Elliot Physician Network

Hooksett, NH 03106
http://elliothospital.org/website/physicians-network.php
(603) 626-4392
Manchester, NH 03109
(603) 626-4392
Goffstown, NH 02045
(603) 626-4392
Raymond, NH 03077
(603) 626-4392
Manchester, NH 03103
(603) 626-4392
Londonderry, NH 03053
(603) 626-4392
25 South River Road Bedford, NH 03110
(603) 626-4392
Windham, NH 03087
(603) 626-4392

All cost information is based on claims data collected in the New Hampshire Comprehensive Healthcare Information System which is updated quarterly. All quality information is based on claims and administrative data collected by the Centers for Medicare and Medicaid Services which is updated annually. For more information click the links above and review our methodology section.

Methodology
Procedure Estimate of Procedure Cost Estimate of Procedure Cost
This is an estimate of the total charge for the health care service before any discounts provided to the uninsured. 		Number of Visits Number of Visits
When the number of visits varies, it is difficult to estimate the total cost of care. This indicates the number of visits you can expect, calculated using the median. To determine the total you might pay, multiply the Estimate of Procedure Cost and the Statewide Average for Number of Visits.
- Above Average: Expect to visit the provider more than the average number of visits.
- Near Average: Expect the visit the provider close to the average number of visits.
- Below Average: Expect to visit the provider less than the average number of visits.
 		What You Will Pay What You Will Pay
The estimated charge amount minus the uninsured discount (when available).
Uninsured Discount: 0%
Antibody Screen, Red Blood Cells (RBC) $161 N/A $161
Antinuclear Antibodies (ANA) Level $191 N/A $191
Arthrocentesis $457 N/A $457
Back MRI $3,515 N/A $3,515
Bacterial Culture Swab $195 N/A $195
Bacterial Culture Swab for Aerobic Isolates $160 N/A $160
Bacterial Culture, Quantitative Colony Count $140 N/A $140
Basic Metabolic Panel $126 N/A $126
Bilirubin Level $87 N/A $87
Biopsy of Skin Lesion $867 N/A $867
Blood Count (Hemoglobin) $60 N/A $60
Blood Glucose (Sugar) Level $23 N/A $23
Blood Glucose Control (Hemoglobin A1C) $35 N/A $35
Blood Typing (ABO) $90 N/A $90
Blood Typing (Rh (D)) $90 N/A $90
Bone Density Scan $782 N/A $782
Borrelia Burgdorferi (Lyme disease) Antibody Level $258 N/A $258
C-reactive Protein (CRP) Level $147 N/A $147
Chlamydia Test $408 N/A $408
Cholesterol Test, Lipid Panel $171 N/A $171
Clotting Time $19 N/A $19
Coagulation Assessment $125 N/A $125
Complete Blood Cell Count (Hemoglobin) $84 N/A $84
Complete Blood Cell Count and Automated White Blood Cells $119 N/A $119
Comprehensive Metabolic Panel $153 N/A $153
Creatinine Level $69 N/A $69
CT Scan of Abdomen and Pelvis, With Contrast $5,286 N/A $5,286
CT Scan of Chest, With Contrast $1,515 N/A $1,515
CT Scan of Pelvis, With Contrast $3,171 N/A $3,171
Detection for Strep (Streptococcus, group A) $44 N/A $44
Detection Test for Human Papillomavirus (HPV) $336 N/A $336
Developmental Screening $34 N/A $34
Diagnostic Mammogram of Both Breasts $1,151 N/A $1,151
Diagnostic Mammogram of One Breast $920 N/A $920
