Dartmouth-Hitchcock (Keene)
580-590 Court Street Keene, NH 03431
Medical Procedures
Radiology Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Bone Density Scan (outpatient) | $649 | 0% | $649 | Medium |
| Mammogram (outpatient) | $1012 | 0% | $1012 | Medium |
| Ultrasound - Pregnancy (outpatient) | $678 | 0% | $678 | High |
| Ultrasound - Pregnancy follow-up | $464 | 0% | $464 | Medium |
| Ultrasound - Transvaginal (non-maternity) | $589 | 0% | $589 | Medium |
| Urine Capacity Measurement | $582 | 0% | $582 | Medium |
| X-Ray - Ankle (outpatient) | $644 | 0% | $644 | Medium |
| X-Ray - Foot (outpatient) | $637 | 0% | $637 | Medium |
| X-Ray - Knee (outpatient) | $883 | 0% | $883 | High |
| X-Ray - Shoulder (outpatient) | $832 | 0% | $832 | High |
| X-Ray - Wrist (outpatient) | $941 | 0% | $941 | Medium |
Outpatient Tests and Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Arthrocentesis (outpatient) | $872 | 0% | $872 | Medium |
| Biopsy, Skin lesion | $1091 | 0% | $1091 | Medium |
| Destruction of Lesion (outpatient) | $550 | 0% | $550 | Medium |
| Destruction of lesions, up to 14 | $665 | 0% | $665 | Medium |
| Diagnostic Laryngoscopy | $1057 | 0% | $1057 | Medium |
| Nasal endoscopy, diagnostic | $1166 | 0% | $1166 | Medium |
Laboratory Services
Physical Therapy
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Low Complexity Evaluation - PT | $126 | 0% | $126 | Medium |
| Re-Evaluation - PT | $74 | 0% | $74 | Medium |
| Manual Therapy - PT | $58 | 0% | $58 | Medium |
| Therapeutic Activities - PT | $53 | 0% | $53 | Medium |
| Therapeutic Exercises - PT | $53 | 0% | $53 | Medium |
| Electrical Stimulation Therapy - PT | $26 | 0% | $26 | Medium |
| Neuromuscular Reeducation - PT | $53 | 0% | $53 | Medium |