Ammonoosuc Community Health Services

25 Mount Eustis Road Littleton, NH 03561
http://www.ammonoosuc.org/
(603) 444-2464
Franconia, NH 03251
(603) 444-2464
Woodsville, NH 03785
(603) 444-2464
Whitefield, NH 03574
(603) 444-2464
Warren, NH 03238
(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%
Arthrocentesis $487 N/A $487
Blood Count (Hemoglobin) $8 N/A $8
Blood Glucose Control (Hemoglobin A1C) $35 N/A $35
Cholesterol Test, Lipid Panel $127 N/A $127
Clotting Time $15 N/A $15
Comprehensive Metabolic Panel $96 N/A $96
Detection for Strep (Streptococcus, group A) $42 N/A $42
Developmental Screening $26 N/A $26
Electrocardiogram (ECG or EKG) With Report and Interpretation $405 N/A $405
Family Psychotherapy with Patient $135 Below Average
State Average: 3
 $135
Family Psychotherapy without Patient $135 Near Average
State Average: 1
 $135
Influenza Vaccine, Injected into Muscle $24 N/A $24
Lab Test to Detect Influenza Virus $32 N/A $32
Lead Level $39 N/A $39
New Patient Preventive Care Visit for Adult, 40-64 $289 N/A $289
New Patient Preventive Care Visit for Adult, Ages 18-39 $266 N/A $266
New Patient Preventive Care Visit for Child, Ages 5-11 $219 N/A $219
Office Visit for Established Patient, Basic $76 N/A $76
Office Visit for Established Patient, High Complexity $260 N/A $260
Office Visit for Established Patient, Low Complexity $132 N/A $132
Office Visit for Established Patient, Minimal Presenting Problem $41 N/A $41
Office Visit for Established Patient, Moderate Complexity $185 N/A $185
Office Visit for New Patient, High Complexity $361 N/A $361
Office Visit for New Patient, Low Complexity $188 N/A $188
Office Visit for New Patient, Minor Complexity $133 N/A $133
Office Visit for New Patient, Moderate Complexity $277 N/A $277
Pregnancy Test $25 N/A $25
Preventive Care Visit for Adolescent, Under Ages 12-17 $217 N/A $217
Preventive Care Visit for Adult, 40-64 $237 N/A $237
Preventive Care Visit for Adult, Ages 18-39 $219 N/A $219
Preventive Care Visit for Child, Under Age 1 $191 N/A $191
Preventive Care Visit for Child, Under Ages 1-4 $198 N/A $198
Preventive Care Visit for Child, Under Ages 5-11 $198 N/A $198
Psychiatric Diagnostic Evaluation $203 Near Average
State Average: 1
 $203
Psychotherapy, 30 Minutes with Patient $81 Above Average
State Average: 1
 $81
Psychotherapy, 45 Minutes with Patient $104 Below Average
State Average: 4
 $104
Psychotherapy, 60 Minutes with Patient $180 Below Average
State Average: 6
 $180
Skin Growth Removal, Premalignant or Precancerous $374 N/A $374
Tangential Biopsy of Skin $451 N/A $451
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $69 N/A $69
Urinalysis, Manual Test $11 N/A $11