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 $750 N/A $750
Automated Pap Test Screening and Manual Rescreening $196 N/A $196
Automated with Microscope Examination $60 N/A $60
Automated without Microscope $53 N/A $53
Bacterial Culture Swab for Aerobic Isolates $88 N/A $88
Bacterial Culture, Quantitative Colony Count $139 N/A $139
Basic Metabolic Panel $71 N/A $71
Blood Glucose (Sugar) Level $45 N/A $45
Blood Glucose Control (Hemoglobin A1C) $22 N/A $22
Bone Density Scan $709 N/A $709
C-reactive Protein (CRP) Level $35 N/A $35
Chlamydia Test $223 N/A $223
Cholesterol Test, Lipid Panel $112 N/A $112
Clotting Time $53 N/A $53
Complete Blood Cell Count (Hemoglobin) $66 N/A $66
Complete Blood Cell Count and Automated White Blood Cells $72 N/A $72
Comprehensive Metabolic Panel $97 N/A $97
Coronavirus (COVID-19) Antibody Level $57 N/A $57
Detection for Strep (Streptococcus, group A) $69 N/A $69
Detection Test for Human Papillomavirus (HPV) $244 N/A $244
Developmental Screening $70 N/A $70
Diagnostic Laryngoscopy $1,114 N/A $1,114
Electrical Stimulation Therapy $41 Below Average
State Average: 3
 $41
Electrocardiogram (ECG or EKG) With Report and Interpretation $576 N/A $576
Follow-Up Pregnancy Ultrasound $1,228 N/A $1,228
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $223 N/A $223
Group Psychotherapy $65 Above Average
State Average: 5
 $65
Hepatitis C Antibody Level $129 N/A $129
Influenza Vaccine, Injected into Muscle $62 N/A $62
Knee MRI $2,834 N/A $2,834
Lab Test to Detect Coronavirus (COVID-19) $107 N/A $107
Lab Test to Detect Influenza Virus $75 N/A $75
Lab Test to Measure Creatinine Level $120 N/A $120
Nasal Endoscopy $1,147 N/A $1,147
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $337 N/A $337
New Patient Preventive Care Visit for Adult, 40-64 $378 N/A $378
New Patient Preventive Care Visit for Adult, Ages 18-39 $326 N/A $326
New Patient Preventive Care Visit for Child, Ages 1-4 $280 N/A $280
New Patient Preventive Care Visit for Child, Ages 5-11 $427 N/A $427
New Patient Preventive Care Visit for Child, Under Age 1 $403 N/A $403
Office Visit for Established Patient, Basic $168 N/A $168
Office Visit for Established Patient, High Complexity $512 N/A $512
Office Visit for Established Patient, Low Complexity $235 N/A $235
Office Visit for Established Patient, Minimal Presenting Problem $107 N/A $107
Office Visit for Established Patient, Moderate Complexity $358 N/A $358
Office Visit for New Patient, High Complexity $684 N/A $684
Office Visit for New Patient, Low Complexity $224 N/A $224
Office Visit for New Patient, Minor Complexity $273 N/A $273
Office Visit for New Patient, Moderate Complexity $544 N/A $544
Pathology Examination of Tissue, Intermediate Complexity $375 N/A $375
Pneumococcal Conjugate Vaccine, Injected into Muscle $654 N/A $654
Pregnancy Test $42 N/A $42
Pregnancy Ultrasound (Outpatient) $744 N/A $744
Preventive Care Visit for Adolescent, Under Ages 12-17 $405 N/A $405
Preventive Care Visit for Adult, 40-64 $461 N/A $461
Preventive Care Visit for Adult, Ages 18-39 $422 N/A $422
Preventive Care Visit for Child, Under Age 1 $302 N/A $302
Preventive Care Visit for Child, Under Ages 1-4 $324 N/A $324
Preventive Care Visit for Child, Under Ages 5-11 $340 N/A $340
Prostate Specific Antigen (PSA) Level $184 N/A $184
Psychotherapy with Evaluation and Management, 45 Minutes with Patient $105 Near Average
State Average: 2
 $105
Psychotherapy, 30 Minutes with Patient $75 Near Average
State Average: 1
 $75
Psychotherapy, 45 Minutes with Patient $120 Below Average
State Average: 4
 $120
Punch Biopsy of Skin $1,955 N/A $1,955
Screening Mammogram of Both Breasts $1,085 N/A $1,085
Skin Growth Removal, Premalignant or Precancerous $653 N/A $653
Skin Growth Removal, Up to 14, Benign or Noncancerous $733 N/A $733
Tangential Biopsy of Skin $1,476 N/A $1,476
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $144 N/A $144
Therapeutic Exercises $103 Below Average
State Average: 4
 $103
Thyroid Stimulating Hormone (TSH) Level $164 N/A $164
Thyroxine (Thyroid Chemical) Level, Free $89 N/A $89
Transvaginal Ultrasound (Non-Maternity) $1,306 N/A $1,306
Urinalysis, Manual Test $57 N/A $57
Urine Capacity Measurement $231 N/A $231
Vitamin D-3 Level $237 N/A $237
Wound Repair, 2.5 Centimeters or Less $394 N/A $394
X-Ray of Foot $767 N/A $767
X-Ray of Hand $940 N/A $940
X-Ray of Knee $870 N/A $870
X-Ray of Shoulder $864 N/A $864