Dartmouth-Hitchcock Medical Center

1 Medical Center Drive Lebanon, NH 03766
Medical Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Arthrocentesis (outpatient)$8020%$802 High
Bacterial Culture Swab$1870%$187 Medium
Biopsy - Skin Lesion$1,4710%$1,471 Medium
Blood Test - Basic Metabolic Panel$480%$48 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 - Electrolytes Panel$900%$90 Medium
Blood Test - Folic Acid Level$1010%$101 Medium
Blood Test - General Health Panel$2250%$225 Medium
Blood Test - Hepatic (Liver) Function Panel$540%$54 Medium
Blood Test - Hepatitis C Antibody Level$2160%$216 Medium
Blood Test - Lipase (fat enzyme) Level$300%$30 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 B-12 (Cyanocobalamin) Level$970%$97 Medium
Blood Test - Vitamin D-3 Level$1860%$186 Medium
Bone Density Scan (outpatient)$8540%$854 Medium
CT Scan - Abdomen and Pelvis, with Contrast$2,6670%$2,667 Medium
CT Scan - Chest, with Contrast (outpatient)$3,0690%$3,069 Medium
Destruction of Lesion (outpatient)$6000%$600 Medium
Destruction of Lesions, up to 14$6660%$666 Medium
Detection Test for Human Papillomavirus (HPV)$1880%$188 Medium
Electrocardiogram (ECG or EKG)$7890%$789 Medium
Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral)$1490%$149 Medium
Mammogram (outpatient)$9470%$947 Medium
MRI - Back (outpatient)$3,4850%$3,485 Medium
MRI - Brain (outpatient)$7,4550%$7,455 Medium
MRI - Knee (outpatient)$3,1400%$3,140 Medium
MRI - Pelvis (outpatient)$6,2330%$6,233 Medium
Office Visit - Basic$1310%$131 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old$4420%$442 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old$4940%$494 Medium
Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old$4070%$407 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old$3540%$354 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old$3680%$368 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old$3820%$382 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old$4220%$422 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old$3540%$354 Medium
Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old$3010%$301 Medium
Office Visit - Established Patient, High Complexity$4820%$482 Medium
Office Visit - Established Patient, Low Complexity$2140%$214 Medium
Office Visit - Established Patient, Moderate Complexity$3270%$327 Medium
Office Visit - New Patient, Low Complexity$3270%$327 Medium
Office Visit - New Patient, Minor$2530%$253 Medium
Pap Test$2360%$236 Medium
Physical Therapy - Manual Therapy$1290%$129 Medium
Physical Therapy - Therapeutic Exercises$1300%$130 Medium
Psychotherapy - Group Session$280%$28 Medium
Strep Test (Streptococcus, group A)$1030%$103 Medium
Ultrasound - Breast (outpatient)$9220%$922 Medium
Ultrasound - Pelvic (outpatient)$6960%$696 High
Ultrasound - Pregnancy (outpatient)$1,0770%$1,077 Medium
Ultrasound - Pregnancy Follow-Up$9560%$956 Medium
Ultrasound - Transvaginal (non-maternity)$6830%$683 Medium
Urine Test - Automated with Microscope Examination$1710%$171 Medium
Urine Test - Automated without Microscope$1910%$191 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$320%$32 Medium
X-Ray - Chest (outpatient)$5810%$581 Medium
X-Ray - Shoulder (outpatient)$7350%$735 Medium
X-Ray - Wrist (outpatient)$5820%$582 Medium