Mass General Brigham

104 Endicott Street, Suite 101 Chelmsford, MA 01824
http://www.massgeneral.org/mgpo/
(978) 882-6600
30 Tuscan Blvd Salem, NH 03079
(857) 282-8100

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%
Bacterial Culture, Quantitative Colony Count $66 N/A $66
Basic Metabolic Panel $112 N/A $112
Blood Glucose Control (Hemoglobin A1C) $78 N/A $78
Borrelia Burgdorferi (Lyme disease) Antibody Level $207 N/A $207
Cholesterol Test, Lipid Panel $167 N/A $167
Clotting Time $56 N/A $56
Complete Blood Cell Count and Automated White Blood Cells $75 N/A $75
Comprehensive Metabolic Panel $96 N/A $96
Detection for Strep (Streptococcus, group A) $47 N/A $47
Developmental Screening $46 N/A $46
Electrocardiogram (ECG or EKG) With Report and Interpretation $91 N/A $91
General Health Panel $352 N/A $352
Hepatic (Liver) Function Panel $109 N/A $109
Hepatitis B Surface Antibody Level $92 N/A $92
Influenza Vaccine, Injected into Muscle $133 N/A $133
Lab Test to Detect Coronavirus (COVID-19) $158 N/A $158
Lab Test to Detect Coronavirus (COVID-19) Antigen $55 N/A $55
Lab Test to Detect HIV-1 and HIV-2 $114 N/A $114
Lab Test to Detect Influenza Virus $46 N/A $46
New Patient Preventive Care Visit for Adult, 40-64 $321 N/A $321
New Patient Preventive Care Visit for Adult, Ages 18-39 $582 N/A $582
Office Visit for Established Patient, Basic $216 N/A $216
Office Visit for Established Patient, High Complexity $351 N/A $351
Office Visit for Established Patient, Low Complexity $227 N/A $227
Office Visit for Established Patient, Minimal Presenting Problem $79 N/A $79
Office Visit for Established Patient, Moderate Complexity $245 N/A $245
Office Visit for New Patient, Low Complexity $278 N/A $278
Pneumococcal Vaccine for Children, Injected into Muscle $79 N/A $79
Preventive Care Visit for Adult, 40-64 $258 N/A $258
Preventive Care Visit for Adult, Ages 18-39 $238 N/A $238
Prostate Cancer Screening $246 N/A $246
Thyroid Stimulating Hormone (TSH) Level $170 N/A $170
Urinalysis, Automated without Microscope $19 N/A $19
Urinalysis, Manual Test $26 N/A $26
Vitamin B-12 (Cyanocobalamin) Level $189 N/A $189