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 1-844-808-0730.
All charges listed below are for services provided at Dartmouth Hitchcock Clinics Concord, Manchester, or Nashua.
Sometimes services are provided by Dartmouth Hitchcock Clinics 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 Clinics location.
See health care charges at Dartmouth Hitchcock Medical Center (DHMC) in Lebanon or Cheshire Medical Center.
CT (computed tomography) scans
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Abdominal CT scan, with contrast | N/A | $2,168 | $2,168 |
| Chest CT scan, without contrast | N/A | $1,883 | $1,883 |
| Head or brain CT scan, without contrast | N/A | $1,489 | $1,489 |
| Pelvis CT scan, with contrast | N/A | $2,138 | $2,138 |
| Pelvis CT scan, without contrast, followed by contrast | N/A | $2,568 | $2,568 |
| Sinus CT scan, limited, without contrast | N/A | $1,628 | $1,628 |
Lab tests
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Assay thyroid stim hormone (TSH) | $96 | N/A | $96 |
| Basic metabolic panel | $82 | N/A | $82 |
| Complete blood count (CBC) | $72 | N/A | $72 |
| Comprehensive metabolic panel | $92 | N/A | $92 |
| Glucose test | $22 | N/A | $22 |
| Hemoglobin A1C | $55 | N/A | $55 |
| Lipid profile | $137 | N/A | $137 |
| Pap test | $251 | N/A | $251 |
| Prostate specific antigen (PSA) | $103 | N/A | $103 |
| Prothrombin time | N/A | $75 | $75 |
| Routine venipuncture | N/A | $32 | $32 |
| Strep test | $115 | N/A | $115 |
| Urinalysis | $157 | N/A | $157 |
| Urine culture | $133 | N/A | $133 |
Mammograms
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Bilateral screening (both breasts) with digitization | N/A | $500 | $500 |
MRI (magnetic resonance imaging) scans
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Brain MRI, without contrast | N/A | $3,520 | $3,520 |
| Brain MRI, without contrast, followed by contrast | N/A | $7,228 | $7,228 |
| Cervical spine MRI, without contrast | N/A | $3,351 | $3,351 |
| Knee MRI, without contrast | N/A | $3,429 | $3,429 |
| Pelvis MRI, without contrast, followed by contrast | N/A | $6,458 | $6,458 |
| Spine MRI, without contrast | N/A | $3,690 | $3,690 |
Neurology
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| EEG, awake and asleep | N/A | $1,330 | $1,330 |
| Nerve conduction studies; 1 to 2 studies | N/A | $635 | $635 |
| Nerve conduction studies; 3 to 4 studies | N/A | $1,275 | $1,275 |
| Nerve conduction studies; 5 to 6 studies | N/A | $1,914 | $1,914 |
| Nerve conduction studies; 7 to 8 studies | N/A | $2,553 | $2,553 |
| Nerve conduction studies; 9 to 10 studies | N/A | $3,192 | $3,192 |
| Nerve conduction studies; 11 to 12 studies | N/A | $3,830 | $3,830 |
| Nerve conduction studies; 13 or more studies | N/A | $4,177 | $4,177 |
PET (positron emission tomography) scans
| Type of Visit | Facility Charge | Professional Charge | Total Charge |
|---|---|---|---|
| Whole body scan | N/A | $12,233 | $12,233 |
Pregnancy and prenatal tests
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| ABO type (blood typing) | $224 | N/A | $224 |
| Chlamydia test | $197 | N/A | $197 |
| Fetal non-stress test | N/A | $435 | $435 |
| Obstetric ultrasound | N/A | $772 | $772 |
| Pregnancy test | N/A | $59 | $59 |
| Pregnancy ultrasound, after 1st trimester, limited | N/A | $539 | $539 |
| Rh type | $225 | N/A | $225 |
Stress tests and echocardiograms
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Cardio stress test | N/A | $833 | $833 |
| Doppler (flow velocity mapping) echocardiogram | N/A | $705 | $705 |
| Doppler (pulsed wave) echocardiogram | N/A | $555 | $555 |
| Echocardiogram, without color or doppler | N/A | $1,313 | $1,313 |
| EKG, tracing only | N/A | $119 | $119 |
| Stress test with echocardiogram (real-time image) | N/A | $1,135 | $1,135 |
| Stress test, TEE echocardiogram (real-time, 2-dimensional image) | N/A | $1,489 | $1,489 |
Ultrasounds
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Ultrasound, abdomen, complete | N/A | $764 | $764 |
| Ultrasound, pelvis, complete | N/A | $618 | $618 |
| Vaginal ultrasound, non OBGYN, non pregnancy | N/A | $597 | $597 |
X-rays
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Ankle X-ray (3+ views) | N/A | $228 | $228 |
| Bone density scan (DEXA scan) | N/A | $740 | $740 |
| Chest X-ray (1 view) | N/A | $187 | $187 |
| Chest X-ray (2 views) | N/A | $259 | $259 |
| Foot X-ray | N/A | $225 | $225 |
| Spine X-ray | N/A | $163 | $163 |
| Spine X-ray (lumbar PA-LAT) | N/A | $258 | $258 |