Home › Hospitals › Hanover Hospital Posts prices for 34 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-29.
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Procedure Cash price Gross charge × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) —
$1,050
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Upper GI endoscopy (EGD) with biopsy (43239) —
$1,100
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Diagnostic colonoscopy (45378) —
$1,500
—
Colonoscopy with biopsy (45380) —
$1,500
—
Colonoscopy with lesion removal (45385) —
$1,774
—
Transforaminal epidural injection, lumbar/sacral (64483) —
$2,162.50
—
CT head/brain without contrast (70450) —
$1,801
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MRI brain without contrast (70551) —
$2,250
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MRI brain with contrast (70552) —
$1,250
—
MRI brain without and with contrast (70553) —
$2,350
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X-ray lower spine, 4+ views (72110) —
$326.20
—
MRI lumbar spine without contrast (72148) —
$2,250
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CT pelvis with contrast (72193) —
$2,325
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MRI lower-extremity joint without contrast (73721) —
$2,250
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CT abdomen and pelvis with contrast (74177) —
$5,000
—
Ultrasound, abdomen complete (76700) —
$875
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Ultrasound, pregnant uterus (≥14 weeks) (76805) —
$750
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Ultrasound, transvaginal (76830) —
$624
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Basic metabolic panel (80048) —
$92
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Comprehensive metabolic panel (80053) —
$150
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Lipid panel (80061) —
$117
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Renal function panel (80069) —
$43
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Hepatic function panel (80076) —
$89
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Urinalysis, non-automated, with microscopy (81000) —
$40
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Urinalysis, non-automated, without microscopy (81002) —
$14
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PSA, total (84153) —
$151
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Thyroid stimulating hormone (TSH) (84443) —
$129
—
CBC with automated differential (85025) —
$94
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CBC, automated (85027) —
$51.25
—
Prothrombin time (PT) (85610) —
$57
—
Partial thromboplastin time (PTT) (85730) —
$35
—
Physical therapy, therapeutic exercise (per 15 min) (97110) —
$84
—
Office visit, new patient (low complexity, ~30 min) (99203) —
$266.50
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Office visit, new patient (moderate complexity, ~45 min) (99204) —
$519
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As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
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