Mary Hitchcock Memorial Hospital

1 Medical Center Drive Lebanon, NH 03756
https://www.dartmouth-hitchcock.org/
(603) 650-5000

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

Patient Experience

8 out of 10

Area Around Room Was Always Quiet at Night:
42%
Nurses Always Communicated Well:
80%
Doctors Always Communicated Well:
80%
Room Was Always Clean:
68%
Help Was Always Received:
68%
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: 33%
Antibody Screen, Red Blood Cells (RBC) $120 N/A $80
Antinuclear Antibodies (ANA) Level $53 N/A $35
Arthrocentesis $2,147 N/A $1,439
Arthroscopic Knee Surgery $27,359 N/A $18,331
Back MRI $5,086 N/A $3,408
Bacterial Culture Swab $172 N/A $115
Bacterial Culture Swab for Aerobic Isolates $83 N/A $56
Bacterial Culture, Quantitative Colony Count $140 N/A $94
Basic Metabolic Panel $86 N/A $58
Bilirubin Level $40 N/A $27
Biopsy of Prostate Gland $5,186 N/A $3,475
Biopsy of Skin Lesion $1,760 N/A $1,179
Blood Count (Hemoglobin) $47 N/A $32
Blood Glucose (Sugar) Level $23 N/A $15
Blood Glucose Control (Hemoglobin A1C) $58 N/A $39
Blood Typing (ABO) $53 N/A $35
Blood Typing (Rh (D)) $103 N/A $69
Bone Density Scan $791 N/A $530
Borrelia Burgdorferi (Lyme disease) Antibody Level $147 N/A $98
Brain MRI $7,201 N/A $4,825
Breast Biopsy $5,461 N/A $3,659
C-reactive Protein (CRP) Level $37 N/A $25
Chlamydia Test $207 N/A $139
Cholesterol Test, Lipid Panel $144 N/A $96
Clotting Time $79 N/A $53
Coagulation Assessment $59 N/A $39
Colonoscopy With Biopsy for Noncancerous Growth $9,892 N/A $6,628
Colonoscopy With Polyp Removal $10,356 N/A $6,939
Colonoscopy Without Biopsy for Encounter for Preventive Health Services $6,871 N/A $4,603
Complete Blood Cell Count (Hemoglobin) $48 N/A $32
Complete Blood Cell Count and Automated White Blood Cells $76 N/A $51
Comprehensive Eye Exam $215 N/A $144
Comprehensive Metabolic Panel $97 N/A $65
Coronavirus (COVID-19) Antibody Level $79 N/A $53
Creatinine Level $30 N/A $20
CT Scan of Abdomen and Pelvis, With Contrast $6,809 N/A $4,562
CT Scan of Chest, With Contrast $4,962 N/A $3,325
CT Scan of Head/Brain, Without Contrast $3,204 N/A $2,146
Cystoscopy $3,863 N/A $2,588
Detection for Strep (Streptococcus, group A) $103 N/A $69
Detection Test for Hepatitis B Surface Antigen $62 N/A $42
Detection Test for Human Papillomavirus (HPV) $280 N/A $188
Diagnostic Mammogram of Both Breasts $1,230 N/A $824
Diagnostic Mammogram of One Breast $770 N/A $516
Electrical Stimulation Therapy $79 Below Average
State Average: 3
$53
Electrolytes Panel $127 N/A $85
Endometrial (Uterus) Biopsy $1,910 N/A $1,280
Evaluation of Antimicrobial Drug (Antibiotic, Antifungal, Antiviral) $129 N/A $87
Eye Cataract Removal, Simple $16,063 N/A $10,762
Ferritin (Blood Protein) Level $82 N/A $55
Fetal Non-Stress Test $1,157 N/A $775
Folic Acid Level $88 N/A $59
Follow-Up Pregnancy Ultrasound $1,034 N/A $693
Gall Bladder Surgery $21,712 N/A $14,547
General Health Panel $273 N/A $183
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $120 N/A $80
Group Psychotherapy $146 Above Average
