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%
Antinuclear Antibodies (ANA) Level $63 N/A $63
Bacterial Culture, Quantitative Colony Count $68 N/A $68
Blood Count (Hemoglobin) $18 N/A $18
Blood Glucose Control (Hemoglobin A1C) $78 N/A $78
C-reactive Protein (CRP) Level $71 N/A $71
Chlamydia Test $294 N/A $294
Cholesterol Test, Lipid Panel $185 N/A $185
Clotting Time $56 N/A $56
Complete Blood Cell Count and Automated White Blood Cells $113 N/A $113
Comprehensive Metabolic Panel $145 N/A $145
Detection for Strep (Streptococcus, group A) $107 N/A $107
Developmental Screening $53 N/A $53
Electrocardiogram (ECG or EKG) With Report and Interpretation $103 N/A $103
Ferritin (Blood Protein) Level $188 N/A $188
General Health Panel $491 N/A $491
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $294 N/A $294
Hepatitis C Antibody Level $197 N/A $197
Influenza Vaccine, Injected into Muscle $97 N/A $97
Iron Binding Capacity $121 N/A $121
Iron Level $90 N/A $90
Lab Test to Detect Coronavirus (COVID-19) $249 N/A $249
Lab Test to Detect Coronavirus (COVID-19) Antigen $53 N/A $53
Lab Test to Detect HIV-1 and HIV-2 $333 N/A $333
Lab Test to Detect Influenza Virus $75 N/A $75
LDL Cholesterol Level $132 N/A $132
Lead Level $67 N/A $67
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $601 N/A $601
New Patient Preventive Care Visit for Adult, 40-64 $672 N/A $672
New Patient Preventive Care Visit for Adult, Ages 18-39 $586 N/A $586
New Patient Preventive Care Visit for Child, Ages 1-4 $518 N/A $518
Office Visit for Established Patient, Minimal Presenting Problem $89 N/A $89
Office Visit for Established Patient, Moderate Complexity $478 N/A $478
Office Visit for New Patient, Moderate Complexity $342 N/A $342
Pregnancy Test $46 N/A $46
Preventive Care Visit for Adolescent, Under Ages 12-17 $510 N/A $510
Preventive Care Visit for Adult, 40-64 $559 N/A $559
Preventive Care Visit for Child, Under Ages 1-4 $476 N/A $476
Preventive Care Visit for Child, Under Ages 5-11 $474 N/A $474
Prostate Cancer Screening $254 N/A $254
Red Blood Cell Sedimentation Rate, Non-Automated $51 N/A $51
Thyroid Stimulating Hormone (TSH) Level $233 N/A $233
Thyroxine (Thyroid Chemical) Level, Free $125 N/A $125
Urinalysis, Automated with Microscope Examination $45 N/A $45
Urinalysis, Automated without Microscope $19 N/A $19
Urinalysis, Manual Test $26 N/A $26
Vitamin B-12 (Cyanocobalamin) Level $79 N/A $79