Endometrial ablation destroys the lining of the uterus to reduce or stop heavy menstrual bleeding. NovaSure, Minerva, Cerene and older thermal balloon systems are all endometrial ablation devices, and all of them were engineered to be quick: Hologic describes NovaSure as a one-time, five-minute procedure that can be done in a doctor’s office, and Channel Medsystems describes Cerene as a 2.5 minute treatment inside about seven minutes total, with no sedation or general anesthesia.
None of that stops it from being billed as surgery. The gap between the cheapest and most expensive version of this procedure is larger than for almost anything else in gynecology, and it is driven entirely by which room you are in. This guide prices all three settings, plus the workup that has to happen first, using published cash prices and 2024 CMS claims data as of September 2026.
What Does Endometrial Ablation Cost Without Insurance?
Prepaid marketplace ranges and published all-inclusive cash bundles below are current as of September 2026. Billed-charge figures come from the CMS Medicare Physician & Other Practitioners file and the CMS Medicare Outpatient Hospitals file, both 2024 claims released in 2026.
| Service / Type | Low | Average | High |
|---|---|---|---|
| Ablation in office, prepaid cash (MDsave) | $1,176 | $1,819 | $2,880 |
| Ablation at an ambulatory surgery center, all-inclusive cash bundle | $4,200 | n/a | $4,448 |
| Ablation at a hospital, prepaid cash (MDsave) | $6,008 | $8,509 | $11,894 |
| Endometrial biopsy beforehand, CPT 58100, office (average billed charge) | n/a | $349.04 | n/a |
| Transvaginal pelvic ultrasound, CPT 76830, office (average billed charge) | n/a | $349.29 | n/a |
| Pathology, CPT 88305, per specimen, published self-pay lab rate | $93 | n/a | $160 |
| CPT 58563 hysteroscopy with ablation, office (average billed charge) | n/a | $4,602.23 | n/a |
| CPT 58353 thermal ablation without hysteroscopy, facility (average billed charge) | n/a | $2,795.87 | n/a |
| CPT 58563 hospital outpatient claim (average total charges billed) | n/a | $27,826.03 | n/a |
| Laparoscopic hysterectomy, prepaid cash (MDsave), for comparison | $8,569 | $17,569 | $26,071 |
Sources: MDsave’s national prepaid listings for endometrial ablation in office and at a facility, and for laparoscopic total or partial hysterectomy; the surgery-center bundle range is Cypress Surgery Center’s $4,448 all-inclusive price on Fair Market Health and $4,200 listed by four Coral Springs gynecologists on HEALTHdrum; billed-charge figures are national averages in the CMS 2024 physician file for non-facility (office) or facility settings as labeled; the hospital outpatient figure is the average total charges billed on 2024 outpatient claims containing CPT 58563, against which Medicare allowed an average of $4,612.85; self-pay pathology rates are from Delta Pathology and Pathology Laboratory Associates.
That is a range of $1,176 to $11,894 for the same treatment, and the sources are consistent about why. MDsave’s own estimated national averages are $2,654 for the office version and $16,524 for the facility version, a spread of more than six to one for a procedure the manufacturer times in minutes.
What Drives the Price
The setting, and almost nothing else
An office ablation involves a device, a paracervical block and an hour of your day. A hospital ablation adds a facility fee, an anesthesia provider, a pre-op area and a recovery bay.
The CMS data shows the seam clearly. For CPT 58563, hysteroscopy with endometrial ablation, the average Medicare-allowed amount was $1,433.97 when the physician performed it in an office (where that one payment covers everything) and $383.54 when it was performed in a facility (where it covers only the physician’s work, and the hospital bills the rest separately). On the hospital’s side of that same procedure, the average allowed amount in 2024 outpatient data was $4,612.85, on average total billed charges of $27,826.03.
Note also how the volume splits: CMS counted 1,078 facility services and 72 office services under 58563 in 2024. The expensive version is by far the more common one.
Whether hysteroscopy is used
There are two billing families. CPT 58353 covers thermal ablation without hysteroscopic guidance, which is how NovaSure and balloon systems are often performed. CPT 58563 covers hysteroscopy with ablation, where a camera goes in first. The hysteroscopic version costs more and is more likely to be done in a facility.
Cerene is coded differently again as endometrial cryoablation (CPT 58356). Ask which code your practice will bill, because it changes the quote by thousands.
The workup before the procedure
ACOG guidance summarized by AAFP is explicit that endometrial sampling should be performed to evaluate all women for malignancy or hyperplasia before ablation, along with imaging such as transvaginal ultrasound, hysteroscopy or saline infusion sonohysterography to assess the cavity.
Those are separate bills. In 2024 CMS data an office endometrial biopsy (CPT 58100) carried an average submitted charge of $349.04 and a transvaginal pelvic ultrasound (CPT 76830) $349.29, with pathology on the biopsy specimen adding $93 to $160. Budget $600 to $900 for the workup on top of any ablation quote, and confirm whether a bundled price includes it. Cypress Surgery Center’s $4,448 bundle covers anesthesia, physician, facility and initial pathology but states it does not include pre-operative clearance.
