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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 $1,980 $1,980
Chest CT scan, without contrast #N/A $1,731 $1,731
Head or brain CT scan, without contrast #N/A $1,367 $1,367
Pelvis CT scan, with contrast #N/A $1,952 $1,952
Pelvis CT scan, without contrast, followed by contrast #N/A $2,345 $2,345
Sinus CT scan, limited, without contrast #N/A $1,496 $1,496

Lab Tests

Type of Visit Facility Charge Professional Charge Total Charge
Assay thyroid stim hormone (TSH) $94.00 N/A $94.00
Basic metabolic panel $48.00 N/A $48.00
Complete blood count (CBC) $70.00 N/A $70.00
Comprehensive metabolic panel $59.00 N/A $59.00
Glucose test $23.00 N/A $23.00
Hemoglobin A1C $97.00 N/A $97.00
Lipid profile $94.00 N/A $94.00
Pap test $234.00 N/A $234.00
Prostate specific antigen (PSA) $111.00 N/A $111.00
Prothrombin time N/A $50 $50
Routine venipuncture N/A $29 $29
Strep test $72.00 N/A $72.00
Urinalysis (urine analysis) $170.00 N/A $170.00
Urine culture $86.00 N/A $86.00

Mammograms

Type of Visit Facility Charge Professional Charge Total Charge
Bilateral screening (both breasts) with digitization N/A $456 $456

MRIs

Type of Visit Facility Charge Professional Charge Total Charge
Brain MRI, without contrast #N/A $3,214 $3,214
Brain MRI, without contrast, followed by contrast #N/A $6,600 $6,600
Cervical spine MRI, without contrast #N/A $3,060 $3,060
Knee MRI, without contrast #N/A $3,131 $3,131
Pelvis MRI, without contrast, followed by contrast #N/A $5,936 $5,936
Spine MRI, without contrast #N/A $3,370 $3,370

Neurology

Type of Visit Facility Charge Professional Charge Total Charge
EEG, awake and asleep #N/A $1,214 $1,214
Nerve conduction studies; 1-2 studies #N/A $587 $587
Nerve conduction studies; 3-4 studies #N/A $1,172 $1,172
Nerve conduction studies; 5-6 studies #N/A $1,759 $1,759
Nerve conduction studies; 7-8 studies #N/A $2,347 $2,347
Nerve conduction studies; 9-10 studies #N/A $2,934 $2,934
Nerve conduction studies; 11-12 studies #N/A $3,521 $3,521
Nerve conduction studies; 13 or more studies #N/A $3,814 $3,814

PET Scans

Type of Visit Facility Charge Professional Charge Total Charge
Whole body scan #N/A $11,685 $11,685

Pregnancy and Prenatal Tests

Type of Visit Facility Charge Professional Charge Total Charge
ABO type (blood typing) $78.00 N/A $78.00
Chlamydia test $156.00 #N/A $156
Fetal non-stress test #N/A $400 $400
Obstetric ultrasound #N/A $709 $709
Pregnancy test #N/A $59 $59
Pregnancy ultrasound, after 1st trimester, limited #N/A $492 $492
Rh type $108.00 #N/A $108

Stress Tests and Echocardiograms

Type of Visit Facility Charge Professional Charge Total Charge
Cardio stress test #N/A $660 $660
Doppler (flow velocity mapping) echocardiogram #N/A $643 $643
Doppler (pulsed wave) echocardiogram #N/A $507 $507
Echocardiogram, without color or doppler #N/A $1,205 $1,205
EKG, tracing only #N/A $109 $109
Stress test with echocardiogram (real-time image) #N/A $1,036 $1,036
Stress test, TEE echocardiogram (real-time 2-dimentional image) #N/A $1,359 $1,359

Ultrasounds

Type of Visit Facility Charge Professional Charge Total Charge
Ultrasound, abdomen, complete #N/A $698 $698
Ultrasound, pelvis, complete #N/A $567 $567
Vaginal ultrasound, Non OBGYN, Non Pregnancy #N/A $545 $545

X-rays

Type of Visit Facility Charge Professional Charge Total Charge
Ankle X-ray (3+ views) #N/A $208 $208
Bone density scan (dexa scan) #N/A $675 $675
Chest X-ray (single view) #N/A $171 $171
Chest X-ray (two views) #N/A $236 $236
Foot X-ray #N/A $206 $206
Spine X-ray #N/A $149 $149
Spine X-ray (lumbar PA-LAT) #N/A $235 $235
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