Dartmouth-Hitchcock (Manchester)

100 Htichcock Way Manchester, NH 03104
Medical Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Arthrocentesis (outpatient)$8800%$880 Medium
Biopsy - Skin Lesion$1,1000%$1,100 Medium
Blood Test - Blood Glucose Control (Hemoglobin A1C)$1090%$109 Medium
Blood Test - Cholesterol Test, Lipid Panel$950%$95 Medium
Blood Test - Clotting Time$620%$62 Medium
Blood Test - Complete Blood Cell Count (Hemoglobin)$670%$67 Medium
Blood Test - Complete Blood Cell Count and Automated WBC$700%$70 Medium
Blood Test - Comprehensive Metabolic Panel$600%$60 Medium
Blood Test - Hepatic (Liver) Function Panel$1540%$154 Medium
Blood Test - Prostate Specific Antigen (PSA) Level$1120%$112 Medium
Blood Test - Thyroid Stimulating Hormone (TSH) Level$950%$95 Medium
Blood Test - Thyroxine (Thyroid Chemical) Level, Free$1170%$117 Medium
Bone Density Scan (outpatient)$6490%$649 Medium
CT Scan - Abdomen and Pelvis, with Contrast$2,4970%$2,497 Medium
CT Scan - Chest, with Contrast (outpatient)$2,0640%$2,064 Medium
Destruction of Lesion (outpatient)$5200%$520 Medium
Destruction of Lesions, up to 14$5160%$516 Medium
Laryngoscopy - Diagnostic$1,1160%$1,116 High
Mammogram (outpatient)$4960%$496 Medium
MRI - Back (outpatient)$3,1990%$3,199 Medium
MRI - Brain (outpatient)$6,4980%$6,498 Medium
MRI - Knee (outpatient)$2,9730%$2,973 Medium
MRI - Pelvis (outpatient)$5,8830%$5,883 High
Nasal Endoscopy - Diagnostic$1,1660%$1,166 Medium
Office Visit - Basic$1530%$153 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old$3680%$368 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old$4430%$443 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old$4370%$437 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old$4940%$494 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$3860%$386 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old$3480%$348 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old$2930%$293 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old$3500%$350 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$3820%$382 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$4170%$417 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$2930%$293 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$2730%$273 Medium
Office Visit - Established Patient, High Complexity$4660%$466 Medium
Office Visit - Established Patient, Low Complexity$2140%$214 Medium
Office Visit - Established Patient, Moderate Complexity$3270%$327 Medium
Office Visit - New Patient, Low Complexity$3270%$327 Medium
Office Visit - New Patient, Minor$1610%$161 Medium
Pap Test$2250%$225 Medium
Physical Therapy - Therapeutic Exercises$1470%$147 Medium
Strep Test (Streptococcus, group A)$980%$98 Medium
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition$1910%$191 Medium
Ultrasound - Breast (outpatient)$4510%$451 Medium
Ultrasound - Pelvic (outpatient)$5420%$542 Medium
Ultrasound - Pregnancy (outpatient)$6780%$678 Medium
Ultrasound - Pregnancy Follow-Up$4640%$464 Medium
Ultrasound - Transvaginal (non-maternity)$5210%$521 Medium
Urine Test - Automated with Microscope Examination$1710%$171 Medium
Urine Test - Automated without Microscope$170%$17 Medium
Urine Test - Bacterial Culture$870%$87 Medium
Urine Test - Chlamydia$1580%$158 Medium
Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria)$1580%$158 Medium
Urine Test - Pregnancy$590%$59 Medium
X-Ray - Ankle (outpatient)$3510%$351 High
X-Ray - Chest (outpatient)$5500%$550 Medium
X-Ray - Foot (outpatient)$7620%$762 Medium
X-Ray - Knee (outpatient)$4310%$431 Medium
X-Ray - Shoulder (outpatient)$6740%$674 High