Wentworth Health Partners

10 Members Way, Suite 400 Dover, NH 03820
https://www.wdhospital.com/whp/specialty-care/diabetes-endocrinology-metabolism/endocrinology-diabetes-consultants
(603) 664-2135

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 $95 N/A $95
Bacterial Culture Swab $70 N/A $70
Bacterial Culture, Quantitative Colony Count $68 N/A $68
Basic Metabolic Panel $114 N/A $114
Blood Count (Hemoglobin) $9 N/A $9
Blood Glucose (Sugar) Level $15 N/A $15
Blood Glucose Control (Hemoglobin A1C) $37 N/A $37
Borrelia Burgdorferi (Lyme disease) Antibody Level $163 N/A $163
C-reactive Protein (CRP) Level $80 N/A $80
Cholesterol Test, Lipid Panel $179 N/A $179
Complete Blood Cell Count (Hemoglobin) $92 N/A $92
Complete Blood Cell Count and Automated White Blood Cells $110 N/A $110
Comprehensive Metabolic Panel $141 N/A $141
Detection for Strep (Streptococcus, group A) $43 N/A $43
Detection Test for Hepatitis B Surface Antigen $82 N/A $82
Diagnostic Laryngoscopy $588 N/A $588
Electrocardiogram (ECG or EKG) With Report and Interpretation $57 N/A $57
Electrocardiogram (ECG or EKG) With Tracing $28 N/A $28
Electrocardiogram (ECG or EKG), Report and Interpretation Only $28 N/A $28
Emergency Transport, Advanced Life Support $1,838 N/A $1,838
Emergency Transport, Basic Life Support $1,437 N/A $1,437
Ferritin (Blood Protein) Level $168 N/A $168
Folic Acid Level $109 N/A $109
General Health Panel $491 N/A $491
Group Psychotherapy $96 Below Average
State Average: 4
 $96
Hepatic (Liver) Function Panel $45 N/A $45
Hepatitis A Vaccine for Adults, Injected into Muscle $221 N/A $221
Hepatitis A Vaccine for Children, Injected into Muscle $435 N/A $435
Hepatitis B Surface Antibody Level $96 N/A $96
Human Papilloma Virus Vaccine, Injected into Muscle $23 N/A $23
Influenza Vaccine, Injected into Muscle $72 N/A $72
Iron Binding Capacity $102 N/A $102
Iron Level $90 N/A $90
Lab Test to Detect Influenza Virus $43 N/A $43
Lab Test to Measure Creatinine Level $88 N/A $88
Lead Level $45 N/A $45
Lipase (Fat Enzyme) Level $94 N/A $94
Liver Enzyme (ALT or SGPT) Level $72 N/A $72
Magnesium Level $93 N/A $93
Microalbumin (Protein) Level $79 N/A $79
Mileage Rate for Ambulance Transport $32 N/A $32
Nasal Endoscopy $834 N/A $834
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $460 N/A $460
New Patient Preventive Care Visit for Adult, 40-64 $517 N/A $517
New Patient Preventive Care Visit for Adult, Ages 18-39 $424 N/A $424
New Patient Preventive Care Visit for Child, Ages 1-4 $391 N/A $391
New Patient Preventive Care Visit for Child, Ages 5-11 $387 N/A $387
New Patient Preventive Care Visit for Child, Under Age 1 $310 N/A $310
Non-Emergency Transport, Basic Life Support $1,030 N/A $1,030
Office Visit for Established Patient, Basic $186 N/A $186
Office Visit for Established Patient, High Complexity $588 N/A $588
Office Visit for Established Patient, Low Complexity $281 N/A $281
Office Visit for Established Patient, Minimal Presenting Problem $77 N/A $77
Office Visit for Established Patient, Moderate Complexity $396 N/A $396
Office Visit for New Patient, High Complexity $721 N/A $721
Office Visit for New Patient, Low Complexity $334 N/A $334
Office Visit for New Patient, Minor Complexity $254 N/A $254
Office Visit for New Patient, Moderate Complexity $372 N/A $372
Pap Test Screening, Automated with Manual Review $291 N/A $291
Pneumococcal Vaccine for Children, Injected into Muscle $23 N/A $23
Pregnancy Test $25 N/A $25
Preventive Care Visit for Adolescent, Under Ages 12-17 $393 N/A $393
Preventive Care Visit for Adult, 40-64 $428 N/A $428
Preventive Care Visit for Adult, Ages 18-39 $382 N/A $382
Preventive Care Visit for Child, Under Age 1 $313 N/A $313
Preventive Care Visit for Child, Under Ages 1-4 $320 N/A $320
Preventive Care Visit for Child, Under Ages 5-11 $326 N/A $326
Prostate Cancer Screening $246 N/A $246
Prostate Specific Antigen (PSA) Level, Total $111 N/A $111
Psychiatric Diagnostic Evaluation $210 Near Average
State Average: 1
 $210
Psychotherapy, 30 Minutes with Patient $247 Above Average
State Average: 1
 $247
Psychotherapy, 45 Minutes with Patient $288 Near Average
State Average: 3
 $288
Psychotherapy, 60 Minutes with Patient $189 Near Average
State Average: 6
 $189
Red Blood Cell Sedimentation Rate, Non-Automated $51 N/A $51
Rotovirus Vaccine, Oral Administration $177 N/A $177
Sleep Monitoring $7,373 N/A $7,373
Telehealth Visit for Established Patient, 11-20 minutes $297 N/A $297
Telehealth Visit for Established Patient, 21-30 minutes $417 N/A $417
Thyroid Stimulating Hormone (TSH) Level $137 N/A $137
Ultrasound of Heart (Echocardiogram) $3,303 N/A $3,303
Urinalysis, Automated with Microscope Examination $45 N/A $45
Urinalysis, Automated without Microscope $7 N/A $7
Urinalysis, Manual Test $9 N/A $9
Vitamin B-12 (Cyanocobalamin) Level $112 N/A $112
Vitamin D-3 Level $301 N/A $301