Dartmouth-Hitchcock Clinic

One Medical Center Drive Lebanon, NH 03756
http://www.dartmouth-hitchcock.org/index.html
(603) 650-5000

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 $889 N/A $889
Bacterial Culture, Quantitative Colony Count $141 N/A $141
Basic Metabolic Panel $82 N/A $82
Biopsy of Skin Lesion $1,539 N/A $1,539
Blood Count (Hemoglobin) $44 N/A $44
Blood Glucose Control (Hemoglobin A1C) $58 N/A $58
Blood Typing (ABO) $48 N/A $48
Blood Typing (Rh (D)) $95 N/A $95
C-reactive Protein (CRP) Level $33 N/A $33
Chlamydia Test $207 N/A $207
Cholesterol Test, Lipid Panel $144 N/A $144
Clotting Time $79 N/A $79
Complete Blood Cell Count (Hemoglobin) $77 N/A $77
Complete Blood Cell Count and Automated White Blood Cells $74 N/A $74
Comprehensive Metabolic Panel $97 N/A $97
CT Scan of Abdomen and Pelvis, With Contrast $5,900 N/A $5,900
Detection for Strep (Streptococcus, group A) $111 N/A $111
Detection Test for Hepatitis B Surface Antigen $90 N/A $90
Detection Test for Human Papillomavirus (HPV) $300 N/A $300
Developmental Screening $74 N/A $74
Diagnostic Laryngoscopy $1,561 N/A $1,561
Electrocardiogram (ECG or EKG) With Report and Interpretation $626 N/A $626
Ferritin (Blood Protein) Level $82 N/A $82
General Health Panel $269 N/A $269
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $107 N/A $107
Group Psychotherapy $140 Below Average
State Average: 5
$140
Hepatic (Liver) Function Panel $49 N/A $49
Hepatitis A Vaccine for Children, Injected into Muscle $384 N/A $384
Hepatitis C Antibody Level $84 N/A $84
Human Papilloma Virus Vaccine, Injected into Muscle $46 N/A $46
Influenza Vaccine, Injected into Muscle $107 N/A $107
Knee MRI $3,014 N/A $3,014
Lab Test to Detect Coronavirus (COVID-19) $107 N/A $107
Lab Test to Detect Coronavirus (COVID-19) Antigen $110 N/A $110
Lab Test to Detect HIV-1 and HIV-2 $153 N/A $153
Lab Test to Measure Creatinine Level $175 N/A $175
Low Complexity Physical Therapy Evaluation $195 Near Average
State Average: 1
$195
Microalbumin (Protein) Level $190 N/A $190
Moderate Complexity Physical Therapy Evaluation $353 Near Average
State Average: 1
$353
Nasal Endoscopy $1,236 N/A $1,236
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $480 N/A $480
New Patient Preventive Care Visit for Adult, 40-64 $413 N/A $413
New Patient Preventive Care Visit for Adult, Ages 18-39 $320 N/A $320
New Patient Preventive Care Visit for Child, Ages 1-4 $282 N/A $282
New Patient Preventive Care Visit for Child, Ages 5-11 $442 N/A $442
New Patient Preventive Care Visit for Child, Under Age 1 $403 N/A $403
Office Visit for Established Patient, Basic $108 N/A $108
Office Visit for Established Patient, High Complexity $522 N/A $522
Office Visit for Established Patient, Low Complexity $165 N/A $165
Office Visit for Established Patient, Minimal Presenting Problem $81 N/A $81
Office Visit for Established Patient, Moderate Complexity $386 N/A $386
Office Visit for New Patient, High Complexity $743 N/A $743
Office Visit for New Patient, Low Complexity $215 N/A $215
Office Visit for New Patient, Minor Complexity $275 N/A $275
Office Visit for New Patient, Moderate Complexity $320 N/A $320
Pap Test Screening, Automated with Manual Review $155 N/A $155
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $310
Pneumococcal Vaccine for Children, Injected into Muscle $65 N/A $65
Pregnancy Test $62 N/A $62
Preventive Care Visit for Adolescent, Under Ages 12-17 $405 N/A $405
Preventive Care Visit for Adult, 40-64 $389 N/A $389
Preventive Care Visit for Adult, Ages 18-39 $419 N/A $419
Preventive Care Visit for Child, Under Age 1 $316 N/A $316
Preventive Care Visit for Child, Under Ages 1-4 $339 N/A $339
Preventive Care Visit for Child, Under Ages 5-11 $290 N/A $290
Psychotherapy, 30 Minutes with Patient $174 Near Average
State Average: 1
$174
Rotovirus Vaccine, Oral Administration $65 N/A $65
Skin Growth Removal, Premalignant or Precancerous $625 N/A $625
Skin Growth Removal, Up to 14, Benign or Noncancerous $710 N/A $710
Smear for Microorganism $169 N/A $169
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $44 N/A $44
Therapeutic Exercises $143 Below Average
State Average: 4
$143
Thyroid Stimulating Hormone (TSH) Level $101 N/A $101
Urinalysis, Automated with Microscope Examination $156 N/A $156
Urinalysis, Automated without Microscope $104 N/A $104
Urinalysis, Manual Test $57 N/A $57
Urine Capacity Measurement $556 N/A $556
Vitamin B-12 (Cyanocobalamin) Level $156 N/A $156
Vitamin D-3 Level $120 N/A $120
X-Ray of Ankle $736 N/A $736
X-Ray of Chest, 2 Views $737 N/A $737
X-Ray of Foot $698 N/A $698
X-Ray of Hand $1,045 N/A $1,045
X-Ray of Hip $1,011 N/A $1,011
X-Ray of Shoulder $896 N/A $896