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%
Arthrocentesis $786 N/A $786
Back MRI $3,875 N/A $3,875
Bacterial Culture Swab for Aerobic Isolates $83 N/A $83
Bacterial Culture, Quantitative Colony Count $141 N/A $141
Basic Metabolic Panel $82 N/A $82
Biopsy of Skin Lesion $1,239 N/A $1,239
Blood Count (Hemoglobin) $47 N/A $47
Blood Glucose (Sugar) Level $22 N/A $22
Blood Glucose Control (Hemoglobin A1C) $58 N/A $58
Blood Typing (ABO) $18 N/A $18
Blood Typing (Rh (D)) $18 N/A $18
Bone Density Scan $777 N/A $777
Brain MRI $7,883 N/A $7,883
C-reactive Protein (CRP) Level $35 N/A $35
Chlamydia Test $207 N/A $207
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 Eye Exam, New Patient $422 N/A $422
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 $2,962 N/A $2,962
CT Scan of Chest, With Contrast $2,455 N/A $2,455
Detection for Strep (Streptococcus, group A) $118 N/A $118
Detection Test for Hepatitis B Surface Antigen $106 N/A $106
Detection Test for Human Papillomavirus (HPV) $280 N/A $280
Developmental Screening $77 N/A $77
Diagnostic Laryngoscopy $1,328 N/A $1,328
Diagnostic Mammogram of Both Breasts $666 N/A $666
Diagnostic Mammogram of One Breast $561 N/A $561
Electrocardiogram (ECG or EKG) With Report and Interpretation $698 N/A $698
Electrocardiogram (ECG or EKG), Report and Interpretation Only $467 N/A $467
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 $552 N/A $552
General Health Panel $269 N/A $269
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $116 N/A $116
Group Psychotherapy $557 Above Average
State Average: 4
 $557
Hepatic (Liver) Function Panel $49 N/A $49
Hepatitis A Vaccine for Adults, Injected into Muscle $192 N/A $192
Hepatitis A Vaccine for Children, Injected into Muscle $218 N/A $218
Hepatitis C Antibody Level $112 N/A $112
Human Papilloma Virus Vaccine, Injected into Muscle $67 N/A $67
Influenza Vaccine, Injected into Muscle $97 N/A $97
Iron Binding Capacity $53 N/A $53
Iron Level $39 N/A $39
Knee MRI $3,600 N/A $3,600
Lab Test to Detect Coronavirus (COVID-19) $158 N/A $158
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 $92 N/A $92
Nasal Endoscopy $1,422 N/A $1,422
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $525 N/A $525
New Patient Preventive Care Visit for Adult, 40-64 $593 N/A $593
New Patient Preventive Care Visit for Adult, Ages 18-39 $525 N/A $525
New Patient Preventive Care Visit for Child, Ages 1-4 $445 N/A $445
New Patient Preventive Care Visit for Child, Ages 5-11 $465 N/A $465
New Patient Preventive Care Visit for Child, Under Age 1 $422 N/A $422
Office Visit for Established Patient, Basic $184 N/A $184
Office Visit for Established Patient, High Complexity $557 N/A $557
Office Visit for Established Patient, Low Complexity $255 N/A $255
Office Visit for Established Patient, Minimal Presenting Problem $112 N/A $112
Office Visit for Established Patient, Moderate Complexity $393 N/A $393
Office Visit for New Patient, High Complexity $743 N/A $743
Office Visit for New Patient, Low Complexity $395 N/A $395
Office Visit for New Patient, Minor Complexity $286 N/A $286
Office Visit for New Patient, Moderate Complexity $595 N/A $595
Pap Test Screening, Automated with Manual Review $261 N/A $261
Pap Test Screening, Manual $265 N/A $265
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $310
Pelvis MRI $7,138 N/A $7,138
Pneumococcal Vaccine for Children, Injected into Muscle $67 N/A $67
Pregnancy Test $62 N/A $62
Pregnancy Ultrasound (Outpatient) $811 N/A $811
Presence of Drug $832 N/A $832
Preventive Care Visit for Adolescent, Under Ages 12-17 $421 N/A $421
Preventive Care Visit for Adult, 40-64 $501 N/A $501
Preventive Care Visit for Adult, Ages 18-39 $460 N/A $460
Preventive Care Visit for Child, Under Age 1 $329 N/A $329
Preventive Care Visit for Child, Under Ages 1-4 $355 N/A $355
Preventive Care Visit for Child, Under Ages 5-11 $353 N/A $353
Prostate Cancer Screening $179 N/A $179
Prostate Specific Antigen (PSA) Level, Total $108 N/A $108
Screening Mammogram of Both Breasts $602 N/A $602
Skin Growth Removal, Premalignant or Precancerous $623 N/A $623
Skin Growth Removal, Up to 14, Benign or Noncancerous $678 N/A $678
Sleep Monitoring $7,035 N/A $7,035
Telehealth Visit for Established Patient, 11-20 minutes $179 N/A $179
Telehealth Visit for Established Patient, 21-30 minutes $244 N/A $244
Telehealth Visit for Established Patient, 5-10 minutes $88 N/A $88
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition $108 N/A $108
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $66 N/A $66
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 Heart (Echocardiogram) $1,932 N/A $1,932
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 $17 N/A $17
Urinalysis, Manual Test $57 N/A $57
Vitamin B-12 (Cyanocobalamin) Level $88 N/A $88
Vitamin D-3 Level $120 N/A $120
X-Ray of Ankle, 3 Views $495 N/A $495
X-Ray of Chest, 2 Views $665 N/A $665
X-Ray of Fingers, 2 Views $482 N/A $482
X-Ray of Foot, 3 Views $603 N/A $603
X-Ray of Hand, 2 Views $630 N/A $630
X-Ray of Hip, 2 or 3 Views $681 N/A $681
X-Ray of Knee, 1 or 2 Views $624 N/A $624
X-Ray of Knee, 4 Views $656 N/A $656
X-Ray of Lower Leg, 2 Views $488 N/A $488
X-Ray of Neck, 4 to 5 Views $796 N/A $796
X-Ray of Shoulder, 2 Views $669 N/A $669