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%
Basic Metabolic Panel $117 N/A $117
Blood Count (Hemoglobin) $9 N/A $9
Blood Glucose (Sugar) Level $15 N/A $15
Blood Glucose Control (Hemoglobin A1C) $38 N/A $38
Cholesterol Test, Lipid Panel $150 N/A $150
Clotting Time $15 N/A $15
Complete Blood Cell Count (Hemoglobin) $65 N/A $65
Complete Blood Cell Count and Automated White Blood Cells $113 N/A $113
Comprehensive Metabolic Panel $51 N/A $51
Detection for Strep (Streptococcus, group A) $44 N/A $44
Detection Test for Hepatitis B Surface Antigen $82 N/A $82
Diagnostic Laryngoscopy $759 N/A $759
Electrocardiogram (ECG or EKG) With Report and Interpretation $49 N/A $49
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 $1,958 N/A $1,958
Emergency Transport, Basic Life Support $1,649 N/A $1,649
General Health Panel $512 N/A $512
Hepatitis A Vaccine for Adults, Injected into Muscle $231 N/A $231
Hepatitis A Vaccine for Children, Injected into Muscle $443 N/A $443
Hepatitis C Antibody Level $118 N/A $118
Human Papilloma Virus Vaccine, Injected into Muscle $23 N/A $23
Lab Test to Detect Influenza Virus $44 N/A $44
Lab Test to Measure Creatinine Level $71 N/A $71
Lead Level $46 N/A $46
Magnesium Level $93 N/A $93
Microalbumin (Protein) Level $79 N/A $79
Mileage Rate for Ambulance Transport $33 N/A $33
Nasal Endoscopy $900 N/A $900
New Patient Preventive Care Visit for Adolescent, Ages 12-17 $460 N/A $460
New Patient Preventive Care Visit for Adult, 40-64 $513 N/A $513
New Patient Preventive Care Visit for Adult, Ages 18-39 $424 N/A $424
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 $297 N/A $297
Office Visit for Established Patient, Minimal Presenting Problem $81 N/A $81
Office Visit for Established Patient, Moderate Complexity $420 N/A $420
Office Visit for New Patient, High Complexity $762 N/A $762
Office Visit for New Patient, Low Complexity $326 N/A $326
Office Visit for New Patient, Minor Complexity $250 N/A $250
Office Visit for New Patient, Moderate Complexity $372 N/A $372
Pregnancy Test $26 N/A $26
Preventive Care Visit for Adolescent, Under Ages 12-17 $393 N/A $393
Preventive Care Visit for Adult, 40-64 $427 N/A $427
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 Specific Antigen (PSA) Level, Total $118 N/A $118
Psychiatric Diagnostic Evaluation $210 Near Average
State Average: 1
 $210
Psychotherapy, 30 Minutes with Patient $271 Above Average
State Average: 1
 $271
Psychotherapy, 45 Minutes with Patient $327 Near Average
State Average: 3
 $327
Psychotherapy, 60 Minutes with Patient $189 Below Average
State Average: 6
 $189
Rotovirus Vaccine, Oral Administration $186 N/A $186
Screening Mammogram of Both Breasts $1,079 N/A $1,079
Telehealth Visit for Established Patient, 11-20 minutes $297 N/A $297
Telehealth Visit for Established Patient, 21-30 minutes $417 N/A $417
Telehealth Visit for Established Patient, 5-10 minutes $184 N/A $184
Tetanus, Diphtheria Toxoids, and Acellular Pertussis (Whooping Cough) Vaccine, Injected into Muscle $23 N/A $23
Thyroid Stimulating Hormone (TSH) Level $115 N/A $115
Thyroxine (Thyroid Chemical) Level, Free $130 N/A $130
Ultrasound of Heart (Echocardiogram) $3,405 N/A $3,405
Urinalysis, Automated without Microscope $7 N/A $7
Urinalysis, Manual Test $9 N/A $9
Vitamin B-12 (Cyanocobalamin) Level $117 N/A $117
Vitamin D-3 Level $301 N/A $301