Veterans Administration Medical Center

718 Smyth Road Manchester, NH 03104
Medical Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Arthrocentesis (outpatient)$1,9310%$1,931
Bacterial Culture - Aerobic Isolates$1170%$117
Blood Test - Blood Glucose Control (Hemoglobin A1C)$1250%$125
Blood Test - Coagulation Assessment$1470%$147
Blood Test - Complete Blood Cell Count (Hemoglobin)$1370%$137
Blood Test - Electrolytes Panel$1660%$166
Blood Test - Folic Acid Level$1890%$189
Blood Test - Hepatitis C Antibody Level$1800%$180
Blood Test - Thyroid Stimulating Hormone (TSH) Level$2030%$203
Blood Test - Thyroxine (Thyroid Chemical) Level, Free$1510%$151
Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement$1910%$191
Blood Test - Vitamin B-12 (Cyanocobalamin) Level$1870%$187
Blood Test - Vitamin D-3 Level$2660%$266
Colonoscopy - Diagnostic (outpatient)$5,2680%$5,268
Colonoscopy - With Biopsy (outpatient)$7,9130%$7,913
Colonoscopy - With Polyp Removal (outpatient)$7,9770%$7,977
CT Scan - Abdomen and Pelvis, with Contrast$2,8870%$2,887
CT Scan - Head/Brain, without Contrast$1,5050%$1,505
Detection test for Human Papillomavirus (HPV)$2210%$221
Emergency Department Visit - Moderate Complexity (outpatient)$2820%$282
Lab Test - Detection test for Hepatitis B Surface Antigen$2090%$209
Lab Test - Smear for Microorganism$990%$99
MRI - Back (outpatient)$1,9020%$1,902
MRI - Knee (outpatient)$1,8700%$1,870
MRI - Shoulder, Elbow, or Wrist$1,8570%$1,857
Physical Therapy - Application of Blood Vessel Compression or Decompression Device$450%$45
Physical Therapy - Manual Electrical Stimulation Therapy, 15 minutes$430%$43
Physical Therapy - Manual Therapy$790%$79
Physical Therapy - Neuromuscular Reeducation$980%$98
Physical Therapy - Self-care or Home Management Training$970%$97
Physical Therapy - Therapeutic Exercises$860%$86
Physical Therapy - Ultrasound Therapy$370%$37
Psychotherapy - 30 Minutes$1170%$117
Psychotherapy - Group Session$910%$91
Ultrasound - Abdominal, Limited$8910%$891
Upper Gastrointestinal Endoscopy - With Biopsy$6,1840%$6,184
Urine Capacity Measurement$8810%$881
Urine Test - Automated with Microscope Examination$1110%$111
Urine Test - Automated without Microscope$800%$80
Urine Test - Chlamydia$2270%$227
Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria)$2210%$221
Urine Test - Microalbumin (Protein) Level$1030%$103
Urine Test - Pregnancy$1480%$148
Vaccine - Pneumococcal Conjugate for Injection into Muscle$4120%$412
X-Ray - Chest (outpatient)$8230%$823
X-Ray - Foot (outpatient)$8340%$834
X-Ray - Hand$7600%$760
X-Ray - Hip$9830%$983
X-Ray - Shoulder (outpatient)$5200%$520
X-Ray - Spine (outpatient)$1,1380%$1,138