $1,485 $1,856 $1,474 $288
Liver function panel $136 $170 $157 $8
Lung function test (PFT) $318 $397 $347 $37
Magnesium blood test $112 $140 $126 $7
MMR vaccine $90 $112 $103
MRA of the brain $6,710 $8,387 $7,354 $226
MRA of the neck $6,245 $7,806 $7,025 $245
MRI of the abdomen $6,551 $8,188 $6,632 $300
MRI of the ankle $6,140 $7,675 $6,831 $261
MRI of the brain $5,888 $7,360 $6,774 $269
MRI of the chest $6,562 $8,202 $7,442 $371
MRI of the knee $5,893 $7,366 $6,556 $315
MRI of the lower back (lumbar spine) $5,050 $6,313 $5,478 $270
MRI of the mid-back (thoracic spine) $5,299 $6,623 $5,819 $271
MRI of the neck (cervical spine) $5,430 $6,787 $5,734 $274
MRI of the pelvis $5,783 $7,228 $6,595 $268
MRI of the shoulder $5,789 $7,236 $6,671 $313
MRI of the wrist $6,159 $7,699 $6,874 $330
Nebulizer breathing treatment $179 $224 $206 $9
Nerve conduction study $482 $603 $555 $118
Occupational therapy evaluation $419 $524 $462 $101
Office visit (new patient) $359 $449 $402 $177
Pap smear (cervical screening) $263 $329 $264 $20
Parathyroid hormone (PTH) test $580 $725 $667 $41
Pelvic ultrasound $995 $1,244 $1,182 $78
Phosphorus blood test $80 $100 $92 $5
Physical therapy evaluation $419 $524 $462 $98
Platelet count $77 $96 $88 $4
Pneumonia vaccine $62 $77 $71
Pregnancy blood test (hCG) $116 $145 $134 $8
Pregnancy ultrasound $1,945 $2,431 $1,762 $126
Prolactin test $309 $386 $355 $19
Prostate biopsy $3,887 $4,859 $4,240
Prostate test (PSA) $260 $325 $299 $18
Psychotherapy session $304 $380 $310 $140
Radiofrequency nerve ablation $2,939 $3,674 $3,380 $462
Sacroiliac joint injection $2,238 $2,798 $2,265 $176
Scoliosis spine X-ray $1,236 $1,545 $1,248 $58
Screening mammogram $619 $774 $712 $126
Scrotal ultrasound $1,006 $1,258 $1,158 $99
Sedimentation rate (ESR) test $60 $75 $69 $3
Semen analysis $209 $261 $241 $12
Soft tissue ultrasound $491 $614 $565 $64
Speech therapy $350 $437 $402 $76
Strep throat test $71 $89 $82 $17
Swallow study $298 $372 $343 $85
T3 thyroid test $253 $316 $291 $14
Tdap (tetanus) vaccine $40 $50 $47
Testosterone test $324 $405 $373 $26
Thyroid test (TSH) $235 $294 $271 $17
Thyroid ultrasound $995 $1,244 $1,145 $109
Tonsillectomy $1,290 $1,612 $1,483 $252
Total IgE allergy test $243 $304 $280 $16
Total protein test $64 $80 $74 $4
Transvaginal ultrasound $999 $1,249 $1,150 $118
Trigger point injection $745 $931 $757 $56
Triglycerides test $87 $109 $100 $6
Troponin (heart) test $170 $212 $195 $12
Upper GI endoscopy (EGD) $737 $921 $796 $371
Upper GI series (barium) $2,121 $2,652 $2,336 $128
Uric acid (gout) test $78 $97 $89 $5
Urinalysis $48 $60 $50 $3
Urine microalbumin test $86 $107 $95 $5
Urine pregnancy test $72 $91 $71 $9
Vaccine administration $38 $48 $45 $19
Vasectomy $1,298 $1,622 $1,492 $347
Vitamin B12 test $179 $224 $206 $15
Vitamin D test $281 $351 $323 $30
X-ray of the abdomen $645 $806 $717 $36
X-ray of the ankle $572 $715 $636 $37
X-ray of the collarbone $491 $614 $565 $33
X-ray of the elbow $611 $764 $703 $33
X-ray of the facial bones $603 $754 $615 $39
X-ray of the foot $555 $694 $618 $34
X-ray of the forearm $474 $593 $546 $29
X-ray of the hand $564 $705 $656 $38
X-ray of the hip $842 $1,052 $929 $49
X-ray of the knee $634 $793 $722 $42
X-ray of the lower back (lumbar spine) $822 $1,027 $841 $47
X-ray of the lower leg $459 $574 $528 $31
X-ray of the mid-back (thoracic spine) $547 $684 $588 $36
X-ray of the neck (cervical spine) $770 $962 $789 $47
X-ray of the pelvis $579 $724 $584 $36
X-ray of the ribs $629 $786 $614 $42
X-ray of the shoulder $496 $620 $571 $36
X-ray of the skull $733 $916 $763 $40
X-ray of the upper arm $491 $614 $565 $32
X-ray of the wrist $661 $826 $760 $43
YAG laser capsulotomy (eye) $2,596 $3,245 $3,018 $335
Zinc blood test $196 $245 $226 $11

Source: this hospital’s machine-readable price file (45 CFR §180). Medicare from CMS fee schedules. Estimates — confirm with the hospital. Report an incorrect price.