Veterans Administration Medical Center

718 Smyth Road Manchester, NH 03104
http://www.manchester.va.gov/
(603) 624-4366

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
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: 0%
Antinuclear Antibodies (ANA) Level $148 N/A $148
Application of Hot or Cold Pack $18 Below Average
State Average: 3
 $18
Application of Mechanical Traction $42 Below Average
State Average: 3
 $42
Back MRI $1,893 N/A $1,893
Bacterial Culture Swab for Aerobic Isolates $116 N/A $116
Bacterial Culture, Quantitative Colony Count $173 N/A $173
Bilirubin Level $92 N/A $92
Blood Glucose (Sugar) Level $78 N/A $78
Blood Glucose Control (Hemoglobin A1C) $127 N/A $127
Borrelia Burgdorferi (Lyme disease) Antibody Level $201 N/A $201
Chlamydia Test $223 N/A $223
Cholesterol Test, Lipid Panel $189 N/A $189
Clotting Time $107 N/A $107
Coagulation Assessment $154 N/A $154
Comprehensive Eye Exam $163 N/A $163
Comprehensive Eye Exam, New Patient $197 N/A $197
CT Scan of Abdomen and Pelvis, With Contrast $2,715 N/A $2,715
Detection for Strep (Streptococcus, group A) $149 N/A $149
Detection Test for Human Papillomavirus (HPV) $207 N/A $207
Diagnostic Imaging of Optic Nerve in Eye $66 N/A $66
Electrocardiogram (ECG or EKG), Report and Interpretation Only $67 N/A $67
Electrolytes Panel $215 N/A $215
Evaluation of Antimicrobial Drug (Antibiotic, Antifungal, Antiviral) $155 N/A $155
Folic Acid Level $212 N/A $212
Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) Test $222 N/A $222
Group Psychotherapy $63 Below Average
State Average: 4
 $63
Hepatitis B Surface Antibody Level $289 N/A $289
Hepatitis C Antibody Level $177 N/A $177
Knee MRI $1,836 N/A $1,836
Lab Test to Detect HIV-1 and HIV-2 $153 N/A $153
Lab Test to Measure Creatinine Level $83 N/A $83
LDL Cholesterol Level $110 N/A $110
Lead Level $117 N/A $117
Liver Enzyme (ALT or SGPT) Level $96 N/A $96
Liver Enzyme (AST or SGOT) Level $94 N/A $94
Low Complexity Physical Therapy Evaluation $366 Near Average
State Average: 1
 $366
Magnesium Level $145 N/A $145
Manual Electrical Stimulation Therapy, 15 minutes $44 Below Average
State Average: 3
 $44
Manual Physical Therapy $81 Below Average
State Average: 4
 $81
Microalbumin (Protein) Level $95 N/A $95
Moderate Complexity (Outpatient) Emergency Department Visit $1,245 N/A $1,245
Moderate Complexity Physical Therapy Evaluation $386 Near Average
State Average: 1
 $386
Natriuretic Peptide Level $338 N/A $338
Neuromuscular Reeducation $103 Near Average
State Average: 4
 $103
Office Visit for Established Patient, Low Complexity $193 N/A $193
Office Visit for Established Patient, Minimal Presenting Problem $185 N/A $185
Office Visit for Established Patient, Moderate Complexity $280 N/A $280
Office Visit for New Patient, High Complexity $565 N/A $565
Office Visit for New Patient, Low Complexity $232 N/A $232
Pap Test Screening, Manual $152 N/A $152
Phosphate Level $128 N/A $128
Pregnancy Test $155 N/A $155
Presence of Drug $499 N/A $499
Preventive Care Visit for Adult, 40-64 $270 N/A $270
Prostate Specific Antigen (PSA) Level, Total $186 N/A $186
Psychiatric Diagnostic Evaluation $291 Near Average
State Average: 1
 $291
Psychotherapy, 30 Minutes with Patient $179 Near Average
State Average: 1
 $179
Psychotherapy, 45 Minutes with Patient $210 Below Average
State Average: 3
 $210
Psychotherapy, 60 Minutes with Patient $383 Below Average
State Average: 6
 $383
Shoulder, Elbow, or Wrist MRI $1,855 N/A $1,855
Telehealth Visit for Established Patient, 11-20 minutes $190 N/A $190
Telehealth Visit for Established Patient, 21-30 minutes $281 N/A $281
Therapeutic Exercises $88 Below Average
State Average: 4
 $88
Thyroglobulin (Thyroid Protein) Antibody Level $144 N/A $144
Thyroid Stimulating Hormone (TSH) Level $201 N/A $201
Thyroxine (Thyroid Chemical) Level, Free $148 N/A $148
Total Protein Level $91 N/A $91
Triiodothyronine (T3) Thyroid Hormone Measurement $190 N/A $190
Troponin (Protein) Analysis, Quantitative $275 N/A $275
Ultrasound of Abdomen, Limited $842 N/A $842
Ultrasound of Head and Neck $833 N/A $833
Urea Nitrogen Level $116 N/A $116
Urinalysis, Automated with Microscope Examination $117 N/A $117
Urinalysis, Automated without Microscope $81 N/A $81
Vitamin B-12 (Cyanocobalamin) Level $191 N/A $191
Vitamin D-3 Level $247 N/A $247
Walking Training, 15 minutes $88 Near Average
State Average: 1
 $88
X-Ray of Chest, 2 Views $537 N/A $537
X-Ray of Foot, 3 Views $552 N/A $552
X-Ray of Knee, 4 Views $676 N/A $676
X-Ray of Shoulder, 2 Views $583 N/A $583