Ammonoosuc Community Health Services

25 Mount Eustis Road Littleton, NH 03561
http://www.ammonoosuc.org/
(603) 444-2464
Woodsville, NH 03785
(603) 444-2464
Whitefield, NH 03574
(603) 444-2464
Warren, NH 03238
(603) 444-2464
Franconia, NH 03251
(603) 444-2464

All cost information is based on claims data collected in the New Hampshire Comprehensive Healthcare Information System which is updated quarterly. All quality information is based on claims and administrative data collected by the Centers for Medicare and Medicaid Services which is updated annually. For more information click the links above and review our methodology section.

Methodology
Procedure Estimate of Procedure Cost Estimate of Procedure Cost
This is an estimate of the total charge for the health care service before any discounts provided to the uninsured. 		Number of Visits Number of Visits
When the number of visits varies, it is difficult to estimate the total cost of care. This indicates the number of visits you can expect, calculated using the median. To determine the total you might pay, multiply the Estimate of Procedure Cost and the Statewide Average for Number of Visits.
- Above Average: Expect to visit the provider more than the average number of visits.
- Near Average: Expect the visit the provider close to the average number of visits.
- Below Average: Expect to visit the provider less than the average number of visits.
 		What You Will Pay What You Will Pay
The estimated charge amount minus the uninsured discount (when available).
Uninsured Discount: 0%
Antibody Screen, Red Blood Cells (RBC) $200 N/A $200
Arthrocentesis $504 N/A $504
Basic Metabolic Panel $147 N/A $147
Biopsy of Skin Lesion $754 N/A $754
Blood Glucose Control (Hemoglobin A1C) $35 N/A $35
Blood Typing (ABO) $68 N/A $68
Blood Typing (Rh (D)) $68 N/A $68
Chlamydia Test $273 N/A $273
Cholesterol Test, Lipid Panel $148 N/A $148
Clotting Time $15 N/A $15
Complete Blood Cell Count and Automated White Blood Cells $68 N/A $68
Comprehensive Metabolic Panel $185 N/A $185
Detection for Strep (Streptococcus, group A) $42 N/A $42
Detection Test for Hepatitis B Surface Antigen $149 N/A $149
Electrocardiogram (ECG or EKG) With Report and Interpretation $70 N/A $70
Family Psychotherapy with Patient $141 Above Average
State Average: 2
 $141
Family Psychotherapy without Patient $141 Above Average
State Average: 1
 $141
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $252 N/A $252
Hepatitis C Antibody Level $70 N/A $70
Lab Test to Detect Coronavirus (COVID-19) $173 N/A $173
Lab Test to Detect Coronavirus (COVID-19) Antigen $37 N/A $37
Lab Test to Detect HIV-1 and HIV-2 $145 N/A $145
Lead Level $43 N/A $43
New Patient Preventive Care Visit for Adult, 40-64 $318 N/A $318
New Patient Preventive Care Visit for Adult, Ages 18-39 $292 N/A $292
New Patient Preventive Care Visit for Child, Ages 1-4 $242 N/A $242
New Patient Preventive Care Visit for Child, Ages 5-11 $242 N/A $242
New Patient Preventive Care Visit for Child, Under Age 1 $235 N/A $235
Office Visit for Established Patient, Basic $83 N/A $83
Office Visit for Established Patient, High Complexity $287 N/A $287
Office Visit for Established Patient, Low Complexity $146 N/A $146
Office Visit for Established Patient, Minimal Presenting Problem $45 N/A $45
Office Visit for Established Patient, Moderate Complexity $204 N/A $204
Office Visit for New Patient, High Complexity $405 N/A $405
Office Visit for New Patient, Low Complexity $207 N/A $207
Office Visit for New Patient, Minor Complexity $165 N/A $165
Office Visit for New Patient, Moderate Complexity $305 N/A $305
Pregnancy Test $28 N/A $28
Preventive Care Visit for Adolescent, Under Ages 12-17 $239 N/A $239
Preventive Care Visit for Adult, 40-64 $261 N/A $261
Preventive Care Visit for Adult, Ages 18-39 $242 N/A $242
Preventive Care Visit for Child, Under Ages 1-4 $217 N/A $217
Preventive Care Visit for Child, Under Ages 5-11 $217 N/A $217
Prostate Cancer Screening $145 N/A $145
Psychiatric Diagnostic Evaluation $211 Near Average
State Average: 1
 $211
Psychotherapy, 30 Minutes with Patient $89 Above Average
State Average: 1
 $89
Psychotherapy, 45 Minutes with Patient $130 Below Average
State Average: 4
 $130
Psychotherapy, 60 Minutes with Patient $167 Below Average
State Average: 6
 $167
Thyroid Stimulating Hormone (TSH) Level $126 N/A $126
Urinalysis, Automated without Microscope $37 N/A $37
Urinalysis, Manual Test $12 N/A $12