Mt. Ascutney Hospital and Health Center
Mt. Ascutney Hospital and Health Center publishes cash prices for 55 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,350.00 | $5,438.00 | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $2,031.00 | $2,539.00 | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $3,549.00 | $4,436.00 | 20% |
| Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts | $638.00 | $797.00 | 20% |
| Diagnostic mammogram, one breast CPT 77065 Mammography of one breast | $638.00 | $797.00 | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $4,128.00 | $5,160.00 | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Lower Extremity Joint W/o&w Contrast | $5,722.00 | $7,152.00 | 20% |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain | $4,274.00 | $5,342.00 | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $6,065.00 | $7,581.00 | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $3,919.00 | $4,899.00 | 20% |
| Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral | $638.00 | $797.00 | 20% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $1,029.00 | $1,286.00 | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $1,137.00 | $1,421.00 | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $978.00 | $1,223.00 | 20% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $149.00 | $186.00 | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $165.00 | $206.00 | 20% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $122.00 | $152.00 | 20% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $100.00 | $125.00 | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $175.00 | $219.00 | 20% |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $124.00 | $155.00 | 20% |
| Liver function blood test panel CPT 80076 Liver function blood test | $140.00 | $175.00 | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test | $323.00 | $404.00 | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $268.00 | $335.00 | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $106.00 | $132.00 | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $74.00 | $92.00 | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $242.00 | $303.00 | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope | $54.00 | $68.00 | 21% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis test | $44.00 | $55.00 | 20% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis test | $23.00 | $29.00 | 21% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 Removal of cataract with insertion of lens | $13,727.00 | $17,159.00 | 20% |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope | $5,602.00 | $7,003.00 | 20% |
| Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope | $8,053.00 | $10,066.00 | 20% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope | $3,062.00 | $3,827.00 | 20% |
| Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope | $22,075.00 | $27,594.00 | 20% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia patient age 5 years or older | $16,088.00 | $20,110.00 | 20% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Removal of recurring cataract in lens capsule using laser | $2,674.00 | $3,342.00 | 20% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection(s) of therapeutic substance | $2,399.00 | $2,999.00 | 20% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection(s) of anesthetic into lower spine using imaging guidance | $3,722.00 | $4,652.00 | 20% |
| Prostate biopsy CPT 55700 Biopsy of prostate gland | $8,423.00 | $10,529.00 | 20% |
| Removal of a breast lump, open surgery CPT 19120 Removal of one or more breast growth, open procedure | $1,199.00 | $1,499.00 | 20% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope | $8,354.00 | $10,442.00 | 20% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope | $7,246.00 | $9,057.00 | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min | $190.00 | $238.00 | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min | $182.00 | $228.00 | 20% |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min | $145.00 | $181.00 | 20% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min | $222.00 | $277.00 | 20% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min | $274.00 | $342.00 | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise | $190.00 | $238.00 | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) | $186.00 | $233.00 | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) | $212.00 | $265.00 | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min | $113.00 | $141.00 | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min | $150.00 | $187.00 | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min | $226.00 | $282.00 | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Patient office consultation, 40 min | $143.00 | $179.00 | 20% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Patient office consultation, 60 min | $225.00 | $281.00 | 20% |