Dartmouth-Hitchcock Clinic

One Medical Center Drive Lebanon, NH 03756
Medical Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Arthrocentesis (outpatient)$5160%$516
Bacterial Culture - Swab$1870%$187
Biopsy - Punch Biopsy of Skin$1,8550%$1,855
Biopsy - Tangential Biopsy of Skin$1,5160%$1,516
Blood Test - Basic Metabolic Panel$1610%$161
Blood Test - Blood Glucose Control (Hemoglobin A1C)$1060%$106
Blood Test - Cholesterol Test, Lipid Panel$1500%$150
Blood Test - Clotting Time$130%$13
Blood Test - Complete Blood Cell Count and Automated WBC$1060%$106
Blood Test - Comprehensive Metabolic Panel$2130%$213
Blood Test - Ferritin (Blood Protein) Level$780%$78
Blood Test - Folic Acid Level$1250%$125
Blood Test - General Health Panel$2080%$208
Blood Test - Hepatitis C Antibody Level$1380%$138
Blood Test - Iron Level$570%$57
Blood Test - Lipase (fat enzyme) Level$300%$30
Blood Test - Prostate Specific Antigen (PSA) Level$1220%$122
Blood Test - Thyroid Stimulating Hormone (TSH) Level$950%$95
Blood Test - Thyroxine (Thyroid Chemical) Level, Free$1260%$126
Blood Test - Vitamin B-12 (Cyanocobalamin) Level$1450%$145
Blood Test - Vitamin D-3 Level$2030%$203
CT Scan - Abdomen and Pelvis, with Contrast$2,5820%$2,582
Destruction of Lesion (outpatient)$6040%$604
Destruction of Lesions, up to 14$6550%$655
Detection test for Human Papillomavirus (HPV)$3490%$349
Electrocardiogram (ECG or EKG)$8950%$895
Lab Test - Detection test for HIV-1 and HIV-2$1320%$132
Lab Test - Detection test for Influenza Virus$850%$85
Lab Test - Smear for Microorganism$1090%$109
Laryngoscopy - Diagnostic$1,3000%$1,300
Mammogram (outpatient)$9470%$947
MRI - Knee (outpatient)$3,2880%$3,288
Nasal Endoscopy - Diagnostic$1,3240%$1,324
Office Visit - Basic$1580%$158
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old$2540%$254
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old$4420%$442
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old$4420%$442
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old$3610%$361
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$3220%$322
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old$3680%$368
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old$3100%$310
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old$2470%$247
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$3870%$387
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$4220%$422
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$2560%$256
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$1960%$196
Office Visit - Established Patient, High Complexity$4820%$482
Office Visit - Established Patient, Low Complexity$1600%$160
Office Visit - Established Patient, Moderate Complexity$3570%$357
Office Visit - New Patient, Low Complexity$2360%$236
Office Visit - New Patient, Minor$1770%$177
Office Visit - New Patient, Moderate Complexity$3590%$359
Pap Test$2270%$227
Physical Therapy - Moderate Complexity Evaluation$3420%$342
Physical Therapy - Therapeutic Exercises$1380%$138
Psychiatric Diagnostic Evaluation$1930%$193
Psychotherapy - 30 Minutes$1610%$161
Psychotherapy - Group Session$1290%$129
Strep Test (Streptococcus, group A)$1030%$103
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition$1060%$106
Urine Capacity Measurement$5070%$507
Urine Test - Automated with Microscope Examination$400%$40
Urine Test - Automated without Microscope$560%$56
Urine Test - Bacterial Culture, Quantitative Colony Count$1110%$111
Urine Test - Chlamydia$2210%$221
Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria)$2380%$238
Urine Test - Microalbumin (Protein) Level$890%$89
Urine Test - Pregnancy$590%$59
Urine Test - Urinalysis, Manual Test$550%$55
Vaccine - Pneumococcal Conjugate for Injection into Muscle$6540%$654
Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle$1410%$141
X-Ray - Chest (outpatient)$5810%$581
X-Ray - Knee (outpatient)$9270%$927