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Diagnostic Services and Tests

Average charges are estimates; your out-of-pocket expense will depend on your individual insurance coverage (such as co-insurance or deductibles).

If you have questions, please contact Patient Accounts Customer Service at (844) 808-0730.

All charges listed below are for services provided at Dartmouth-Hitchcock Concord, Manchester, or Nashua.

Sometimes services are provided by Dartmouth-Hitchcock physicians at local hospitals. In those cases, there may be more charges billed that are not listed here and you may receive bills from other facilities. Please contact the hospital you will be using to get cost information for procedures and tests not performed at a Dartmouth-Hitchcock location.

See health care charges at DHMC in Lebanon or Cheshire Medical Center/Dartmouth-Hitchcock.

CT Scans

Type of Visit Facility Charge Professional Charge Total Charge
Abdominal CT scan, with contrast N/A $1,791 $1,791
Chest CT scan, without contrast N/A $1,565 $1,565
Head or brain CT scan, without contrast N/A $1,236 $1,236
Pelvis CT scan, with contrast N/A $1,765 $1,765
Pelvis CT scan, without contrast, followed by contrast N/A $2,135 $2,135
Sinus CT scan, limited, without contrast N/A $1,353 $1,353

Lab Tests

Type of Visit Facility Charge Professional Charge Total Charge
Assay thyroid stim hormone (TSH) $90 N/A $90
Basic metabolic panel $46 N/A $46
Complete blood count (CBC) $67 N/A $67
Comprehensive metabolic panel $57 N/A $57
Glucose test $22 N/A $22
Hemoglobin A1C $93 N/A $93
Lipid profile $90 N/A $90
Pap test $225 N/A $225
Prostate specific antigen (PSA) $107 N/A $107
Prothrombin time $51 N/A $51
Routine venipuncture N/A $24 $24
Strep test $69 N/A $69
Urinalysis (urine analysis) $163 N/A $163
Urine culture $83 N/A $83

Mammograms

Type of Visit Facility Charge Professional Charge Total Charge
Bilateral screening (both breasts) with digitization N/A $412 $412

MRIs

Type of Visit Facility Charge Professional Charge Total Charge
Brain MRI, without contrast N/A $2,906 $2,906
Brain MRI, without contrast, followed by contrast N/A $6,009 $6,009
Cervical spine MRI, without contrast N/A $2,767 $2,767
Knee MRI, without contrast N/A $2,831 $2,831
Pelvis MRI, without contrast, followed by contrast N/A $5,406 $5,406
Spine MRI, without contrast N/A $3,047 $3,047

Neurology

Type of Visit Facility Charge Professional Charge Total Charge
EEG, awake and asleep N/A $1,098 $1,098

PET Scans

Type of Visit Facility Charge Professional Charge Total Charge
Whole body scan N/A $10,639 $10,639

Pregnancy and Prenatal Tests

Type of Visit Facility Charge Professional Charge Total Charge
ABO type (blood typing) $75 N/A $75
Chlamydia test $150 N/A $150
Fetal non-stress test N/A $365 $365
Obstetric ultrasound N/A $646 $646
Pregnancy test N/A $56 $56
Pregnancy ultrasound, after 1st trimester, limited N/A $445 $445
Prenatal blood work $420 N/A $420
Rh type $104 N/A $104

Stress Tests and Echocardiograms

Type of Visit Facility Charge Professional Charge Total Charge
Cardio stress test N/A $597 $597
Doppler (flow velocity mapping) echocardiogram N/A $581 $581
Doppler (pulsed wave) echocardiogram N/A $462 $462
Echocardiogram, without color or doppler N/A $1,090 $1,090
EKG, tracing only N/A $99 $99
Stress test with echocardiogram (real-time image) N/A $937 $937
Stress test, TEE echocardiogram (real-time 2-dimentional image) N/A $1,229 $1,229

Ultrasounds

Type of Visit Facility Charge Professional Charge Total Charge
Ultrasound, abdomen, complete N/A $632 $632
Ultrasound, pelvis, complete N/A $516 $516
Vaginal ultrasound, Non OBGYN, Non Pregnancy N/A $496 $496

X-rays

Type of Visit Facility Charge Professional Charge Total Charge
Ankle X-ray (3+ views) N/A $188 $188
Bone density scan (dexa scan) N/A $618 $618
Chest X-ray (single view) N/A $154 $154
Chest X-ray (two views) N/A $213 $213
Foot X-ray N/A $188 $188
Spine X-ray N/A $134 $134
Spine X-ray (lumbar PA-LAT) N/A $212 $212
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