New London Hospital is providing this price list containing some of our charges for room and board, emergency department, operating room, physical therapy and other procedures. This information is for the patient to receive basic, facility-specific information about services and charges. This is only a partial listing of charges for more information please contact Claire Boyd.
• Hospital charges are the same for all patients, but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurances companies.
• Uninsured patients should consult with our Customer Service in Revenue Cycle Services to determine whether they qualify for fincancial assistance.
• Medicare and Medicaid cover medically necessary services. Medicare does not cover convenience items or self-administered pharmacy for outpatient, observation or ambulatory surgery.
• The rates below will be charged beginning on the day of admission but not on the day of discharge.
• The charge for an Observation Bed is per minute. This rate will be charged from the time of admission to the time of discharge. The rate tops at $818.00 per day (same as semi-private).
These prices are correct as of October 1, 2007
ROOM AND BOARD ~ Per Day Charges:
Semi Private Room $818.00
Private Room Rate Medical Floor $931.00
Telemetry Room $1,397.00
The Special Care Unit (Intensive Care) room rate $2072.00
Skilled Nursing $516.00
Skilled Nursing Private Room $639.00
The Clough Center - Nursing Home
ROOM AND BOARD ~ Per Day Charges
Skilled Nursing $516.00
Skilled Nursing Private Room $639.00
Intermediate Care $674.00
Intermediate Care Private Room $748.00
Emergency Department
Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with level 1 representing basic emergency care, reflect the type of accommodations needed, the intensity of care, amount of time needed to provide treatment, personnel resources, The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. Each patient seen in the Emergency Department will be charged a hospital technical level and a professional level charge fee.
Emergency Room Level I $169.00
Emergency Room Level II $276.00
Emergency Room Level III $409.00
Emergency Room Level IV $600.00
Emergency Room Level V $897.00
Emergency Room Critical Care $950.00
Physician Professional fee for Emergency Room
Emergency Professional Fee Level I $95.00
Emergency Professional Fee Level II $127.00
Emergency Professional Fee Level III $191.00
Emergency Professional Fee Level IV $292.00
Emergency Professional Fee Level V $440.00
Emergency Professional Fee Critical Care $495.00
Ambulance Services
Ambulance Basic Life Support Rate Emergency $1,056.00
Ambulance Basic Life Support Rate Nonemergent $660.00
Ambulance Oxygen Service $55.00
Ambulance Loaded Mile (Per Mile Charge) $27.00
OPERATING ROOM CHARGES
Operating Room charges are based on the type of procedure performed. Additional charges are incurred for surgical supplies utilized during the procedure.
OR-Inpatient/15 Min. $963.00
OR-Outpatient/15 Min. $963.00
OR-Surgicare/15 Min. $923.00
Endoscopy or Colonoscopy Charge $1,146.00
Sigmoidoscopy (Flex) $756.00
Endoscopy And Colonoscopy Charge $1,597.00
PHYSICAL THERAPY CHARGES
The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.
PT Evaluation/Untimed $180.00
PT Re-Evaluation/Untimed $113.00
Ultrasound Treatment/15 Min. $58.00
Gait Training/15 Min $73.00
Therapeutic Activities/15 Min $88.00
Therapeutic Exercise/15 Min $78.00
Electrical Stimulation/Tens set up/15 Min $88.00
ST Speech Treatment/Untimed $186.00
ST Speech Evaluation $393.00
ST Dysphagia Evaluation $399.00
ST Dysphagia Therapy/Untimed $250.00
X-RAY AND RADIOLOGICAL CHARGES
The following charges reflect the hospital's most common x-ray and radiological procedures
Chest x-ray -1 view $114.00
Chest x-ray - 4 view $142.00
Dexa Scan $555.00
CT head W/Contrast $1,010.00
CT-Head-W/O Contrast $845.00
CT abdomen -W/Contrast $1,224.00
CT-Abdomen-W/O Contrast $1,010.00
CT pelvis -W/Contrast $1,224.00
CT-Pelvis-W/O Contrast $1,056.00
MRI - Brain W/ Contrast $2,402.00
MRI - Brain W/O Contrast $2.002.00
Pelvis 1-2 views $114.00
NHC - Mammogram – Digital Screening $240.00
NHC - Mammogram – Digital Diagnostic $236.00
Mammogram- Computer aided detection - Screening $312.00
Mammogram- Computer aided detection - Diagnostic $308.00
Other Special Screening Mammogram for Malignant Neoplasm/Breast $240.96
LABORATORY CHARGES
The following charges reflect the hospital's most common laboratory procedures
Venipuncture $20.00
CBC for panel $37.00
Cholesterol, Total – Serum $30.00
Urine culture $37.00
Urine Dip $15.00
TSH $98.00
Electrolytes $40.00
Hemoglobin A1C $56.00
Glucose $23.00
T4 $34.00
PSA Screening $84.00
PSA Diagnostic $84.00
Potassium $27.00
CARDIOPULMONARY CHARGES
The following charges reflect the most common services offered by our Cardio-Pulmonary Department. Patients may have additional charges, depending on the services performed.
Pulmonary Function Test/Screen $98.00
Pulmonary Function Test Pre/Post $374.00
Echocardiography $954.00
EKG $54.00
EKG Interpretation and Reporting $41.00
Stress Test $758.00
Holter Monitor $339.00
Bp Monitoring $213.00
Cardiac Event Hook Up Monitoring $140.00
Cardiac Loop Hookup $140.00
Cardiac Loop Interpretation $87.00
Sleep Lab Services
Initial Sleep Staging $1,588.00
Sleep Staging W/CPAP Or BIPAP $1,588.00
Sleep Staging Split Night $1,588.00
Sleep Staging W/CPAP/BPAP Split Night $1,588.00
CPAP = Continuous Positive Airway Pressure
BIPAP= Bi-Level Positive Airway Pressure
Pricing does not include services for Radiology or Pathology physicians. That information may be requested by contacting:
Valley Radiology
AMS Plus, Inc.
91 Stiles Rd
Salem, NH 03079
Telephone 800-927-0118
Pathology
Triad Medical Services
71 Lyme Rd
Hanover, NH 03755
Telephone 603-643-1405
If you should have any questions regarding any of the information listed above please contact New London Hospital's Revenue Cycle Services Customer Service staff at 1.603.526.5292
Thank you and we hope this information was helpful
For more information on patient financial services please click here
