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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 $1,891 $1,891
Chest CT scan, without contrast N/A $1,653 $1,653
Head or brain CT scan, without contrast N/A $1,305 $1,305
Pelvis CT scan, with contrast N/A $1,864 $1,864
Pelvis CT scan, without contrast, followed by contrast N/A $2,255 $2,255
Sinus CT scan, limited, without contrast N/A $1,429 $1,429

Lab Tests

Type of Visit Facility Charge Professional Charge Total Charge
Assay thyroid stim hormone (TSH) $90.00 N/A $90.00
Basic metabolic panel $46.00 N/A $46.00
Complete blood count (CBC) $67.00 N/A $67.00
Comprehensive metabolic panel $57.00 N/A $57.00
Glucose test $22.00 N/A $22.00
Hemoglobin A1C $93.00 N/A $93.00
Lipid profile $90.00 N/A $90.00
Pap test $225.00 N/A $225.00
Prostate specific antigen (PSA) $107.00 N/A $107.00
Prothrombin time N/A $59 $59
Routine venipuncture N/A $28 $28
Strep test $69.00 N/A $69.00
Urinalysis (urine analysis) $163.00 N/A $163.00
Urine culture $83.00 N/A $83.00

Mammograms

Type of Visit Facility Charge Professional Charge Total Charge
Bilateral screening (both breasts) with digitization N/A $435 $435

MRIs

Type of Visit Facility Charge Professional Charge Total Charge
Brain MRI, without contrast N/A $3,069 $3,069
Brain MRI, without contrast, followed by contrast N/A $6,346 $6,346
Cervical spine MRI, without contrast N/A $2,922 $2,922
Knee MRI, without contrast N/A $2,990 $2,990
Pelvis MRI, without contrast, followed by contrast N/A $5,709 $5,709
Spine MRI, without contrast N/A $3,218 $3,218

Neurology

Type of Visit Facility Charge Professional Charge Total Charge
EEG, awake and asleep N/A $1,159 $1,159
Nerve conduction studies; 1-2 studies N/A $561 $561
Nerve conduction studies; 3-4 studies N/A $1,119 $1,119
Nerve conduction studies; 5-6 studies N/A $1,680 $1,680
Nerve conduction studies; 7-8 studies N/A $2,241 $2,241
Nerve conduction studies; 9-10 studies N/A $2,802 $2,802
Nerve conduction studies; 11-12 studies N/A $3,362 $3,362
Nerve conduction studies; 13 or more studies N/A $3,642 $3,642

PET Scans

Type of Visit Facility Charge Professional Charge Total Charge
Whole body scan N/A $11,235 $11,235

Pregnancy and Prenatal Tests

Type of Visit Facility Charge Professional Charge Total Charge
ABO type (blood typing) $75.00 N/A $75
Chlamydia test $150.00 N/A $150
Fetal non-stress test N/A $385 $385
Obstetric ultrasound N/A $682 $682
Pregnancy test N/A $56 $56
Pregnancy ultrasound, after 1st trimester, limited N/A $470 $470
Prenatal blood work $420.00 N/A $420
Rh type $104.00 N/A $104

Stress Tests and Echocardiograms

Type of Visit Facility Charge Professional Charge Total Charge
Cardio stress test N/A $630 $630
Doppler (flow velocity mapping) echocardiogram N/A $614 $614
Doppler (pulsed wave) echocardiogram N/A $488 $488
Echocardiogram, without color or doppler N/A $1,151 $1,151
EKG, tracing only N/A $105 $105
Stress test with echocardiogram (real-time image) N/A $989 $989
Stress test, TEE echocardiogram (real-time 2-dimentional image) N/A $1,298 $1,298

Ultrasounds

Type of Visit Facility Charge Professional Charge Total Charge
Ultrasound, abdomen, complete N/A $667 $667
Ultrasound, pelvis, complete N/A $545 $545
Vaginal ultrasound, Non OBGYN, Non Pregnancy N/A $524 $524

X-rays

Type of Visit Facility Charge Professional Charge Total Charge
Ankle X-ray (3+ views) N/A $199 $199
Bone density scan (dexa scan) N/A $649 $649
Chest X-ray (single view) N/A $163 $163
Chest X-ray (two views) N/A $225 $225
Foot X-ray N/A $199 $199
Spine X-ray N/A $142 $142
Spine X-ray (lumbar PA-LAT) N/A $224 $224
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