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) $175 N/A $175
Antinuclear Antibodies (ANA) Level $191 N/A $191
Arthrocentesis $530 N/A $530
Back MRI $4,467 N/A $4,467
Bacterial Culture Swab $226 N/A $226
Bacterial Culture Swab for Aerobic Isolates $160 N/A $160
Bacterial Culture, Quantitative Colony Count $121 N/A $121
Basic Metabolic Panel $108 N/A $108
Bilirubin Level $87 N/A $87
Biopsy of Skin Lesion $1,148 N/A $1,148
Blood Count (Hemoglobin) $54 N/A $54
Blood Glucose (Sugar) Level $26 N/A $26
Blood Glucose Control (Hemoglobin A1C) $35 N/A $35
Blood Typing (ABO) $105 N/A $105
Blood Typing (Rh (D)) $105 N/A $105
Bone Density Scan $797 N/A $797
Borrelia Burgdorferi (Lyme disease) Antibody Level $258 N/A $258
C-reactive Protein (CRP) Level $147 N/A $147
Cholesterol Test, Lipid Panel $168 N/A $168
Clotting Time $19 N/A $19
Coagulation Assessment $107 N/A $107
Complete Blood Cell Count (Hemoglobin) $74 N/A $74
Complete Blood Cell Count and Automated White Blood Cells $100 N/A $100
Comprehensive Metabolic Panel $134 N/A $134
CT Scan of Abdomen and Pelvis, With Contrast $5,286 N/A $5,286
CT Scan of Pelvis, With Contrast $3,345 N/A $3,345
Detection for Strep (Streptococcus, group A) $44 N/A $44
Detection Test for Human Papillomavirus (HPV) $157 N/A $157
Developmental Screening $36 N/A $36
Diagnostic Mammogram of Both Breasts $1,205 N/A $1,205
Diagnostic Mammogram of One Breast $961 N/A $961
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) $234 N/A $234
Family Psychotherapy with Patient $126 Near Average
State Average: 3
 $126
Ferritin (Blood Protein) Level $191 N/A $191
General Health Panel $470 N/A $470
Hepatic (Liver) Function Panel $118 N/A $118
Hepatitis A Vaccine for Adults, Injected into Muscle $224 N/A $224
Hepatitis A Vaccine for Children, Injected into Muscle $450 N/A $450
Hepatitis C Antibody Level $224 N/A $224
Human Papilloma Virus Vaccine, Injected into Muscle $66 N/A $66
Hydration Infusion $303 N/A $303
Influenza Vaccine, Injected into Muscle $118 N/A $118
Injection of Substance for Pain Management, Lower Back or Tailbone $1,218 N/A $1,218
Iron Binding Capacity $125 N/A $125
Iron Level $106 N/A $106
Knee MRI $4,453 N/A $4,453
Lab Test to Detect Coronavirus (COVID-19) $317 N/A $317
Lab Test to Detect Coronavirus (COVID-19) Antigen $84 N/A $84
Lab Test to Detect HIV-1 and HIV-2 $299 N/A $299
Lab Test to Detect Influenza Virus $40 N/A $40
Lab Test to Measure Creatinine Level $87 N/A $87
Lead Level $179 N/A $179
Lipase (Fat Enzyme) Level $128 N/A $128
Liver Enzyme (ALT or SGPT) Level $80 N/A $80
Liver Enzyme (AST or SGOT) Level $98 N/A $98
Low Back MRI, Before and After Contrast $6,748 N/A $6,748
Low Complexity Physical Therapy Evaluation $536 Near Average
State Average: 1
 $536
Magnesium Level $127 N/A $127
Manual Physical Therapy $170 Below Average
State Average: 4
 $170
Microalbumin (Protein) Level $113 N/A $113
Moderate Complexity Physical Therapy Evaluation $526 Near Average
State Average: 1
 $526
Natriuretic Peptide Level $284 N/A $284
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $406 N/A $406
New Patient Preventive Care Visit for Adult, 40-64 $455 N/A $455
New Patient Preventive Care Visit for Adult, Ages 18-39 $394 N/A $394
New Patient Preventive Care Visit for Child, Ages 1-4 $344 N/A $344
New Patient Preventive Care Visit for Child, Ages 5-11 $359 N/A $359
New Patient Preventive Care Visit for Child, Under Age 1 $329 N/A $329
Office Visit for Established Patient, Basic $184 N/A $184
Office Visit for Established Patient, High Complexity $452 N/A $452
