Dartmouth-Hitchcock (Keene)

580-590 Court Street Keene, NH 03431
http://www.dartmouth-hitchcock.org/index.html
(603) 354-5400

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 $874 N/A $874
Automated Pap Test Screening and Manual Rescreening $205 N/A $205
Automated with Microscope Examination $63 N/A $63
Automated without Microscope $29 N/A $29
Bacterial Culture, Quantitative Colony Count $142 N/A $142
Basic Metabolic Panel $71 N/A $71
Blood Glucose Control (Hemoglobin A1C) $22 N/A $22
Bone Density Scan $742 N/A $742
Chlamydia Test $232 N/A $232
Cholesterol Test, Lipid Panel $112 N/A $112
Clotting Time $79 N/A $79
Complete Blood Cell Count (Hemoglobin) $66 N/A $66
Complete Blood Cell Count and Automated White Blood Cells $76 N/A $76
Comprehensive Metabolic Panel $97 N/A $97
Coronavirus (COVID-19) Antibody Level $57 N/A $57
Detection for Strep (Streptococcus, group A) $30 N/A $30
Detection Test for Hepatitis B Surface Antigen $68 N/A $68
Detection Test for Human Papillomavirus (HPV) $254 N/A $254
Developmental Screening $74 N/A $74
Diagnostic Laryngoscopy $1,292 N/A $1,292
Diagnostic Mammogram of One Breast $807 N/A $807
Electrocardiogram (ECG or EKG) With Report and Interpretation $576 N/A $576
Electrocardiogram (ECG or EKG), Report and Interpretation Only $591 N/A $591
Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) $107 N/A $107
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $232 N/A $232
Hepatitis B Surface Antibody Level $76 N/A $76
Hepatitis C Antibody Level $129 N/A $129
Influenza Vaccine, Injected into Muscle $62 N/A $62
Knee MRI $2,885 N/A $2,885
Lab Test to Detect Coronavirus (COVID-19) $107 N/A $107
Lab Test to Detect Coronavirus (COVID-19) Antigen $105 N/A $105
Lab Test to Detect Influenza Virus $75 N/A $75
Liver Enzyme (ALT or SGPT) Level $77 N/A $77
Liver Enzyme (AST or SGOT) Level $72 N/A $72
Low Complexity Physical Therapy Evaluation $382 Near Average
State Average: 1
$382
Manual Physical Therapy $43 Below Average
State Average: 4
$43
Nasal Endoscopy $1,350 N/A $1,350
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $419 N/A $419
New Patient Preventive Care Visit for Adult, 40-64 $378 N/A $378
New Patient Preventive Care Visit for Adult, Ages 18-39 $502 N/A $502
New Patient Preventive Care Visit for Child, Ages 1-4 $353 N/A $353
New Patient Preventive Care Visit for Child, Ages 5-11 $446 N/A $446
New Patient Preventive Care Visit for Child, Under Age 1 $339 N/A $339
Office Visit for Established Patient, Basic $176 N/A $176
Office Visit for Established Patient, High Complexity $247 N/A $247
Office Visit for Established Patient, Low Complexity $247 N/A $247
Office Visit for Established Patient, Minimal Presenting Problem $112 N/A $112
Office Visit for Established Patient, Moderate Complexity $375 N/A $375
Office Visit for New Patient, High Complexity $715 N/A $715
Office Visit for New Patient, Low Complexity $228 N/A $228
Office Visit for New Patient, Minor Complexity $286 N/A $286
Office Visit for New Patient, Moderate Complexity $349 N/A $349
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $310
Pneumococcal Conjugate Vaccine, Injected into Muscle $720 N/A $720
Pregnancy Test $62 N/A $62
Pregnancy Ultrasound (Outpatient) $780 N/A $780
Presence of Drug $571 N/A $571
Preventive Care Visit for Adolescent, Under Ages 12-17 $405 N/A $405
Preventive Care Visit for Adult, 40-64 $482 N/A $482
Preventive Care Visit for Adult, Ages 18-39 $441 N/A $441
Preventive Care Visit for Child, Under Age 1 $317 N/A $317
Preventive Care Visit for Child, Under Ages 1-4 $339 N/A $339
Preventive Care Visit for Child, Under Ages 5-11 $340 N/A $340
Prostate Specific Antigen (PSA) Level $191 N/A $191
Psychotherapy with Evaluation and Management, 45 Minutes with Patient $105 Below Average
State Average: 2
$105
Punch Biopsy of Skin $1,931 N/A $1,931
Screening Mammogram of Both Breasts $1,120 N/A $1,120
Skin Growth Removal, Premalignant or Precancerous $610 N/A $610
Skin Growth Removal, Up to 14, Benign or Noncancerous $769 N/A $769
Tangential Biopsy of Skin $1,476 N/A $1,476
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $71 N/A $71
Therapeutic Exercises $123 Below Average
State Average: 4
$123
Thyroid Stimulating Hormone (TSH) Level $164 N/A $164
Thyroxine (Thyroid Chemical) Level, Free $122 N/A $122
Transvaginal Ultrasound (Non-Maternity) $1,542 N/A $1,542
Urinalysis, Manual Test $57 N/A $57
Urine Capacity Measurement $231 N/A $231
Vitamin D-3 Level $258 N/A $258
Wound Repair, 2.5 Centimeters or Less $429 N/A $429
X-Ray of Foot $749 N/A $749
X-Ray of Hand $1,045 N/A $1,045
X-Ray of Knee $897 N/A $897
X-Ray of Shoulder $945 N/A $945
X-Ray of Wrist $920 N/A $920