Dartmouth-Hitchcock (Keene)

580-590 Court Street Keene, NH 03431
Medical Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Arthrocentesis (outpatient)$8050%$805
Biopsy - Punch Biopsy of Skin$1,1240%$1,124
Biopsy - Tangential Biopsy of Skin$1,3000%$1,300
Blood Test - Basic Metabolic Panel$1020%$102
Blood Test - Blood Glucose Control (Hemoglobin A1C)$230%$23
Blood Test - Cholesterol Test, Lipid Panel$1120%$112
Blood Test - Clotting Time$620%$62
Blood Test - Complete Blood Cell Count (Hemoglobin)$620%$62
Blood Test - Complete Blood Cell Count and Automated WBC$290%$29
Blood Test - Comprehensive Metabolic Panel$890%$89
Blood Test - General Health Panel$1990%$199
Blood Test - Hepatic (Liver) Function Panel$740%$74
Blood Test - Hepatitis C Antibody Level$1310%$131
Blood Test - Iron Level$690%$69
Blood Test - Prostate Specific Antigen (PSA) Level$1840%$184
Blood Test - Thyroid Stimulating Hormone (TSH) Level$1510%$151
Blood Test - Thyroxine (Thyroid Chemical) Level, Free$810%$81
Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement$1520%$152
Blood Test - Vitamin D-3 Level$2920%$292
Bone Density Scan (outpatient)$6810%$681
Destruction of Lesion (outpatient)$6110%$611
Destruction of Lesions, up to 14$7010%$701
Detection test for Human Papillomavirus (HPV)$2340%$234
Electrocardiogram (ECG or EKG)$5510%$551
Lab Test - Detection test for Influenza Virus$750%$75
Laryngoscopy - Diagnostic$1,1790%$1,179
Mammogram (outpatient)$1,0510%$1,051
Nasal Endoscopy - Diagnostic$1,2320%$1,232
Office Visit - Basic$1620%$162
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old$3340%$334
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old$3370%$337
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old$4610%$461
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old$5210%$521
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$4080%$408
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$3700%$370
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$4030%$403
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$4400%$440
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$3100%$310
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$2890%$289
Office Visit - Established Patient, High Complexity$4920%$492
Office Visit - Established Patient, Low Complexity$2260%$226
Office Visit - Established Patient, Moderate Complexity$3440%$344
Office Visit - New Patient, Low Complexity$3440%$344
Office Visit - New Patient, Minor$2600%$260
Office Visit - New Patient, Moderate Complexity$5200%$520
Pap Test$1660%$166
Physical Therapy - Electrical Stimulation Therapy$390%$39
Physical Therapy - Low Complexity Evaluation$1270%$127
Physical Therapy - Manual Therapy$390%$39
Physical Therapy - Moderate Complexity Evaluation$2460%$246
Physical Therapy - Therapeutic Exercises$390%$39
Psychiatric Diagnostic Evaluation$1950%$195
Psychotherapy - 30 Minutes$750%$75
Psychotherapy - 45 Minutes$1200%$120
Psychotherapy - Group Session$650%$65
Strep Test (Streptococcus, group A)$1030%$103
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition$120%$12
Ultrasound - Pregnancy (outpatient)$7160%$716
Ultrasound - Pregnancy Follow-Up$8120%$812
Ultrasound - Transvaginal (non-maternity)$1,4180%$1,418
Urine Test - Automated with Microscope Examination$540%$54
Urine Test - Automated without Microscope$530%$53
Urine Test - Bacterial Culture, Quantitative Colony Count$370%$37
Urine Test - Chlamydia$2180%$218
Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria)$2180%$218
Urine Test - Microalbumin (Protein) Level$480%$48
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 - Ankle (outpatient)$6750%$675
X-Ray - Foot (outpatient)$7860%$786
X-Ray - Hand$6820%$682
X-Ray - Knee (outpatient)$7360%$736
X-Ray - Shoulder (outpatient)$8730%$873
X-Ray - Wrist (outpatient)$8780%$878