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 $914 N/A $914
Bacterial Culture, Quantitative Colony Count $57 N/A $57
Basic Metabolic Panel $75 N/A $75
Bilirubin Level $75 N/A $75
Biopsy of Skin Lesion $1,515 N/A $1,515
Blood Glucose Control (Hemoglobin A1C) $22 N/A $22
Bone Density Scan $777 N/A $777
Borrelia Burgdorferi (Lyme disease) Antibody Level $172 N/A $172
C-reactive Protein (CRP) Level $112 N/A $112
Cholesterol Test, Lipid Panel $118 N/A $118
Clotting Time $79 N/A $79
Complete Blood Cell Count (Hemoglobin) $84 N/A $84
Complete Blood Cell Count and Automated White Blood Cells $79 N/A $79
Comprehensive Metabolic Panel $158 N/A $158
Detection for Strep (Streptococcus, group A) $30 N/A $30
Detection Test for Human Papillomavirus (HPV) $265 N/A $265
Developmental Screening $77 N/A $77
Diagnostic Laryngoscopy $1,167 N/A $1,167
Diagnostic Mammogram of One Breast $835 N/A $835
Electrocardiogram (ECG or EKG) With Report and Interpretation $565 N/A $565
Electrocardiogram (ECG or EKG) With Tracing $681 N/A $681
Electrocardiogram (ECG or EKG), Report and Interpretation Only $601 N/A $601
Evaluation of Antimicrobial Drug (Antibiotic, Antifungal, Antiviral) $107 N/A $107
Hepatitis A Vaccine for Adults, Injected into Muscle $208 N/A $208
Hepatitis A Vaccine for Children, Injected into Muscle $355 N/A $355
Hepatitis C Antibody Level $134 N/A $134
Human Papilloma Virus Vaccine, Injected into Muscle $67 N/A $67
Influenza Vaccine, Injected into Muscle $97 N/A $97
Knee MRI $2,993 N/A $2,993
Lab Test to Detect Coronavirus (COVID-19) $200 N/A $200
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 $104 N/A $104
Liver Enzyme (AST or SGOT) Level $104 N/A $104
Nasal Endoscopy $1,221 N/A $1,221
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $337 N/A $337
New Patient Preventive Care Visit for Adult, 40-64 $571 N/A $571
New Patient Preventive Care Visit for Adult, Ages 18-39 $502 N/A $502
New Patient Preventive Care Visit for Child, Ages 1-4 $445 N/A $445
New Patient Preventive Care Visit for Child, Ages 5-11 $446 N/A $446
New Patient Preventive Care Visit for Child, Under Age 1 $422 N/A $422
Office Visit for Established Patient, Basic $184 N/A $184
Office Visit for Established Patient, High Complexity $557 N/A $557
Office Visit for Established Patient, Low Complexity $255 N/A $255
Office Visit for Established Patient, Minimal Presenting Problem $112 N/A $112
Office Visit for Established Patient, Moderate Complexity $393 N/A $393
Office Visit for New Patient, High Complexity $715 N/A $715
Office Visit for New Patient, Low Complexity $395 N/A $395
Office Visit for New Patient, Minor Complexity $186 N/A $186
Office Visit for New Patient, Moderate Complexity $595 N/A $595
Pap Test Screening, Automated with Manual Review $213 N/A $213
Pap Test Screening, Manual $100 N/A $100
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $310
Pneumococcal Vaccine for Children, Injected into Muscle $132 N/A $132
Pregnancy Test $62 N/A $62
Presence of Drug $571 N/A $571
Preventive Care Visit for Adolescent, Under Ages 12-17 $421 N/A $421
Preventive Care Visit for Adult, 40-64 $501 N/A $501
Preventive Care Visit for Adult, Ages 18-39 $460 N/A $460
Preventive Care Visit for Child, Under Age 1 $329 N/A $329
Preventive Care Visit for Child, Under Ages 1-4 $355 N/A $355
Preventive Care Visit for Child, Under Ages 5-11 $353 N/A $353
Prostate Specific Antigen (PSA) Level, Total $200 N/A $200
Psychotherapy, 30 Minutes with Patient $105 Near Average
State Average: 1
 $105
Rotovirus Vaccine, Oral Administration $67 N/A $67
Screening Mammogram of Both Breasts $1,156 N/A $1,156
Skin Growth Removal, Premalignant or Precancerous $642 N/A $642
Skin Growth Removal, Up to 14, Benign or Noncancerous $797 N/A $797
Telehealth Visit for Established Patient, 11-20 minutes $183 N/A $183
Telehealth Visit for Established Patient, 21-30 minutes $244 N/A $244
Telehealth Visit for Established Patient, 5-10 minutes $109 N/A $109
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $67 N/A $67
Therapeutic Exercises $131 Below Average
State Average: 4
 $131
Thyroid Stimulating Hormone (TSH) Level $171 N/A $171
Thyroxine (Thyroid Chemical) Level, Free $150 N/A $150
Ultrasound of Heart (Echocardiogram) $2,777 N/A $2,777
Urinalysis, Automated with Microscope Examination $63 N/A $63
Urinalysis, Automated without Microscope $5 N/A $5
Urinalysis, Manual Test $57 N/A $57
Urine Capacity Measurement $233 N/A $233
Urine Test with Examination $11 N/A $11
Vitamin D-3 Level $258 N/A $258
X-Ray of Fingers, 2 Views $623 N/A $623
X-Ray of Foot, 3 Views $886 N/A $886
X-Ray of Hand, 3 Views $1,066 N/A $1,066
X-Ray of Knee, 3 Views $902 N/A $902
X-Ray of Knee, 4 Views $1,159 N/A $1,159
X-Ray of Lower Leg, 2 Views $725 N/A $725
X-Ray of Shoulder, 2 Views $984 N/A $984
X-Ray of Wrist, 3 Views $971 N/A $971