Dartmouth-Hitchcock (Manchester)

100 Htichcock Way Manchester, NH 03104
http://www.dartmouth-hitchcock.org/index.html
(603) 695-2500

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%
Antibody Screen, Red Blood Cells (RBC) $109 N/A $109
Antinuclear Antibodies (ANA) Level $209 N/A $209
Arthrocentesis $867 N/A $867
Back MRI $3,701 N/A $3,701
Bacterial Culture Swab for Aerobic Isolates $83 N/A $83
Bacterial Culture, Quantitative Colony Count $143 N/A $143
Basic Metabolic Panel $82 N/A $82
Bilirubin Level $40 N/A $40
Biopsy of Skin Lesion $1,229 N/A $1,229
Blood Count (Hemoglobin) $44 N/A $44
Blood Glucose (Sugar) Level $22 N/A $22
Blood Glucose Control (Hemoglobin A1C) $58 N/A $58
Blood Typing (ABO) $33 N/A $33
Blood Typing (Rh (D)) $56 N/A $56
Bone Density Scan $742 N/A $742
Borrelia Burgdorferi (Lyme disease) Antibody Level $139 N/A $139
Brain MRI $7,669 N/A $7,669
C-reactive Protein (CRP) Level $33 N/A $33
Chlamydia Test $156 N/A $156
Cholesterol Test, Lipid Panel $144 N/A $144
Clotting Time $79 N/A $79
Complete Blood Cell Count (Hemoglobin) $46 N/A $46
Complete Blood Cell Count and Automated White Blood Cells $71 N/A $71
Comprehensive Metabolic Panel $97 N/A $97
Coronavirus (COVID-19) Antibody Level $112 N/A $112
Creatinine Level $30 N/A $30
CT Scan of Abdomen and Pelvis, With Contrast $2,961 N/A $2,961
CT Scan of Chest, With Contrast $2,351 N/A $2,351
Detection for Strep (Streptococcus, group A) $44 N/A $44
Detection Test for Hepatitis B Surface Antigen $62 N/A $62
Detection Test for Human Papillomavirus (HPV) $300 N/A $300
Developmental Screening $74 N/A $74
Diagnostic Laryngoscopy $1,340 N/A $1,340
Diagnostic Mammogram of Both Breasts $650 N/A $650
Diagnostic Mammogram of One Breast $534 N/A $534
Electrocardiogram (ECG or EKG) With Report and Interpretation $805 N/A $805
Evaluation of Antimicrobial Drug (Antibiotic, Antifungal, Antiviral) $135 N/A $135
Ferritin (Blood Protein) Level $82 N/A $82
Folic Acid Level $88 N/A $88
Follow-Up Pregnancy Ultrasound $531 N/A $531
General Health Panel $269 N/A $269
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $156 N/A $156
Group Psychotherapy $533 Above Average
State Average: 5
$533
Hepatic (Liver) Function Panel $49 N/A $49
Hepatitis A Vaccine for Adults, Injected into Muscle $193 N/A $193
Hepatitis A Vaccine for Children, Injected into Muscle $297 N/A $297
Hepatitis B Core Antibody Level $72 N/A $72
Hepatitis B Surface Antibody Level $64 N/A $64
Hepatitis C Antibody Level $84 N/A $84
Human Papilloma Virus Vaccine, Injected into Muscle $65 N/A $65
Influenza Vaccine, Injected into Muscle $124 N/A $124
Iron Binding Capacity $53 N/A $53
Iron Level $39 N/A $39
Knee MRI $3,439 N/A $3,439
Lab Test to Detect Coronavirus (COVID-19) $107 N/A $107
Lab Test to Detect Coronavirus (COVID-19) Antigen $105 N/A $105
Lab Test to Detect HIV-1 and HIV-2 $167 N/A $167
Lab Test to Detect Influenza Virus $35 N/A $35
Lab Test to Measure Creatinine Level $175 N/A $175
Lead Level $92 N/A $92
Lipase (Fat Enzyme) Level $41 N/A $41
Liver Enzyme (ALT or SGPT) Level $32 N/A $32
Liver Enzyme (AST or SGOT) Level $32 N/A $32
Microalbumin (Protein) Level $190 N/A $190
Nasal Endoscopy $1,498 N/A $1,498
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $525 N/A $525
New Patient Preventive Care Visit for Adult, 40-64 $570 N/A $570
New Patient Preventive Care Visit for Adult, Ages 18-39 $502 N/A $502
New Patient Preventive Care Visit for Child, Ages 1-4 $425 N/A $425
New Patient Preventive Care Visit for Child, Ages 5-11 $447 N/A $447
New Patient Preventive Care Visit for Child, Under Age 1 $403 N/A $403
Office Visit for Established Patient, Basic $175 N/A $175
Office Visit for Established Patient, High Complexity $536 N/A $536
Office Visit for Established Patient, Low Complexity $246 N/A $246
Office Visit for Established Patient, Minimal Presenting Problem $112 N/A $112
Office Visit for Established Patient, Moderate Complexity $375 N/A $375
Office Visit for New Patient, High Complexity $715 N/A $715
Office Visit for New Patient, Low Complexity $305 N/A $305
Office Visit for New Patient, Minor Complexity $234 N/A $234
Office Visit for New Patient, Moderate Complexity $569 N/A $569
Pap Test Screening, Automated with Manual Review $261 N/A $261
Pap Test Screening, Manual $226 N/A $226
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $310
Pelvis MRI $6,920 N/A $6,920
Pneumococcal Vaccine for Children, Injected into Muscle $65 N/A $65
Pregnancy Test $62 N/A $62
Pregnancy Ultrasound (Outpatient) $779 N/A $779
Presence of Drug $212 N/A $212
Preventive Care Visit for Adolescent, Under Ages 12-17 $405 N/A $405
Preventive Care Visit for Adult, 40-64 $482 N/A $482
Preventive Care Visit for Adult, Ages 18-39 $442 N/A $442
Preventive Care Visit for Child, Under Age 1 $316 N/A $316
Preventive Care Visit for Child, Under Ages 1-4 $339 N/A $339
Preventive Care Visit for Child, Under Ages 5-11 $339 N/A $339
Prostate Specific Antigen (PSA) Level, Total $108 N/A $108
Screening Mammogram of Both Breasts $573 N/A $573
Skin Growth Removal, Premalignant or Precancerous $597 N/A $597
Skin Growth Removal, Up to 14, Benign or Noncancerous $542 N/A $542
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition $163 N/A $163
Therapeutic Exercises $111 Below Average
State Average: 4
$111
Thyroid Stimulating Hormone (TSH) Level $101 N/A $101
Thyroxine (Thyroid Chemical) Level, Free $54 N/A $54
Total Protein Level $185 N/A $185
Transvaginal Ultrasound (Non-Maternity) $627 N/A $627
Ultrasound of Breast $389 N/A $389
Ultrasound of Pelvis $649 N/A $649
Urea Nitrogen Level $24 N/A $24
Urinalysis, Automated with Microscope Examination $156 N/A $156
Urinalysis, Automated without Microscope $53 N/A $53
Urinalysis, Manual Test $57 N/A $57
Vitamin B-12 (Cyanocobalamin) Level $88 N/A $88
Vitamin D-3 Level $120 N/A $120
Wound Repair, 2.5 Centimeters or Less $1,026 N/A $1,026
X-Ray of Ankle $495 N/A $495
X-Ray of Chest, 2 Views $634 N/A $634
X-Ray of Foot $603 N/A $603
X-Ray of Hip $681 N/A $681
X-Ray of Shoulder $671 N/A $671