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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.

CT Scans

Type of Visit Facility Charge Professional Charge Total Charge
Abdominal CT scan, with contrast #N/A $2,071 $2,071
Chest CT scan, without contrast #N/A $1,811 $1,811
Head or brain CT scan, without contrast #N/A $1,422 $1,422
Pelvis CT scan, with contrast #N/A $2,042 $2,042
Pelvis CT scan, without contrast, followed by contrast #N/A $2,453 $2,453
Sinus CT scan, limited, without contrast #N/A $1,565 $1,565

Lab Tests

Type of Visit Facility Charge Professional Charge Total Charge
Assay thyroid stim hormone (TSH) $96 N/A $96
Basic metabolic panel $78 N/A $78
Complete blood count (CBC) $68 N/A $68
Comprehensive metabolic panel $92 N/A $92
Glucose test $21 N/A $21
Hemoglobin A1C $55 N/A $55
Lipid profile $137 N/A $137
Pap test $249 N/A $249
Prostate specific antigen (PSA) $103 N/A $103
Prothrombin time N/A $75 $75
Routine venipuncture N/A $31 $31
Strep test $106 N/A $106
Urinalysis (urine analysis) $149 N/A $149
Urine culture $136 N/A $136

Mammograms

Type of Visit Facility Charge Professional Charge Total Charge
Bilateral screening (both breasts) with digitization N/A $477 $477

MRIs

Type of Visit Facility Charge Professional Charge Total Charge
Brain MRI, without contrast #N/A $3,362 $3,362
Brain MRI, without contrast, followed by contrast #N/A $6,904 $6,904
Cervical spine MRI, without contrast #N/A $3,201 $3,201
Knee MRI, without contrast #N/A $3,275 $3,275
Pelvis MRI, without contrast, followed by contrast #N/A $6,210 $6,210
Spine MRI, without contrast #N/A $3,525 $3,525

Neurology

Type of Visit Facility Charge Professional Charge Total Charge
EEG, awake and asleep #N/A $1,270 $1,270
Nerve conduction studies; 1-2 studies #N/A $611 $611
Nerve conduction studies; 3-4 studies #N/A $1,226 $1,226
Nerve conduction studies; 5-6 studies #N/A $1,840 $1,840
Nerve conduction studies; 7-8 studies #N/A $2,455 $2,455
Nerve conduction studies; 9-10 studies #N/A $3,069 $3,069
Nerve conduction studies; 11-12 studies #N/A $3,683 $3,683
Nerve conduction studies; 13 or more studies #N/A $3,990 $3,990

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) $207 N/A $207
Chlamydia test $197 #N/A $197
Fetal non-stress test #N/A $418 $418
Obstetric ultrasound #N/A $742 $742
Pregnancy test #N/A $59 $59
Pregnancy ultrasound, after 1st trimester, limited #N/A $515 $515
Rh type $207 #N/A $207

Stress Tests and Echocardiograms

Type of Visit Facility Charge Professional Charge Total Charge
Cardio stress test #N/A $690 $690
Doppler (flow velocity mapping) echocardiogram #N/A $673 $673
Doppler (pulsed wave) echocardiogram #N/A $530 $530
Echocardiogram, without color or doppler #N/A $1,254 $1,254
EKG, tracing only #N/A $114 $114
Stress test with echocardiogram (real-time image) #N/A $1,084 $1,084
Stress test, TEE echocardiogram (real-time 2-dimentional image) #N/A $1,422 $1,422

Ultrasounds

Type of Visit Facility Charge Professional Charge Total Charge
Ultrasound, abdomen, complete #N/A $730 $730
Ultrasound, pelvis, complete #N/A $590 $590
Vaginal ultrasound, Non OBGYN, Non Pregnancy #N/A $570 $570

X-rays

Type of Visit Facility Charge Professional Charge Total Charge
Ankle X-ray (3+ views) #N/A $218 $218
Bone density scan (dexa scan) #N/A $707 $707
Chest X-ray (single view) #N/A $179 $179
Chest X-ray (two views) #N/A $247 $247
Foot X-ray #N/A $215 $215
Spine X-ray #N/A $156 $156
Spine X-ray (lumbar PA-LAT) #N/A $246 $246
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