Dartmouth-Hitchcock (Manchester)
100 Htichcock Way Manchester, NH 03104
Medical Procedures
Radiology Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Mammogram (outpatient) | $912 | 0% | $912 | High |
| MRI - Knee (outpatient) | $3557 | 0% | $3557 | Medium |
| Ultrasound - Pelvic (outpatient) | $542 | 0% | $542 | Medium |
| Ultrasound - Pregnancy (outpatient) | $678 | 0% | $678 | Medium |
| Ultrasound - Pregnancy follow-up | $464 | 0% | $464 | Medium |
| Ultrasound - Transvaginal (non-maternity) | $521 | 0% | $521 | Medium |
| X-Ray - Foot (outpatient) | $844 | 0% | $844 | Medium |
| X-Ray - Knee (outpatient) | $563 | 0% | $563 | High |
| X-Ray - Shoulder (outpatient) | $672 | 0% | $672 | High |
Outpatient Tests and Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Arthrocentesis (outpatient) | $867 | 0% | $867 | Medium |
| Biopsy, Skin lesion | $1188 | 0% | $1188 | Medium |
| Destruction of Lesion (outpatient) | $519 | 0% | $519 | Medium |
| Destruction of lesions, up to 14 | $566 | 0% | $566 | Medium |
| Diagnostic Laryngoscopy | $1116 | 0% | $1116 | 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 |
|---|---|---|---|---|
| Therapeutic Exercises - PT | $147 | 0% | $147 | Medium |