Dartmouth Health

One Medical Center Drive Lebanon, NH 03756
https://www.dartmouth-health.org/
(603) 650-5000
204 Dartmouth College Highway Lyme, NH 03768
(603) 650-1070

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 $992 N/A $992
Back MRI $2,667 N/A $2,667
Biopsy of Skin Lesion $2,099 N/A $2,099
Blood Count (Hemoglobin) $53 N/A $53
Blood Glucose (Sugar) Level $46 N/A $46
Blood Glucose Control (Hemoglobin A1C) $61 N/A $61
Blood Typing (Rh (D)) $32 N/A $32
Bone Density Scan $578 N/A $578
Brain MRI $3,560 N/A $3,560
Chlamydia Test $69 N/A $69
Clotting Time $15 N/A $15
CT Scan of Abdomen and Pelvis, With Contrast $1,821 N/A $1,821
CT Scan of Chest, With Contrast $1,175 N/A $1,175
Detection for Strep (Streptococcus, group A) $143 N/A $143
Developmental Screening $104 N/A $104
Diagnostic Laryngoscopy $1,861 N/A $1,861
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
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $69 N/A $69
Group Psychotherapy $192 Above Average
State Average: 4
 $192
Hepatitis A Vaccine for Adults, Injected into Muscle $224 N/A $224
Hepatitis A Vaccine for Children, Injected into Muscle $511 N/A $511
Human Papilloma Virus Vaccine, Injected into Muscle $84 N/A $84
Knee MRI $4,073 N/A $4,073
Lead Level $50 N/A $50
Low Back MRI, Before and After Contrast $1,819 N/A $1,819
Nasal Endoscopy $1,686 N/A $1,686
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $679 N/A $679
New Patient Preventive Care Visit for Adult, 40-64 $587 N/A $587
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 $576 N/A $576
New Patient Preventive Care Visit for Child, Under Age 1 $552 N/A $552
Office Visit for Established Patient, Basic $238 N/A $238
Office Visit for Established Patient, High Complexity $663 N/A $663
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 $943 N/A $943
Office Visit for New Patient, Low Complexity $541 N/A $541
Office Visit for New Patient, Moderate Complexity $504 N/A $504
Pelvis MRI $3,499 N/A $3,499
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 $596 N/A $596
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
Psychiatric Diagnostic Evaluation $189 Near Average
State Average: 1
 $189
Psychotherapy, 30 Minutes with Patient $238 Near Average
State Average: 1
 $238
Psychotherapy, 45 Minutes with Patient $163 Below Average
State Average: 3
 $163
Psychotherapy, 60 Minutes with Patient $184 Below Average
State Average: 6
 $184
Rotovirus Vaccine, Oral Administration $84 N/A $84
Screening Mammogram of Both Breasts $379 N/A $379
Skin Growth Removal, Premalignant or Precancerous $948 N/A $948
Skin Growth Removal, Up to 14, Benign or Noncancerous $1,021 N/A $1,021
Telehealth Visit for Established Patient, 11-20 minutes $221 N/A $221
Telehealth Visit for Established Patient, 21-30 minutes $236 N/A $236
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $87 N/A $87
Therapeutic Exercises $11 Below Average
State Average: 4
 $11
Transvaginal Ultrasound (Non-Maternity) $1,840 N/A $1,840
Ultrasound of Heart (Echocardiogram) $3,374 N/A $3,374
Urinalysis, Manual Test $60 N/A $60
Urine Capacity Measurement $233 N/A $233
X-Ray of Chest, 1 View $412 N/A $412
X-Ray of Chest, 2 Views $378 N/A $378
X-Ray of Fingers, 2 Views $443 N/A $443
X-Ray of Knee, 1 or 2 Views $374 N/A $374
X-Ray of Knee, 4 Views $454 N/A $454
X-Ray of Neck, 4 to 5 Views $270 N/A $270