Electrocardiogram (ECG or EKG) With Report and Interpretation $69 N/A $69
Electrocardiogram (ECG or EKG), Report and Interpretation Only $49 N/A $49
Evaluation of Antimicrobial Drug (Antibiotic, Antifungal, Antiviral) $203 N/A $203
Family Psychotherapy with Patient $126 Near Average
State Average: 3
 $126
Ferritin (Blood Protein) Level $212 N/A $212
Folic Acid Level $230 N/A $230
General Health Panel $442 N/A $442
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $408 N/A $408
Hepatitis A Vaccine for Adults, Injected into Muscle $208 N/A $208
Hepatitis A Vaccine for Children, Injected into Muscle $353 N/A $353
Hepatitis B Surface Antibody Level $96 N/A $96
Hepatitis C Antibody Level $224 N/A $224
Human Papilloma Virus Vaccine, Injected into Muscle $60 N/A $60
Hydration Infusion $255 N/A $255
Influenza Vaccine, Injected into Muscle $112 N/A $112
Injection of Substance for Pain Management, Lower Back or Tailbone $1,147 N/A $1,147
Iron Binding Capacity $139 N/A $139
Iron Level $118 N/A $118
Knee MRI $4,901 N/A $4,901
Lab Test to Detect Coronavirus (COVID-19) $274 N/A $274
Lab Test to Detect Coronavirus (COVID-19) Antigen $84 N/A $84
Lab Test to Detect HIV-1 and HIV-2 $258 N/A $258
Lab Test to Detect Influenza Virus $40 N/A $40
Lab Test to Measure Creatinine Level $97 N/A $97
LDL Cholesterol Level $152 N/A $152
Lead Level $197 N/A $197
Lipase (Fat Enzyme) Level $143 N/A $143
Liver Enzyme (ALT or SGPT) Level $88 N/A $88
Liver Enzyme (AST or SGOT) Level $108 N/A $108
Low Complexity Physical Therapy Evaluation $505 Near Average
State Average: 1
 $505
Magnesium Level $134 N/A $134
Manual Physical Therapy $163 Below Average
State Average: 4
 $163
Microalbumin (Protein) Level $152 N/A $152
Moderate Complexity Physical Therapy Evaluation $505 Near Average
State Average: 1
 $505
Natriuretic Peptide Level $315 N/A $315
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $295 N/A $295
New Patient Preventive Care Visit for Adult, 40-64 $331 N/A $331
New Patient Preventive Care Visit for Adult, Ages 18-39 $305 N/A $305
New Patient Preventive Care Visit for Child, Ages 1-4 $263 N/A $263
New Patient Preventive Care Visit for Child, Ages 5-11 $260 N/A $260
New Patient Preventive Care Visit for Child, Under Age 1 $242 N/A $242
Office Visit for Established Patient, Basic $153 N/A $153
Office Visit for Established Patient, High Complexity $393 N/A $393
Office Visit for Established Patient, Low Complexity $198 N/A $198
Office Visit for Established Patient, Minimal Presenting Problem $53 N/A $53
Office Visit for Established Patient, Moderate Complexity $280 N/A $280
Office Visit for New Patient, High Complexity $479 N/A $479
Office Visit for New Patient, Low Complexity $245 N/A $245
Office Visit for New Patient, Minor Complexity $167 N/A $167
Office Visit for New Patient, Moderate Complexity $363 N/A $363
Pap Test Screening, Automated with Manual Review $202 N/A $202
Pap Test Screening, Manual $148 N/A $148
Parathyroid Hormone (PTH) Level $533 N/A $533
Pathology Examination of Tissue, Intermediate Complexity $46 N/A $46
Phosphate Level $87 N/A $87
Pneumococcal Vaccine for Children, Injected into Muscle $151 N/A $151
Pregnancy Test $82 N/A $82
Presence of Drug $425 N/A $425
