Dartmouth-Hitchcock Medical Center
1 Medical Center Drive Lebanon, NH 03766
Medical Procedures
Radiology Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Mammogram (outpatient) | $778 | 0% | $778 | Medium |
| Ultrasound - Pelvic (outpatient) | $604 | 0% | $604 | Medium |
| Ultrasound - Pregnancy follow-up | $956 | 0% | $956 | Medium |
| Ultrasound - Transvaginal (non-maternity) | $683 | 0% | $683 | Medium |
| X-Ray - Wrist (outpatient) | $653 | 0% | $653 | High |
Outpatient Tests and Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Arthrocentesis (outpatient) | $874 | 0% | $874 | Medium |
| Destruction of Lesion (outpatient) | $670 | 0% | $670 | High |
Laboratory Services
Office Visits
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Basic Office Visit | $140 | 0% | $140 | Medium |
| Office Visit, Established Pt | $206 | 0% | $206 | Medium |
| Office Visit of Moderate Complexity | $312 | 0% | $312 | Medium |
| Office Visit of Moderate to High Complexity | $450 | 0% | $450 | Medium |
| Office Visit, New Pt, Minor | $240 | 0% | $240 | Medium |
| Office Visit, New Pt, Low | $327 | 0% | $327 | Medium |
| Comp Preventive Medicine younger than 1 yrs old | $258 | 0% | $258 | Medium |
| Comp Preventive Medicine 1-4 yrs old | $293 | 0% | $293 | Medium |
| Comp Preventive Medicine 5-11 yrs old | $277 | 0% | $277 | Medium |
| Comp Preventive Medicine 12-17 yrs old | $350 | 0% | $350 | Medium |
| Comp Preventive Medicine 18-39 yrs old | $368 | 0% | $368 | Medium |
| Comp Preventive Medicine 40-64 yrs old | $401 | 0% | $401 | Medium |
| New Patient, Comp Prevent Medicine younger than 1 yrs old | $339 | 0% | $339 | Medium |
| New Patient, Comp Prevent Medicine 12-17 yrs old | $399 | 0% | $399 | Medium |
| New Patient, Comp Prevent Medicine 18-39 yrs old | $420 | 0% | $420 | Medium |
| New Patient, Comp Prevent Medicine 40-64 yrs old | $489 | 0% | $489 | Medium |