Dartmouth Health (Manchester)

100 Htichcock Way Manchester, NH 03104
https://www.dartmouth-health.org/
(603) 695-2500
58 Hawthorn Drive Bedford, NH 03110
(603) 695-2817

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 $1,174 N/A $1,174
Back MRI $5,229 N/A $5,229
Biopsy of Skin Lesion $2,370 N/A $2,370
Blood Count (Hemoglobin) $53 N/A $53
Blood Glucose (Sugar) Level $46 N/A $46
Blood Glucose Control (Hemoglobin A1C) $61 N/A $61
Bone Density Scan $1,049 N/A $1,049
Brain MRI $10,243 N/A $10,243
Cholesterol Test, Lipid Panel $108 N/A $108
Clotting Time $69 N/A $69
Comprehensive Metabolic Panel $51 N/A $51
CT Scan of Abdomen and Pelvis, With Contrast $3,714 N/A $3,714
CT Scan of Chest, With Contrast $3,129 N/A $3,129
Detection for Strep (Streptococcus, group A) $152 N/A $152
Developmental Screening $104 N/A $104
Diagnostic Laryngoscopy $2,114 N/A $2,114
Diagnostic Mammogram of Both Breasts $795 N/A $795
Diagnostic Mammogram of One Breast $654 N/A $654
Electrocardiogram (ECG or EKG) With Report and Interpretation $483 N/A $483
Electrocardiogram (ECG or EKG) With Tracing $313 N/A $313
Electrocardiogram (ECG or EKG), Report and Interpretation Only $170 N/A $170
Hepatitis A Vaccine for Adults, Injected into Muscle $224 N/A $224
Hepatitis A Vaccine for Children, Injected into Muscle $655 N/A $655
Human Papilloma Virus Vaccine, Injected into Muscle $84 N/A $84
Knee MRI $4,858 N/A $4,858
Lead Level $125 N/A $125
Nasal Endoscopy $1,944 N/A $1,944
New Patient Preventive Care Visit for Adult, 40-64 $769 N/A $769
New Patient Preventive Care Visit for Adult, Ages 18-39 $679 N/A $679
New Patient Preventive Care Visit for Child, Ages 1-4 $576 N/A $576
New Patient Preventive Care Visit for Child, Ages 5-11 $544 N/A $544
New Patient Preventive Care Visit for Child, Under Age 1 $537 N/A $537
Office Visit for Established Patient, Basic $238 N/A $238
Office Visit for Established Patient, High Complexity $702 N/A $702
Office Visit for Established Patient, Low Complexity $331 N/A $331
Office Visit for Established Patient, Minimal Presenting Problem $144 N/A $144
Office Visit for Established Patient, Moderate Complexity $509 N/A $509
Office Visit for New Patient, High Complexity $1,000 N/A $1,000
Office Visit for New Patient, Low Complexity $541 N/A $541
Office Visit for New Patient, Moderate Complexity $753 N/A $753
Pelvis MRI $9,152 N/A $9,152
Pregnancy Test $89 N/A $89
Preventive Care Visit for Adolescent, Under Ages 12-17 $545 N/A $545
Preventive Care Visit for Adult, 40-64 $632 N/A $632
Preventive Care Visit for Adult, Ages 18-39 $545 N/A $545
Preventive Care Visit for Child, Under Age 1 $464 N/A $464
Preventive Care Visit for Child, Under Ages 1-4 $519 N/A $519
Preventive Care Visit for Child, Under Ages 5-11 $519 N/A $519
Psychotherapy, 30 Minutes with Patient $225 Near Average
State Average: 1
 $225
Psychotherapy, 45 Minutes with Patient $368 Below Average
State Average: 3
 $368
Screening Mammogram of Both Breasts $820 N/A $820
Skin Growth Removal, Up to 14, Benign or Noncancerous $1,184 N/A $1,184
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $84 N/A $84
Therapeutic Exercises $17 Near Average
State Average: 4
 $17
Ultrasound of Breast $526 N/A $526
Ultrasound of Heart (Echocardiogram) $2,607 N/A $2,607
Ultrasound of Pelvis $876 N/A $876
Urinalysis, Manual Test $60 N/A $60
Urine Capacity Measurement $233 N/A $233
X-Ray of Chest, 2 Views $368 N/A $368
X-Ray of Fingers, 2 Views $222 N/A $222
X-Ray of Foot, 2 Views $298 N/A $298
X-Ray of Hand, 2 Views $586 N/A $586
X-Ray of Knee, 1 or 2 Views $312 N/A $312
X-Ray of Knee, 4 Views $355 N/A $355
X-Ray of Low Back, 4 Views $475 N/A $475
X-Ray of Lower Leg, 2 Views $316 N/A $316
X-Ray of Neck, 4 to 5 Views $545 N/A $545