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)$8920%$892 Medium
Bacterial Culture Swab$1870%$187 Medium
Biopsy - Skin Lesion$1,0270%$1,027 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 - General Health Panel$1990%$199 Medium
Blood Test - Hepatitis C Antibody Level$2160%$216 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$1110%$111 Medium
Blood Test - Vitamin D-3 Level$2870%$287 Medium
Bone Density Scan (outpatient)$6810%$681 High
CT Scan - Abdomen and Pelvis, with Contrast$2,6250%$2,625 Medium
CT Scan - Chest, with Contrast (outpatient)$2,1720%$2,172 Medium
Destruction of Lesion (outpatient)$5460%$546 Medium
Destruction of Lesions, up to 14$5850%$585 Medium
Detection Test for Human Papillomavirus (HPV)$1880%$188 Medium
Electrocardiogram (ECG or EKG)$5460%$546 Medium
Laryngoscopy - Diagnostic$1,1790%$1,179 Medium
Mammogram (outpatient)$5230%$523 Medium
MRI - Back (outpatient)$3,3790%$3,379 High
MRI - Brain (outpatient)$6,9360%$6,936 Medium
MRI - Knee (outpatient)$3,1400%$3,140 Medium
MRI - Pelvis (outpatient)$6,3300%$6,330 Medium
Nasal Endoscopy - Diagnostic$1,2320%$1,232 Medium
Office Visit - Basic$1530%$153 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$5210%$521 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$4080%$408 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old$3680%$368 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old$3100%$310 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old$3700%$370 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$4030%$403 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$4400%$440 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$3100%$310 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$2890%$289 Medium
Office Visit - Established Patient, High Complexity$4920%$492 Medium
Office Visit - Established Patient, Low Complexity$2260%$226 Medium
Office Visit - Established Patient, Moderate Complexity$3440%$344 Medium
Office Visit - New Patient, Low Complexity$3440%$344 Medium
Office Visit - New Patient, Minor$1590%$159 Medium
Pap Test$2360%$236 Medium
Strep Test (Streptococcus, group A)$1030%$103 Medium
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition$1910%$191 Medium
Ultrasound - Breast (outpatient)$8310%$831 Medium
Ultrasound - Pelvic (outpatient)$5720%$572 Medium
Ultrasound - Pregnancy (outpatient)$7160%$716 Medium
Ultrasound - Pregnancy Follow-Up$4900%$490 Medium
Ultrasound - Transvaginal (non-maternity)$5500%$550 Medium
Urine Test - Automated with Microscope Examination$1120%$112 Medium
Urine Test - Automated without Microscope$170%$17 Medium
Urine Test - Bacterial Culture, Quantitative Colony Count$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)$3710%$371 Medium
X-Ray - Chest (outpatient)$5810%$581 Medium
X-Ray - Foot (outpatient)$6870%$687 High
X-Ray - Knee (outpatient)$6240%$624 Medium
X-Ray - Shoulder (outpatient)$6060%$606 High