State Average: 4
$98
Hepatic (Liver) Function Panel $79 N/A $53
Hepatitis A Vaccine for Adults, Injected into Muscle $198 N/A $133
Hepatitis B Surface Antibody Level $64 N/A $43
Hepatitis C Antibody Level $84 N/A $56
High Complexity Physical Therapy Evaluation $590 Near Average
State Average: 1
$395
Hydration Infusion $269 N/A $180
Influenza Vaccine, Injected into Muscle $101 N/A $68
Injection of Substance for Pain Management, Lower Back or Tailbone $4,580 N/A $3,069
Iron Binding Capacity $53 N/A $35
Iron Level $39 N/A $26
Knee MRI $5,070 N/A $3,397
Lab Test to Detect Coronavirus (COVID-19) $158 N/A $106
Lab Test to Detect HIV-1 and HIV-2 $171 N/A $115
Lab Test to Measure Creatinine Level $183 N/A $122
Laparoscopic Hernia Repair $39,358 N/A $26,370
LDL Cholesterol Level $36 N/A $24
Lead Level $48 N/A $32
Lipase (Fat Enzyme) Level $41 N/A $27
Liver Enzyme (ALT or SGPT) Level $32 N/A $21
Liver Enzyme (AST or SGOT) Level $32 N/A $21
Low Back MRI, Before and After Contrast $7,431 N/A $4,979
Low Complexity (Outpatient) Emergency Department Visit $827 N/A $554
Low Complexity Physical Therapy Evaluation $195 Near Average
State Average: 1
$131
Magnesium Level $40 N/A $27
Microalbumin (Protein) Level $142 N/A $95
Mileage Rate for Ambulance Transport $38 N/A $26
Minor (Outpatient) Emergency Department Visit $506 N/A $339
Moderate Complexity (Outpatient) Emergency Department Visit $1,255 N/A $841
Moderate Complexity Occupational Therapy Evaluation $342 Near Average
State Average: 1
$229
Moderate Complexity Physical Therapy Evaluation $342 Near Average
State Average: 1
$229
Myocardial Imaging $6,041 N/A $4,047
Natriuretic Peptide Level $141 N/A $94
New Patient Preventive Care Visit for Adult, 40-64 $593 N/A $397
New Patient Preventive Care Visit for Adult, Ages 18-39 $525 N/A $352
Non-Emergency Transport, Advanced Life Support $993 N/A $666
Office Visit for Established Patient, Basic $108 N/A $72
Office Visit for Established Patient, High Complexity $543 N/A $364
Office Visit for Established Patient, Low Complexity $273 N/A $183
Office Visit for Established Patient, Minimal Presenting Problem $108 N/A $72
Office Visit for Established Patient, Moderate Complexity $402 N/A $269
Office Visit for New Patient, High Complexity $773 N/A $518
Office Visit for New Patient, Low Complexity $418 N/A $280
Office Visit for New Patient, Minor Complexity $286 N/A $191
Office Visit for New Patient, Moderate Complexity $617 N/A $414
Pap Test Screening, Automated with Manual Review $264 N/A $177
Pap Test Screening, Manual $272 N/A $182
Parathyroid Hormone (PTH) Level $69 N/A $46
Pathology Examination of Tissue, Intermediate Complexity $310 N/A $208
Pelvis MRI $8,038 N/A $5,385
Phosphate Level $28 N/A $19
Pregnancy Test $62 N/A $42
Presence of Drug $229 N/A $153
Preventive Care Visit for Adult, 40-64 $501 N/A $336
Preventive Care Visit for Adult, Ages 18-39 $471 N/A $316
Prostate Cancer Screening $108 N/A $72
Prostate Specific Antigen (PSA) Level, Free $165 N/A $110
Prostate Specific Antigen (PSA) Level, Total $108 N/A $72