Anesthesia
If you are sedated, the anesthesia provider bills separately. In 2024 CMS data, CPT 00952 (anesthesia for hysteroscopy) carried an average submitted charge of $1,183.07 in facility settings, with Medicare allowing $109.63. This charge simply does not exist in the office version of the procedure, which is done under local anesthetic.
Whether the price is bundled at all
The most useful thing a cash-pay patient can find is an all-inclusive number. Ambulatory surgery centers increasingly publish them: $4,448 covering anesthesia, surgeon, facility, equipment and initial pathology at Cypress Surgery Center, or $4,200 for NovaSure from four gynecologists in Coral Springs. A bundle removes the two charges that most often turn into surprise bills, anesthesia and pathology.
Cash Price vs. Insurance
Ablation is treatment, so no preventive-coverage rule applies and every dollar runs against your deductible. In practice that makes the setting decision matter just as much for insured patients: a $6,008 hospital ablation on a $7,000 deductible plan is functionally the same as paying cash.
For an uninsured patient the ranking is straightforward. An office ablation at $1,176 to $2,880 is the cheapest real route. An all-inclusive surgery-center bundle at roughly $4,200 to $4,448 is the best value if you need or want sedation, because it caps the anesthesia and pathology exposure. A hospital outpatient department is the most expensive route by a wide margin and rarely offers anything clinical in exchange.
If a hospital is the only option offered, ask two questions before agreeing: whether the practice performs ablation in the office, and what the hospital’s posted discounted cash price is for the procedure. Hospitals are required to publish that figure, and it is usually far below the chargemaster number an uninsured patient gets billed by default.
How to Pay Less
- Ask for the in-office version by name. The script is “do you perform NovaSure, Minerva or Cerene in the office, and what is your self-pay price.” Manufacturers designed these for office use, so the answer is often yes. Check any quote against our fair price checker.
- Buy a bundled surgery-center price instead of an unbundled hospital one. All-inclusive cash bundles at $4,200 to $4,448 cover the anesthesia and pathology that otherwise arrive as separate bills weeks later. Ask in writing what the bundle excludes, since pre-operative clearance is commonly outside it.
- Price the workup separately and shop it. The endometrial biopsy, the ultrasound and the pathology are all separately shoppable, and an independent imaging center is usually cheaper than the hospital that will do the procedure.
- Pull the hospital’s posted cash rate before you schedule. Our guide to hospital price transparency explains how to find the machine-readable file and locate CPT 58353 or 58563 in it.
- Try a community health center or sliding-scale clinic for the workup. Even when they do not perform ablation, they can order and bill the biopsy and ultrasound at income-based rates. Our guide to free clinics and sliding-scale care covers how to find one.
- If bills already arrived, take them apart. Request an itemized hospital bill so the facility fee, device charge, anesthesia and pathology show as separate lines, then use our negotiation guide and phone script. Apply for hospital charity care before you agree to any payment plan.
Ablation vs. Hysterectomy vs. an IUD
Ablation is usually pitched as the middle option, and on price it clearly is. A laparoscopic hysterectomy runs $8,569 to $26,071 prepaid on MDsave with a national average of $17,569, roughly ten times an in-office ablation. But the AAFP summary of ACOG’s guidance notes that hysterectomy rates after ablation are 24 percent or more within four years, and that patient satisfaction is higher with hysterectomy. A cheaper first procedure is not automatically the cheaper total.
Going the other way, a hormonal IUD is the cheapest option of the three and the one guidance points to first. ACOG’s 2022 clinical consensus on menstrual suppression states that surgical options affecting future fertility, including endometrial ablation and hysterectomy, are not considered first-line approaches. Planned Parenthood of Florida lists Liletta at $850 and Paragard at $1,300 before insertion and visit fees, and a levonorgestrel device is reversible, which ablation is not. If your clinician has not raised it, it is a fair question to ask before you price surgery.
Related procedures with the same office-versus-hospital pricing pattern include a D&C, a colposcopy and a LEEP.
This is a cost guide, not medical guidance. Whether ablation is appropriate for you, and which device or setting fits your case, is a conversation for a clinician. What it should cost, and how to avoid paying the hospital version of that price, is what this page is for.
Bottom Line
Endometrial ablation is a $1,176 to $2,880 office procedure, a roughly $4,200 to $4,448 all-inclusive surgery-center bundle, and a $6,008 to $11,894 hospital procedure. The device, the technique and the recovery are the same in all three. Add $600 to $900 for the biopsy, ultrasound and pathology that come first.
Ask the office question before you accept a hospital date. It is worth several thousand dollars, and for a procedure the manufacturer measures in minutes, it is a reasonable thing to ask.