Mary Jo Montanarella, MD
30 Canton Street, Suite 6 Manchester, NH 03103
Medical Procedures
Radiology Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Ultrasound - Pelvic (outpatient) | $525 | 0% | $525 | Medium |
| Ultrasound - Pregnancy (outpatient) | $320 | 0% | $320 | Medium |
| Ultrasound - Transvaginal (non-maternity) | $929 | 0% | $929 | Medium |
Laboratory Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Pregnancy test, urine | $26 | 0% | $26 | Medium |
Office Visits
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Basic Office Visit | $74 | 0% | $74 | Medium |
| Office Visit, Established Pt | $147 | 0% | $147 | Medium |
| Office Visit of Moderate Complexity | $236 | 0% | $236 | Medium |
| Office Visit of Moderate to High Complexity | $263 | 0% | $263 | Medium |
| Comp Preventive Medicine 18-39 yrs old | $236 | 0% | $236 | Medium |
| Comp Preventive Medicine 40-64 yrs old | $236 | 0% | $236 | Medium |
| New Patient, Comp Prevent Medicine 18-39 yrs old | $231 | 0% | $231 | Medium |
| New Patient, Comp Prevent Medicine 40-64 yrs old | $315 | 0% | $315 | Medium |