Dartmouth-Hitchcock (Nashua)

2300 Southwood Drive Nashua, NH 03063
http://www.dartmouth-hitchcock.org/index.html
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Radiology Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Mammogram (outpatient)$8950%$895 Medium
Ultrasound - Pregnancy (outpatient)$6780%$678 Medium
Ultrasound - Pregnancy follow-up$4640%$464 Medium
Ultrasound - Transvaginal (non-maternity)$7910%$791 Medium
X-Ray - Ankle (outpatient)$6760%$676 Medium
X-Ray - Foot (outpatient)$5240%$524 Medium
X-Ray - Hand$6360%$636 Medium
X-Ray - Knee (outpatient)$5310%$531 Medium
X-Ray - Shoulder (outpatient)$6720%$672 Medium

Outpatient Tests and Procedures

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Arthrocentesis (outpatient)$8930%$893 Medium
Biopsy, Skin lesion$14020%$1402 Medium
Destruction of Lesion (outpatient)$5800%$580 Medium
Destruction of lesions, up to 14$4500%$450 Medium

Laboratory Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Blood test for basic metabolic panel$480%$48 Medium
Blood test for blood glucose control (Hemoglobin A1C)$290%$29 Medium
Blood test for clotting time$620%$62 Medium
Blood test for complete blood cell count and automated WBC$700%$70 Medium
Blood test for complete blood cell count (hemoglobin)$670%$67 Medium
Blood test for PSA (prostate specific antigen) level$1120%$112 Medium
Blood test for thyroxine (thyroid chemical) level, free$270%$27 Medium
Blood test for TSH (thyroid stimulating hormone) level$950%$95 Medium
Blood test for vitamin B-12 (cyanocobalamin) level$970%$97 Medium
Health Screening - General Health Panel$1660%$166 Medium
Lipid Panel - Cholesterol Test$410%$41 Medium
Urinalysis test automated with microscope examination$1710%$171 Medium
Metabolic Panel - Comprehensive$320%$32 Medium
Pap Test$2360%$236 Medium
Pregnancy test, urine$590%$59 Medium
Test for disease-causing (pathogenic) organisms, not limited to a specific condition$200%$20 Medium
Strep Test (Streptococcus, group A)$980%$98 Medium
Test for vitamin D-3 level$890%$89 Medium
Urinalysis test automated without microscope$1910%$191 Medium
Urine test for bacterial culture$870%$87 Medium

Office Visits

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Basic Office Visit$1530%$153 Medium
Office Visit, Established Pt$2140%$214 Medium
Office Visit of Moderate Complexity$3270%$327 Medium
Office Visit of Moderate to High Complexity$4660%$466 Medium
Office Visit, New Pt, Minor$2470%$247 Medium
Office Visit, New Pt, Low$3270%$327 Medium
Comp Preventive Medicine younger than 1 yrs old$2730%$273 Medium
Comp Preventive Medicine 1-4 yrs old$2930%$293 Medium
Comp Preventive Medicine 5-11 yrs old$2930%$293 Medium
Comp Preventive Medicine 12-17 yrs old$3500%$350 Medium
Comp Preventive Medicine 18-39 yrs old$3820%$382 Medium
Comp Preventive Medicine 40-64 yrs old$4170%$417 Medium
New Patient, Comp Prevent Medicine younger than 1 yrs old$3480%$348 Medium
New Patient, Comp Prevent Medicine 1-4 yrs old$3680%$368 Medium
New Patient, Comp Prevent Medicine 5-11 yrs old$3860%$386 Medium
New Patient, Comp Prevent Medicine 12-17 yrs old$4430%$443 Medium
New Patient, Comp Prevent Medicine 18-39 yrs old$4370%$437 Medium
New Patient, Comp Prevent Medicine 40-64 yrs old$4940%$494 Medium