Average charges are estimates; your out-of-pocket expense will depend on your individual insurance coverage (such as co-insurance or deductibles).
While Cheshire Medical Center (CMC) now encompasses both our hospital’s inpatient services and outpatient clinics, some of our billing charges remain separate.
Uninsured patients are eligible for a 64% reduction of charges with Dartmouth Hitchcock Clinics Keene and a 68.5% reduction with Cheshire Medical Center.
Questions? Please call Dartmouth Health Patient Financial Services at 844-647-6436.
Our myDH patient portal website provides estimates for services provided at Dartmouth Health. Estimates can be requested for individual procedures and may factor in your specific insurance to estimate out-of-pocket expenses. Learn more about myDH Estimates.
Additional charges: These charges represent those of Dartmouth Hitchcock Clinics Keene and CMC. There may be additional charges from other contract providers, such as radiologists and anesthesiologists, depending on the services you receive.
Estimates valid between July 1, 2023 and June 30, 2024
Doctor's office visit for a new patient
(first visit or patients not seen within past 3 years)
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Low-to-moderate-level visit | $209 | $140 | $349 |
| Moderate-level visit | $280 | $206 | $486 |
| Moderate-to-high-level visit | $422 | $295 | $717 |
| High-level visit | $496 | $402 | $898 |
Doctor's office visit for an established patient
(return visit for follow-up)
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Low-level visit | $109 | $20 | $129 |
| Low-to-moderate-level visit | $169 | $45 | $214 |
| Moderate-level visit | $192 | $105 | $297 |
| Moderate-to-high-level visit | $292 | $165 | $457 |
| High-level visit | $385 | $246 | $631 |
Doctor's office visit for consultation
(examination and coordination between healthcare providers)
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Low-to-moderate-level visit | $438 | $190 | $628 |
| Moderate-level visit | $548 | $248 | $796 |
| Moderate-to-high-level visit | $752 | $233 | $985 |
| High-level visit | $932 | $439 | $1,371 |
Emergency Department visit
(unscheduled emergency visit for patients requiring immediate medical attention)
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Low-level visit | $283 | $153 | $436 |
| Low-to-moderate-level visit | $487 | $243 | $730 |
| Moderate-level visit | $848 | $382 | $1,230 |
| Moderate-to-high-level visit | $1,373 | $655 | $2,028 |
| High-level visit | $1,999 | $966 | $2,965 |
Eye exams
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| New patient comprehensive eye exam | $268 | $244 | $512 |
| New patient intermediate eye exam | $245 | $91 | $336 |
| Established patient comprehensive eye exam | $188 | $211 | $399 |
| Established patient intermediate eye exam | $172 | $104 | $276 |
| Refraction test | $77 | $49 | $126 |
Rehabilitation services
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Physical therapy evaluation: moderate complexity | $706 | N/A | $706 |
| Re-evaluation of physical therapy established plan of care | $352 | N/A | $352 |
| Occupational therapy evaluation, moderate complexity | $706 | N/A | $706 |
| Re-evaluation of occupational therapy established plan of care | $352 | N/A | $352 |
| Physical therapy dynamic functional activities | $178 | N/A | $178 |
| Physical therapy manual therapy, per 15 min | $178 | N/A | $178 |
| Physical therapy therapeutic exercises, per 15 min | $178 | N/A | $178 |
| Speech therapy evaluation | $300 | N/A | $300 |
| Speech therapy visit | $267 | N/A | $267 |
Routine annual physical for a new patient
(charge is based on age groups)
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| New patient physical: age 0 to 1 | $298 | $198 | $496 |
| New patient physical: age 1 to 4 | $311 | $207 | $518 |
| New patient physical: age 5 to 11 | $366 | $244 | $610 |
| New patient physical: age 12 to 17 | $366 | $244 | $610 |
| New patient physical: age 18 to 39 | $414 | $276 | $690 |
| New patient physical: age 40 to 64 | $311 | $207 | $518 |
| New patient physical: age 65 and over | $428 | $286 | $714 |
Routine annual physical for an established patient
(charge is based on age groups)
Charges do not include diagnostic testing such as lab services or X-rays.
| Type of visit | Facility charge | Professional charge | Total charge |
|---|---|---|---|
| Established patient physical: age 0 to 1 | $249 | $167 | $416 |
| Established patient physical: age 1 to 4 | $280 | $186 | $466 |
| Established patient physical: age 5 to 11 | $280 | $186 | $466 |
| Established patient physical: age 12 to 17 | $293 | $196 | $489 |
| Established patient physical: age 18 to 39 | $293 | $196 | $489 |
| Established patient physical: age 40 to 64 | $341 | $227 | $568 |
| Established patient physical: age 65 and over | $359 | $239 | $598 |