Psychiatric Diagnostic Evaluation $266 Near Average
State Average: 1
$178
Psychotherapy, 30 Minutes with Patient $97 Above Average
State Average: 1
$65
Psychotherapy, 45 Minutes with Patient $276 Below Average
State Average: 4
$185
Psychotherapy, 60 Minutes with Patient $184 Above Average
State Average: 6
$123
Removal of Tonsils and Adenoid Glands, Patient Younger than 12 $16,192 N/A $10,848
Renal (Kidney) Function Panel $84 N/A $56
Screening Mammogram of Both Breasts $1,029 N/A $689
Shoulder, Elbow, or Wrist MRI $5,196 N/A $3,482
Single-Level Injection for Pain Management, Lower Back or Tailbone $6,467 N/A $4,333
Skin Growth Removal, Premalignant or Precancerous $741 N/A $497
Skin Growth Removal, Up to 14, Benign or Noncancerous $741 N/A $497
Sleep Monitoring $5,022 N/A $3,365
Smear for Microorganism $162 N/A $108
Telehealth Visit for Established Patient, 21-30 minutes $273 N/A $183
Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition $163 N/A $109
Therapeutic Activities $95 Below Average
State Average: 3
$63
Therapeutic Exercises $95 Below Average
State Average: 4
$63
Thyroglobulin (Thyroid Protein) Antibody Level $181 N/A $121
Thyroid Stimulating Hormone (TSH) Level $101 N/A $68
Thyroxine (Thyroid Chemical) Level, Free $54 N/A $36
Total Protein Level $138 N/A $92
Transvaginal Ultrasound (Non-Maternity) $1,558 N/A $1,044
Treatment of Speech, Language, Voice, Communication, or Hearing Processing Disorder $347 N/A $232
Triiodothyronine (T3) Thyroid Hormone Measurement $36 N/A $24
Troponin (Protein) Analysis, Quantitative $64 N/A $43
Ultrasound of Abdomen, Limited $1,395 N/A $935
Ultrasound of Breast $1,099 N/A $737
Ultrasound of Head and Neck $1,404 N/A $941
Ultrasound of Heart (Echocardiogram) $4,500 N/A $3,015
Ultrasound Therapy $81 Below Average
State Average: 3
$54
Upper Gastrointestinal (GI) Endoscopy With Biopsy $10,608 N/A $7,107
Upper Gastrointestinal (GI) Endoscopy Without Biopsy $8,298 N/A $5,559
Urea Nitrogen Level $24 N/A $16
Urinalysis, Automated with Microscope Examination $165 N/A $110
Urinalysis, Automated without Microscope $116 N/A $77
Urinalysis, Manual Test $57 N/A $38
Vitamin B-12 (Cyanocobalamin) Level $88 N/A $59
Vitamin D-3 Level $171 N/A $115
Walking Training, 15 minutes $168 Near Average
State Average: 1
$113
X-Ray of Abdomen, 1 View $701 N/A $470
X-Ray of Ankle, 3 Views $568 N/A $381
X-Ray of Chest, 1 View $667 N/A $447
X-Ray of Chest, 2 Views $707 N/A $473
X-Ray of Fingers, 2 Views $555 N/A $372
X-Ray of Foot, 3 Views $579 N/A $388
X-Ray of Hand, 3 Views $755 N/A $506
X-Ray of Hip, 2 or 3 Views $729 N/A $488
X-Ray of Knee, 1 or 2 Views $735 N/A $492
X-Ray of Knee, 3 Views $1,034 N/A $693
X-Ray of Knee, 4 Views $797 N/A $534
X-Ray of Low Back, 2 or 3 Views $813 N/A $545
X-Ray of Lower Leg, 2 Views $510 N/A $342
X-Ray of Middle Back, 2 Views $795 N/A $533
X-Ray of Neck, 2 or 3 Views $680 N/A $456
X-Ray of Neck, 4 to 5 Views $940 N/A $630
X-Ray of Pelvis, 1 or 2 Views $566 N/A $379
X-Ray of Shoulder, 2 Views $621 N/A $416
X-Ray of Wrist, 3 Views $550 N/A $369