Dartmouth Health (Keene)

580-590 Court Street Keene, NH 03431
http://www.dartmouth-hitchcock.org/index.html
(603) 354-5400

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%
Arthrocentesis $983 N/A $983
Bacterial Culture, Quantitative Colony Count $148 N/A $148
Basic Metabolic Panel $75 N/A $75
Bilirubin Level $68 N/A $68
Biopsy of Skin Lesion $1,792 N/A $1,792
Blood Glucose Control (Hemoglobin A1C) $26 N/A $26
Bone Density Scan $907 N/A $907
C-reactive Protein (CRP) Level $130 N/A $130
Cholesterol Test, Lipid Panel $118 N/A $118
Clotting Time $79 N/A $79
Complete Blood Cell Count (Hemoglobin) $72 N/A $72
Complete Blood Cell Count and Automated White Blood Cells $79 N/A $79
Comprehensive Metabolic Panel $92 N/A $92
Detection for Strep (Streptococcus, group A) $36 N/A $36
Detection Test for Human Papillomavirus (HPV) $201 N/A $201
Developmental Screening $89 N/A $89
Diagnostic Laryngoscopy $1,370 N/A $1,370
Electrocardiogram (ECG or EKG) With Report and Interpretation $63 N/A $63
Electrocardiogram (ECG or EKG) With Tracing $150 N/A $150
Electrocardiogram (ECG or EKG), Report and Interpretation Only $102 N/A $102
Evaluation of Antimicrobial Drug (Antibiotic, Antifungal, Antiviral) $107 N/A $107
Family Psychotherapy with Patient $147 Above Average
State Average: 2
 $147
Follow-Up Pregnancy Ultrasound $599 N/A $599
General Health Panel $464 N/A $464
Group Psychotherapy $166 Below Average
State Average: 5
 $166
Hepatic (Liver) Function Panel $184 N/A $184
Hepatitis A Vaccine for Adults, Injected into Muscle $207 N/A $207
Hepatitis A Vaccine for Children, Injected into Muscle $406 N/A $406
Hepatitis C Antibody Level $134 N/A $134
Human Papilloma Virus Vaccine, Injected into Muscle $71 N/A $71
Influenza Vaccine, Injected into Muscle $101 N/A $101
Lab Test to Detect Coronavirus (COVID-19) $200 N/A $200
Lab Test to Detect Coronavirus (COVID-19) Antigen $105 N/A $105
Lab Test to Detect Influenza Virus $36 N/A $36
Liver Enzyme (ALT or SGPT) Level $104 N/A $104
Liver Enzyme (AST or SGOT) Level $104 N/A $104
Low Complexity Physical Therapy Evaluation $426 Near Average
State Average: 1
 $426
Magnesium Level $141 N/A $141
Nasal Endoscopy $1,431 N/A $1,431
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $588 N/A $588
New Patient Preventive Care Visit for Adult, 40-64 $665 N/A $665
New Patient Preventive Care Visit for Adult, Ages 18-39 $588 N/A $588
New Patient Preventive Care Visit for Child, Ages 1-4 $499 N/A $499
New Patient Preventive Care Visit for Child, Ages 5-11 $482 N/A $482
New Patient Preventive Care Visit for Child, Under Age 1 $274 N/A $274
Office Visit for Established Patient, Basic $206 N/A $206
Office Visit for Established Patient, High Complexity $557 N/A $557
Office Visit for Established Patient, Low Complexity $286 N/A $286
Office Visit for Established Patient, Minimal Presenting Problem $124 N/A $124
Office Visit for Established Patient, Moderate Complexity $440 N/A $440
Office Visit for New Patient, High Complexity $865 N/A $865
Office Visit for New Patient, Low Complexity $468 N/A $468
Office Visit for New Patient, Minor Complexity $299 N/A $299
Office Visit for New Patient, Moderate Complexity $691 N/A $691
Pap Test Screening, Automated with Manual Review $213 N/A $213
Pap Test Screening, Manual $100 N/A $100
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $310
Pneumococcal Vaccine for Children, Injected into Muscle $71 N/A $71
Pregnancy Test $62 N/A $62
Pregnancy Ultrasound (Outpatient) $947 N/A $947
Presence of Drug $571 N/A $571
Preventive Care Visit for Adolescent, Under Ages 12-17 $471 N/A $471
Preventive Care Visit for Adult, 40-64 $547 N/A $547
Preventive Care Visit for Adult, Ages 18-39 $471 N/A $471
Preventive Care Visit for Child, Under Age 1 $401 N/A $401
Preventive Care Visit for Child, Under Ages 1-4 $449 N/A $449
Preventive Care Visit for Child, Under Ages 5-11 $449 N/A $449
Prostate Cancer Screening $208 N/A $208
Prostate Specific Antigen (PSA) Level, Total $200 N/A $200
Psychiatric Diagnostic Evaluation $179 Near Average
State Average: 1
 $179
Psychotherapy, 30 Minutes with Patient $206 Above Average
State Average: 1
 $206
Psychotherapy, 45 Minutes with Patient $106 Below Average
State Average: 4
 $106
Psychotherapy, 60 Minutes with Patient $154 Below Average
State Average: 6
 $154
Rotovirus Vaccine, Oral Administration $71 N/A $71
Screening Mammogram of Both Breasts $1,167 N/A $1,167
Skin Growth Removal, Premalignant or Precancerous $715 N/A $715
Skin Growth Removal, Up to 14, Benign or Noncancerous $919 N/A $919
Telehealth Visit for Established Patient, 11-20 minutes $205 N/A $205
Telehealth Visit for Established Patient, 21-30 minutes $273 N/A $273
Telehealth Visit for Established Patient, 5-10 minutes $109 N/A $109
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $71 N/A $71
Therapeutic Exercises $171 Below Average
State Average: 4
 $171
Thyroid Stimulating Hormone (TSH) Level $171 N/A $171
Thyroxine (Thyroid Chemical) Level, Free $119 N/A $119
Transvaginal Ultrasound (Non-Maternity) $732 N/A $732
Ultrasound of Heart (Echocardiogram) $3,025 N/A $3,025
Ultrasound of Pelvis $758 N/A $758
Urinalysis, Automated with Microscope Examination $63 N/A $63
Urinalysis, Automated without Microscope $53 N/A $53
Urinalysis, Manual Test $57 N/A $57
Urine Capacity Measurement $145 N/A $145
Vitamin D-3 Level $258 N/A $258
X-Ray of Fingers, 2 Views $368 N/A $368
X-Ray of Foot, 3 Views $450 N/A $450