Office Visit for Established Patient, Low Complexity $231 N/A $231
Office Visit for Established Patient, Minimal Presenting Problem $71 N/A $71
Office Visit for Established Patient, Moderate Complexity $334 N/A $334
Office Visit for New Patient, High Complexity $636 N/A $636
Office Visit for New Patient, Low Complexity $331 N/A $331
Office Visit for New Patient, Minor Complexity $234 N/A $234
Office Visit for New Patient, Moderate Complexity $504 N/A $504
Pap Test Screening, Automated with Manual Review $167 N/A $167
Parathyroid Hormone (PTH) Level $480 N/A $480
Pathology Examination of Tissue, Intermediate Complexity $23 N/A $23
Phosphate Level $79 N/A $79
Pregnancy Test $82 N/A $82
Presence of Drug $491 N/A $491
Preventive Care Visit for Adolescent, Under Ages 12-17 $347 N/A $347
Preventive Care Visit for Adult, 40-64 $377 N/A $377
Preventive Care Visit for Adult, Ages 18-39 $355 N/A $355
Preventive Care Visit for Child, Under Age 1 $297 N/A $297
Preventive Care Visit for Child, Under Ages 1-4 $316 N/A $316
Preventive Care Visit for Child, Under Ages 5-11 $315 N/A $315
Prostate Cancer Screening $208 N/A $208
Prostate Specific Antigen (PSA) Level, Free $180 N/A $180
Prostate Specific Antigen (PSA) Level, Total $163 N/A $163
Psychiatric Diagnostic Evaluation $350 Near Average
State Average: 1
 $350
Psychotherapy, 30 Minutes with Patient $195 Near Average
State Average: 1
 $195
Psychotherapy, 45 Minutes with Patient $201 Below Average
State Average: 3
 $201
Psychotherapy, 60 Minutes with Patient $210 Above Average
State Average: 6
 $210
Rotovirus Vaccine, Oral Administration $186 N/A $186
Screening Mammogram of Both Breasts $1,305 N/A $1,305
Single-Level Injection for Pain Management, Lower Back or Tailbone $2,169 N/A $2,169
Skin Growth Removal, Premalignant or Precancerous $565 N/A $565
Smear for Microorganism $108 N/A $108
Telehealth Visit for Established Patient, 11-20 minutes $189 N/A $189
Telehealth Visit for Established Patient, 5-10 minutes $133 N/A $133
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition $168 N/A $168
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $105 N/A $105
Therapeutic Exercises $185 Near Average
State Average: 4
 $185
Thyroid Stimulating Hormone (TSH) Level $179 N/A $179
Thyroxine (Thyroid Chemical) Level, Free $144 N/A $144
Total Protein Level $43 N/A $43
Treatment of Speech, Language, Voice, Communication, or Hearing Processing Disorder $455 N/A $455
Troponin (Protein) Analysis, Quantitative $219 N/A $219
Ultrasound of Breast $789 N/A $789
Ultrasound of Heart (Echocardiogram) $4,003 N/A $4,003
Ultrasound of Pelvis $1,625 N/A $1,625
Urea Nitrogen Level $68 N/A $68
Urinalysis, Automated with Microscope Examination $108 N/A $108
Urinalysis, Automated without Microscope $56 N/A $56
Urinalysis, Manual Test $5 N/A $5
Urine Test with Examination $22 N/A $22
Vitamin D-3 Level $270 N/A $270
Wound Repair, 2.5 Centimeters or Less $1,246 N/A $1,246
X-Ray of Abdomen, 1 View $601 N/A $601
X-Ray of Ankle, 3 Views $810 N/A $810
X-Ray of Chest, 1 View $506 N/A $506
X-Ray of Chest, 2 Views $573 N/A $573
X-Ray of Fingers, 2 Views $284 N/A $284
X-Ray of Foot, 3 Views $417 N/A $417
X-Ray of Hand, 3 Views $803 N/A $803
X-Ray of Hip, 2 or 3 Views $827 N/A $827
X-Ray of Knee, 1 or 2 Views $488 N/A $488
X-Ray of Knee, 3 Views $459 N/A $459
X-Ray of Knee, 4 Views $565 N/A $565
X-Ray of Low Back, 2 or 3 Views $1,007 N/A $1,007
X-Ray of Low Back, 4 Views $142 N/A $142
X-Ray of Lower Leg, 2 Views $805 N/A $805
X-Ray of Neck, 4 to 5 Views $1,167 N/A $1,167
X-Ray of Shoulder, 2 Views $877 N/A $877
X-Ray of Wrist, 3 Views $827 N/A $827