Endometrial ablations can be done in the office with anesthesia that might provide significant savings for the patient (more info here)
Different approaches for different patients
"Vaginal Hysterectomy is the approach of choice whenever feasible, based on its well-documented advantages and lower complication rates." American College of Obstetricians and Gynecologists - reaffirmed 2011.
Diagnostic Evaluations: examination; gynecologic ultrasound; Dilation and Curettage (D&C)