Dartmouth-Hitchcock Clinic

One Medical Center Drive Lebanon, NH 03756
Medical Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Arthrocentesis (outpatient)$518N/A$518
Bacterial Culture - Swab$191N/A$191
Biopsy - Punch Biopsy of Skin$1,555N/A$1,555
Biopsy - Tangential Biopsy of Skin$1,458N/A$1,458
Blood Test - Basic Metabolic Panel$161N/A$161
Blood Test - Blood Glucose (Sugar) Level$43N/A$43
Blood Test - Blood Glucose Control (Hemoglobin A1C)$106N/A$106
Blood Test - Blood Typing (ABO)$82N/A$82
Blood Test - Blood Typing (Rh (D))$113N/A$113
Blood Test - C-reactive Protein (CRP) Level$107N/A$107
Blood Test - Cholesterol Test, Lipid Panel$154N/A$154
Blood Test - Clotting Time$13N/A$13
Blood Test - Complete Blood Cell Count (Hemoglobin)$70N/A$70
Blood Test - Complete Blood Cell Count and Automated WBC$80N/A$80
Blood Test - Comprehensive Metabolic Panel$213N/A$213
Blood Test - Coronavirus (COVID-19) Antibody Level$57N/A$57
Blood Test - Ferritin (Blood Protein) Level$153N/A$153
Blood Test - Folic Acid Level$125N/A$125
Blood Test - General Health Panel$208N/A$208
Blood Test - Hepatitis C Antibody Level$138N/A$138
Blood Test - Iron Binding Capacity$93N/A$93
Blood Test - Iron Level$58N/A$58
Blood Test - Magnesium Level$95N/A$95
Blood Test - Prostate Specific Antigen (PSA) Level$122N/A$122
Blood Test - Thyroid Stimulating Hormone (TSH) Level$99N/A$99
Blood Test - Vitamin B-12 (Cyanocobalamin) Level$149N/A$149
Blood Test - Vitamin D-3 Level$208N/A$208
CT Scan - Abdomen and Pelvis, with Contrast$3,711N/A$3,711
Destruction of Lesion (outpatient)$589N/A$589
Destruction of Lesions, up to 14$681N/A$681
Developmental Screening$70N/A$70
Electrocardiogram (ECG or EKG), Tracing$930N/A$930
Electrocardiogram (ECG or EKG), with Report and Interpretation$653N/A$653
Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral)$186N/A$186
Lab Test - Creatinine Level$49N/A$49
Lab Test - Detection for Strep (Streptococcus, group A)$107N/A$107
Lab Test - Detection test for Hepatitis B Surface Antigen$197N/A$197
Lab Test - Detection test for HIV-1 and HIV-2$132N/A$132
Lab Test - Detection test for Human Papillomavirus (HPV)$349N/A$349
Lab Test - Detection test for Influenza Virus$88N/A$88
Lab Test - Smear for Microorganism$111N/A$111
Laryngoscopy - Diagnostic$1,300N/A$1,300
Mammogram (outpatient)$947N/A$947
MRI - Knee (outpatient)$3,581N/A$3,581
MRI - Pelvis (outpatient)$6,277N/A$6,277
Nasal Endoscopy - Diagnostic$1,290N/A$1,290
Office Visit - Basic$104N/A$104
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old$254N/A$254
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old$357N/A$357
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old$442N/A$442
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old$361N/A$361
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$237N/A$237
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old$372N/A$372
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old$256N/A$256
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old$247N/A$247
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$387N/A$387
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$422N/A$422
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$324N/A$324
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$196N/A$196
Office Visit - Established Patient, High Complexity$501N/A$501
Office Visit - Established Patient, Low Complexity$160N/A$160
Office Visit - Established Patient, Moderate Complexity$278N/A$278
Office Visit - New Patient, Low Complexity$236N/A$236
Office Visit - New Patient, Minor$264N/A$264
Office Visit - New Patient, Moderate Complexity$359N/A$359
Pap Test, automated screening and manual rescreening$227N/A$227
Pap Test, manual screening$163N/A$163
Physical Therapy - Moderate Complexity Evaluation$342 Near Average
State Average: 1
$342
Physical Therapy - Therapeutic Exercises$138 Below Average
State Average: 4
$138
Psychotherapy - 30 Minutes$167 Near Average
State Average: 1
$167
Psychotherapy - Group Session$134 Near Average
State Average: 5
$134
Ultrasound - Breast (outpatient)$596N/A$596
Urine Capacity Measurement$507N/A$507
Urine Test - Automated with Microscope Examination$40N/A$40
Urine Test - Automated without Microscope$60N/A$60
Urine Test - Bacterial Culture, Quantitative Colony Count$113N/A$113
Urine Test - Chlamydia$226N/A$226
Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria)$244N/A$244
Urine Test - Microalbumin (Protein) Level$89N/A$89
Urine Test - Pregnancy$62N/A$62
Urine Test - Urinalysis, Manual Test$19N/A$19
Vaccine - Influenza for Injection into Muscle$62N/A$62
Vaccine - Pneumococcal Conjugate for Injection into Muscle$654N/A$654
Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle$144N/A$144
X-Ray - Chest (outpatient)$597N/A$597
X-Ray - Hip$886N/A$886
X-Ray - Shoulder (outpatient)$930N/A$930