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 $968 N/A $968
Back MRI $2,667 N/A $2,667
Biopsy of Skin Lesion $1,998 N/A $1,998
Blood Count (Hemoglobin) $51 N/A $51
Blood Glucose (Sugar) Level $35 N/A $35
Blood Glucose Control (Hemoglobin A1C) $58 N/A $58
Bone Density Scan $292 N/A $292
Brain MRI $3,358 N/A $3,358
Chlamydia Test $69 N/A $69
Cholesterol Test, Lipid Panel $64 N/A $64
Complete Blood Cell Count (Hemoglobin) $32 N/A $32
Comprehensive Metabolic Panel $57 N/A $57
CT Scan of Abdomen and Pelvis, With Contrast $3,436 N/A $3,436
CT Scan of Chest, With Contrast $1,109 N/A $1,109
Detection for Strep (Streptococcus, group A) $143 N/A $143
Developmental Screening $98 N/A $98
Diagnostic Laryngoscopy $1,751 N/A $1,751
Electrocardiogram (ECG or EKG) With Report and Interpretation $418 N/A $418
Electrocardiogram (ECG or EKG) With Tracing $295 N/A $295
Electrocardiogram (ECG or EKG), Report and Interpretation Only $161 N/A $161
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $69 N/A $69
Group Psychotherapy $182 Below Average
State Average: 4
 $182
Hepatitis A Vaccine for Children, Injected into Muscle $336 N/A $336
Hepatitis C Antibody Level $70 N/A $70
Human Papilloma Virus Vaccine, Injected into Muscle $51 N/A $51
Influenza Vaccine, Injected into Muscle $112 N/A $112
Knee MRI $4,279 N/A $4,279
Lab Test to Detect HIV-1 and HIV-2 $57 N/A $57
Lead Level $118 N/A $118
Nasal Endoscopy $1,403 N/A $1,403
Neuromuscular Reeducation $16 Below Average
State Average: 4
 $16
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $641 N/A $641
New Patient Preventive Care Visit for Adult, 40-64 $332 N/A $332
New Patient Preventive Care Visit for Adult, Ages 18-39 $588 N/A $588
New Patient Preventive Care Visit for Child, Ages 1-4 $302 N/A $302
New Patient Preventive Care Visit for Child, Ages 5-11 $274 N/A $274
New Patient Preventive Care Visit for Child, Under Age 1 $521 N/A $521
Office Visit for Established Patient, Basic $225 N/A $225
Office Visit for Established Patient, High Complexity $663 N/A $663
Office Visit for Established Patient, Low Complexity $312 N/A $312
Office Visit for Established Patient, Minimal Presenting Problem $135 N/A $135
Office Visit for Established Patient, Moderate Complexity $480 N/A $480
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 $340 N/A $340
Office Visit for New Patient, Moderate Complexity $753 N/A $753
Pelvis MRI $3,301 N/A $3,301
Pneumococcal Vaccine for Children, Injected into Muscle $79 N/A $79
Pregnancy Test $84 N/A $84
Preventive Care Visit for Adolescent, Under Ages 12-17 $513 N/A $513
Preventive Care Visit for Adult, 40-64 $547 N/A $547
Preventive Care Visit for Adult, Ages 18-39 $513 N/A $513
Preventive Care Visit for Child, Under Age 1 $401 N/A $401
Preventive Care Visit for Child, Under Ages 1-4 $489 N/A $489
Preventive Care Visit for Child, Under Ages 5-11 $489 N/A $489
Psychiatric Diagnostic Evaluation $189 Near Average
State Average: 1
 $189
Psychotherapy, 30 Minutes with Patient $225 Near Average
State Average: 1
 $225
Psychotherapy, 45 Minutes with Patient $147 Below Average
State Average: 3
 $147
Psychotherapy, 60 Minutes with Patient $184 Below Average
State Average: 6
 $184
Rotovirus Vaccine, Oral Administration $79 N/A $79
Screening Mammogram of Both Breasts $358 N/A $358
Skin Growth Removal, Premalignant or Precancerous $873 N/A $873
Skin Growth Removal, Up to 14, Benign or Noncancerous $884 N/A $884
Telehealth Visit for Established Patient, 11-20 minutes $222 N/A $222
Telehealth Visit for Established Patient, 21-30 minutes $236 N/A $236
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition $170 N/A $170
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $51 N/A $51
Therapeutic Exercises $15 Above Average
State Average: 4
 $15
Thyroid Stimulating Hormone (TSH) Level $90 N/A $90
Ultrasound of Heart (Echocardiogram) $3,018 N/A $3,018
Urinalysis, Manual Test $57 N/A $57
Urine Capacity Measurement $158 N/A $158
X-Ray of Chest, 1 View $393 N/A $393
X-Ray of Chest, 2 Views $509 N/A $509
X-Ray of Fingers, 2 Views $400 N/A $400
X-Ray of Hip, 2 or 3 Views $434 N/A $434
X-Ray of Knee, 1 or 2 Views $434 N/A $434
X-Ray of Knee, 4 Views $428 N/A $428
X-Ray of Low Back, 4 Views $387 N/A $387
X-Ray of Lower Leg, 2 Views $292 N/A $292
X-Ray of Neck, 4 to 5 Views $381 N/A $381