Preventive Care Visit for Adolescent, Under Ages 12-17 $254 N/A $254
Preventive Care Visit for Adult, 40-64 $277 N/A $277
Preventive Care Visit for Adult, Ages 18-39 $256 N/A $256
Preventive Care Visit for Child, Under Age 1 $223 N/A $223
Preventive Care Visit for Child, Under Ages 1-4 $231 N/A $231
Preventive Care Visit for Child, Under Ages 5-11 $230 N/A $230
Prostate Cancer Screening $208 N/A $208
Prostate Specific Antigen (PSA) Level, Free $180 N/A $180
Prostate Specific Antigen (PSA) Level, Total $171 N/A $171
Psychiatric Diagnostic Evaluation $210 Near Average
State Average: 1
 $210
Psychotherapy, 30 Minutes with Patient $137 Near Average
State Average: 1
 $137
Psychotherapy, 45 Minutes with Patient $158 Near Average
State Average: 3
 $158
Psychotherapy, 60 Minutes with Patient $210 Below Average
State Average: 6
 $210
Rotovirus Vaccine, Oral Administration $151 N/A $151
Screening Mammogram of Both Breasts $1,219 N/A $1,219
Self-Care or Home Management Training $56 Below Average
State Average: 2
 $56
Single-Level Injection for Pain Management, Lower Back or Tailbone $2,106 N/A $2,106
Skin Growth Removal, Premalignant or Precancerous $459 N/A $459
Skin Growth Removal, Up to 14, Benign or Noncancerous $463 N/A $463
Smear for Microorganism $93 N/A $93
Telehealth Visit for Established Patient, 11-20 minutes $189 N/A $189
Telehealth Visit for Established Patient, 21-30 minutes $264 N/A $264
Telehealth Visit for Established Patient, 5-10 minutes $126 N/A $126
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition $145 N/A $145
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $105 N/A $105
Therapeutic Exercises $177 Near Average
State Average: 4
 $177
Thyroglobulin (Thyroid Protein) Antibody Level $288 N/A $288
Thyroid Stimulating Hormone (TSH) Level $198 N/A $198
Thyroxine (Thyroid Chemical) Level, Free $144 N/A $144
Total Protein Level $48 N/A $48
Triiodothyronine (T3) Thyroid Hormone Measurement $257 N/A $257
Troponin (Protein) Analysis, Quantitative $219 N/A $219
Ultrasound of Breast $734 N/A $734
Ultrasound of Heart (Echocardiogram) $3,468 N/A $3,468
Urea Nitrogen Level $83 N/A $83
Urinalysis, Automated with Microscope Examination $93 N/A $93
Urinalysis, Automated without Microscope $48 N/A $48
Urinalysis, Manual Test $5 N/A $5
Urine Capacity Measurement $100 N/A $100
Urine Test with Examination $17 N/A $17
Vitamin B-12 (Cyanocobalamin) Level $117 N/A $117
Vitamin D-3 Level $289 N/A $289
Wound Repair, 2.5 Centimeters or Less $1,124 N/A $1,124
X-Ray of Abdomen, 1 View $570 N/A $570
X-Ray of Ankle, 2 Views $63 N/A $63
X-Ray of Ankle, 3 Views $740 N/A $740
X-Ray of Chest, 1 View $67 N/A $67
X-Ray of Chest, 2 Views $506 N/A $506
X-Ray of Fingers, 2 Views $260 N/A $260
X-Ray of Foot, 3 Views $378 N/A $378
X-Ray of Hand, 2 Views $290 N/A $290
X-Ray of Hand, 3 Views $735 N/A $735
X-Ray of Hip, 2 or 3 Views $757 N/A $757
X-Ray of Knee, 1 or 2 Views $460 N/A $460
X-Ray of Knee, 3 Views $456 N/A $456
X-Ray of Knee, 4 Views $469 N/A $469
X-Ray of Low Back, 2 or 3 Views $921 N/A $921
X-Ray of Low Back, 4 Views $142 N/A $142
X-Ray of Lower Leg, 2 Views $737 N/A $737
X-Ray of Neck, 4 to 5 Views $1,028 N/A $1,028
X-Ray of Shoulder, 2 Views $802 N/A $802
X-Ray of Wrist, 3 Views $757 N/A $757