Veterans Administration Medical Center

718 Smyth Road Manchester, NH 03104
Medical Procedures
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Radiology Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
CT - Abdomen & Pelvis, with contrast$22830%$2283 Medium
CT - Head/Brain, without dye$14900%$1490 High
MRI - Back (outpatient)$16830%$1683 Medium
MRI - Knee (outpatient)$17520%$1752 Medium
Ultrasound - Abdominal, Limited$10050%$1005 High
X-Ray - Ankle (outpatient)$5030%$503 Medium
X-Ray - Chest (outpatient)$9920%$992 Medium
X-Ray - Foot (outpatient)$7460%$746 High
X-Ray - Hand$11340%$1134 Medium
X-Ray - Shoulder (outpatient)$8640%$864 High
X-Ray - Spine (outpatient)$7000%$700 High

Outpatient Tests and Procedures

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Arthrocentesis (outpatient)$13580%$1358 Medium
Colonoscopy with biopsy (outpatient)$69640%$6964 Medium
Upper Gastrointestinal Endoscopy, with biopsy$52830%$5283 Medium

Laboratory Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Blood test for clotting time$810%$81 Medium
Blood test for thyroxine (thyroid chemical) level, free$1630%$163 Medium
Electrolytes Panel$1690%$169 Medium
Urinalysis test automated with microscope examination$1030%$103 Medium
Test for vitamin D-3 level$3770%$377 Medium
Urinalysis test automated without microscope$790%$79 Medium

Physical Therapy

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Low Complexity Evaluation - PT$2120%$212 Medium

Behavioral Health Care

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
30 Minute - Psychotherapy$1760%$176 Medium
Diagnostic Evaluation - Psychiatric$2810%$281 Medium
Group Session - Psychotherapy$2560%$256 Medium

Emergency Visits

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Emergency Room Visit - Medium (outpatient)$10100%$1010 Medium

Ambulance Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Emergency Transport, Advanced Life Support - Ambulance Service$11330%$1133 Medium
Mileage Rate for Ambulance Transport$160%$16 Medium