Upper Connecticut Valley Hospital
181 Corliss Lane Colebrook, NH 03576
Medical Procedures
Radiology Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| CT - Abdomen & Pelvis, with contrast | $6415 | 40% | $3849 | Medium |
| Mammogram (outpatient) | $665 | 40% | $399 | Medium |
| MRI - Back (outpatient) | $986 | 40% | $592 | Medium |
| MRI - Knee (outpatient) | $1513 | 40% | $908 | Medium |
| MRI - Shoulder, Elbow, or Wrist | $1364 | 40% | $818 | Medium |
| Ultrasound - Abdominal, Limited | $889 | 40% | $534 | Medium |
| Ultrasound - Breast (outpatient) | $841 | 40% | $504 | Medium |
| Ultrasound - Head and Neck | $944 | 40% | $566 | Medium |
| Ultrasound - Transvaginal (non-maternity) | $1367 | 40% | $820 | Medium |
| X-Ray - Ankle (outpatient) | $415 | 40% | $249 | Medium |
| X-Ray - Chest (outpatient) | $665 | 40% | $399 | High |
| X-Ray - Foot (outpatient) | $334 | 40% | $200 | Medium |
| X-Ray - Hand | $682 | 40% | $409 | Medium |
| X-Ray - Hip | $616 | 40% | $370 | Medium |
| X-Ray - Shoulder (outpatient) | $636 | 40% | $382 | Medium |
| X-Ray - Spine (outpatient) | $795 | 40% | $477 | Medium |
| X-Ray - Wrist (outpatient) | $528 | 40% | $317 | Medium |
Outpatient Tests and Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Colonoscopy with biopsy (outpatient) | $7427 | 40% | $4456 | High |
| Diagnostic colonoscopy (outpatient) | $5727 | 40% | $3436 | Medium |
Laboratory Services
Physical Therapy
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Low Complexity Evaluation - PT | $334 | 40% | $200 | Medium |
| Moderate Complexity Evaluation - PT | $334 | 40% | $200 | Medium |
| High Complexity Evaluation - PT | $334 | 40% | $200 | Medium |
| Manual Therapy - PT | $143 | 40% | $86 | Medium |
| Therapeutic Activities - PT | $143 | 40% | $86 | Medium |
| Therapeutic Exercises - PT | $143 | 40% | $86 | Medium |
Office Visits
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Office Visit of Moderate Complexity | $315 | 40% | $189 | Medium |
| Office Visit of Moderate to High Complexity | $394 | 40% | $236 | Medium |
| Office Visit, New Pt, Minor | $210 | 40% | $126 | Medium |
| Office Visit, New Pt, Low | $263 | 40% | $158 | Medium |
| Comp Preventive Medicine 1-4 yrs old | $184 | 40% | $110 | Medium |
| Comp Preventive Medicine 5-11 yrs old | $236 | 40% | $142 | Medium |
| Comp Preventive Medicine 12-17 yrs old | $263 | 40% | $158 | Medium |
| Comp Preventive Medicine 18-39 yrs old | $184 | 40% | $110 | Medium |
| Comp Preventive Medicine 40-64 yrs old | $184 | 40% | $110 | Medium |
Emergency Visits
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Emergency Room Visit - Very Minor (outpatient) | $216 | 40% | $130 | Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $543 | 40% | $326 | Medium |
| Emergency Room Visit - Medium (outpatient) | $727 | 40% | $436 | Medium |
Patient Centered Care
| Measure | Performance | |
|---|---|---|
| Hospital Recommended | Near Average | |
| Best Hospital Experience | Above Average | |
| Area Around Room Was Always Quiet at Night | Near Average | |
| Nurses Always Communicated Well | Above Average | |
| Doctors Always Communicated Well | Above Average | |
| Room Was Always Clean | Above Average | |
| Help Was Always Received | Above Average | |
| Hospital Staff Provided Discharge Information | Above Average |
Timely Care
| Measure | Performance | |
|---|---|---|
| Time Spent in the Emergency Department Before Seeing Healthcare Provider | Above Average | |
| Time Spent in the Emergency Department Before Being Admitted | Above Average | |
| Time Spent in the Emergency Department After Being Admitted Before Getting to Room | Above Average | |
| Time Spent in the Emergency Department Before Being Discharged | Above Average | |
| Time Spent Before Receiving Pain Treatment for Long Bone Fracture | Near Average | |
| Patients with Chest Pain or Possible Heart Attack Received Aspirin at Arrival | Near Average | |
| Time Spent Before Receiving Electrocardiography (ECG) | Near Average |