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 - Head/Brain, without dye$23160%$2316 Medium
MRI - Back (outpatient)$16830%$1683 High
MRI - Brain (outpatient)$33080%$3308 Medium
MRI - Knee (outpatient)$18420%$1842 Medium
Ultrasound - Abdominal, Limited$8750%$875 Medium
X-Ray - Chest (outpatient)$9920%$992 Medium
X-Ray - Foot (outpatient)$6740%$674 High
X-Ray - Hand$11490%$1149 Medium
X-Ray - Shoulder (outpatient)$5600%$560 Medium
X-Ray - Spine (outpatient)$7470%$747 High
X-Ray - Wrist (outpatient)$5250%$525 Medium

Outpatient Tests and Procedures

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Arthrocentesis (outpatient)$14330%$1433 Medium
Colonoscopy with biopsy (outpatient)$57740%$5774 Medium
Colonoscopy with polyp removal (outpatient)$59250%$5925 Medium
Diagnostic colonoscopy (outpatient)$47400%$4740 Medium
Upper Gastrointestinal Endoscopy, with biopsy$53330%$5333 Medium

Physical Therapy

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Low Complexity Evaluation - PT$2280%$228 Medium
Manual Therapy - PT$860%$86 Medium
Therapeutic Exercises - PT$920%$92 Medium
Ultrasound Therapy - PT$360%$36 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$2610%$261 Medium
Group Session - Psychotherapy$880%$88 Medium

Emergency Visits

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Emergency Room Visit - Medium (outpatient)$3030%$303 Medium

Ambulance Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Emergency Transport, Advanced Life Support - Ambulance Service$12380%$1238 Medium
Mileage Rate for Ambulance Transport$170%$17 Medium
Non-emergency Transport, Basic Life Support - Ambulance Service$6800%$680 Medium