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 Typical Patient Complexity
Arthrocentesis (outpatient)$7160%$716 Medium
Bacterial Culture Swab$1240%$124 Medium
Biopsy - Skin Lesion$1,4580%$1,458 Medium
Blood Test - Basic Metabolic Panel$1680%$168 Medium
Blood Test - Blood Glucose Control (Hemoglobin A1C)$230%$23 Medium
Blood Test - Cholesterol Test, Lipid Panel$1460%$146 Medium
Blood Test - Clotting Time$620%$62 Medium
Blood Test - Complete Blood Cell Count (Hemoglobin)$620%$62 Medium
Blood Test - Complete Blood Cell Count and Automated WBC$690%$69 Medium
Blood Test - Comprehensive Metabolic Panel$920%$92 Medium
Blood Test - General Health Panel$1990%$199 Medium
Blood Test - Hepatic (Liver) Function Panel$740%$74 Medium
Blood Test - Hepatitis C Antibody Level$1130%$113 Medium
Blood Test - Prostate Specific Antigen (PSA) Level$1490%$149 Medium
Blood Test - Thyroid Stimulating Hormone (TSH) Level$1510%$151 Medium
Blood Test - Thyroxine (Thyroid Chemical) Level, Free$1060%$106 Medium
Blood Test - Vitamin D-3 Level$2920%$292 Medium
Bone Density Scan (outpatient)$6810%$681 Medium
Destruction of Lesion (outpatient)$6110%$611 Medium
Destruction of Lesions, up to 14$6650%$665 Medium
Detection Test for Human Papillomavirus (HPV)$2340%$234 Medium
Electrocardiogram (ECG or EKG)$7950%$795 Medium
Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral)$170%$17 Medium
Laryngoscopy - Diagnostic$1,1790%$1,179 Medium
Mammogram (outpatient)$1,0510%$1,051 Medium
MRI - Knee (outpatient)$2,6840%$2,684 Medium
Nasal Endoscopy - Diagnostic$1,2320%$1,232 Medium
Office Visit - Basic$1620%$162 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old$3890%$389 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old$4680%$468 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old$4610%$461 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old$5210%$521 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$4080%$408 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old$3680%$368 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old$3100%$310 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old$3700%$370 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$4030%$403 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$4400%$440 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$3100%$310 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$2890%$289 Medium
Office Visit - Established Patient, High Complexity$4920%$492 Medium
Office Visit - Established Patient, Low Complexity$2260%$226 Medium
Office Visit - Established Patient, Moderate Complexity$3440%$344 Medium
Office Visit - New Patient, Low Complexity$3440%$344 Medium
Office Visit - New Patient, Minor$2600%$260 Medium
Pap Test$1760%$176 Medium
Physical Therapy - Low Complexity Evaluation$3520%$352 Medium
Physical Therapy - Manual Therapy$1210%$121 Medium
Physical Therapy - Moderate Complexity Evaluation$2460%$246 Medium
Physical Therapy - Therapeutic Exercises$1410%$141 Medium
Strep Test (Streptococcus, group A)$1030%$103 Medium
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition$120%$12 Medium
Ultrasound - Pelvic (outpatient)$5420%$542 Medium
Ultrasound - Pregnancy (outpatient)$7160%$716 High
Ultrasound - Pregnancy Follow-Up$4900%$490 Medium
Ultrasound - Transvaginal (non-maternity)$1,4180%$1,418 Medium
Urine Test - Automated with Microscope Examination$540%$54 Medium
Urine Test - Automated without Microscope$260%$26 Medium
Urine Test - Bacterial Culture, Quantitative Colony Count$130%$13 Medium
Urine Test - Chlamydia$2130%$213 Medium
Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria)$2130%$213 Medium
Urine Test - Pregnancy$590%$59 Medium
X-Ray - Ankle (outpatient)$6440%$644 Medium
X-Ray - Foot (outpatient)$7500%$750 High
X-Ray - Hand$6700%$670 Medium
X-Ray - Knee (outpatient)$7490%$749 Medium
X-Ray - Shoulder (outpatient)$8730%$873 Medium
X-Ray - Wrist (outpatient)$8730%$873 Medium