Charges for Radiology Services >>
When comparing charges with other hospitals or provider practices, it is important to understand that their charges may or may not include both the hospital and the doctor or other provider services. (Southern New Hampshire Medical Center charges do not include physician services.) Average charges are estimates; your out-of-pocket expense will depend on your individual insurance coverage (such as co-pays, co-insurance, and deductibles). If you have any questions, please contact our Business Office at 603-577-7800. If you have questions about your insurance policy, please contact your insurance company directly.
CHEST PA LATERAL |
71020 |
$217.69 |
SCREENING MAMMOGRAPHY - BILATERAL |
77057 |
$191.24 |
SCREENING MAMMOGRAPHY |
77052 |
$51.91 |
CHEST PORTABLE |
71010 |
$139.18 |
CT HEAD OR BRAIN W/O CONTRAST |
70450 |
$1,367.47 |
BONE DENSITY SCAN (DEXA) |
77080 |
$341.79 |
CT ABDOMEN WITH CONTRAST |
74160 |
$1,689.91 |
ULTRASOUND GB LIVER/PANC |
76700 |
$661.66 |
DIGITIZATION OF DIAGNOSTIC MAMMOGRAPHY |
77051 |
$49.32 |
CT PELVIS WITH CONTRAST |
72193 |
$1,616.09 |
XRAY SPINE, LUMBOSACRAL |
72100 |
$300.39 |
XRAY ABDOMEN |
74000 |
$216.29 |
XRAY ABDOMEN COMPLETE |
74020 |
$221.27 |
MAMMOGRAPHY BILATERAL |
77056 |
$206.39 |
XRAY CERVICAL, SPINE W/OBL |
72050 |
$387.47 |
CT ABDOMEN W/O CONTRAST |
74150 |
$1,523.72 |
CT PELVIS W/O CONTRAST |
72192 |
$1,321.10 |
ULTRASOUND DUPLEX CAROTID ARTERIES BILATERAL |
93880 |
$694.71 |
ULTRASOUND RENAL |
76705 |
$484.70 |
CT CHEST WITH CONTRAST |
71260 |
$1,476.30 |
The services you receive from your provider are based on your individual need and medical condition. Actual charges will vary based on services delivered and medical condition. Additional tests or services not listed in the estimate may be ordered by your doctor or provider in order to treat, diagnose, or care for individual needs.These estimates of charges are valid between October 1, 2007 and September 30, 2008.
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