Posted Price

Gouverneur Hospital

77 West Barney Street, Gouverneur, NY 13642 · Critical access hospital · Emergency room

These are Gouverneur Hospital's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

151 of the services we track have a posted price here; 143 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

ServiceCash priceGross chargeInsurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291$1,619.98$2,492.27
Emergency room visit, level 1 (minor) CPT 99281$206.39$317.52
Emergency room visit, level 2 CPT 99282$332.48$511.50
Emergency room visit, level 3 (moderate) CPT 99283$369.10$567.85
Emergency room visit, level 4 CPT 99284$663.54$1,020.83
Emergency room visit, level 5 (most severe) CPT 99285$927.69$1,427.21
Simple wound repair (stitches), 2.5 cm or less CPT 12001$273.31$420.47

Office visits

ServiceCash priceGross chargeInsurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202$271.03$416.97
New patient office visit, about 30 minutes CPT 99203$313.92$482.95
New patient office visit, about 45 minutes CPT 99204$390.13$600.20
New patient office visit, about 60 minutes CPT 99205$514.76$791.94
Office consultation, about 40 minutes CPT 99243$158.91$244.47
Office consultation, about 60 minutes CPT 99244$298.91$459.86
Office visit, established patient, about 10 to 19 minutes CPT 99212$254.61$391.71
Office visit, established patient, about 20 to 29 minutes CPT 99213$288.41$443.71
Office visit, established patient, about 30 to 39 minutes CPT 99214$358.44$551.44
Office visit, established patient, about 40 to 54 minutes CPT 99215$472.92$727.57
Office visit, established patient, brief (often a nurse) CPT 99211$234.61$360.94
Preventive checkup, new patient, age 18 to 39 CPT 99385$112.46$173.02
Preventive checkup, new patient, age 40 to 64 CPT 99386$131.23$201.89

Imaging

ServiceCash priceGross chargeInsurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063$84.37$129.80
Abdominal X-ray, 1 view CPT 74018$191.26$294.25
Ankle X-ray, 3 or more views CPT 73610$232.59$357.83
Bone density scan (DEXA), hips and spine CPT 77080$493.27$758.88
Breast ultrasound, one breast, complete CPT 76641$882.15$1,357.15
Breast ultrasound, one breast, limited CPT 76642$356.52$548.49
Chest X-ray, 1 view CPT 71045$204.91$315.24
Chest X-ray, 2 views CPT 71046$276.45$425.31
CT angiogram of the chest (checks for lung clots) CPT 71275$2,462.91$3,789.09
CT angiogram of the head CPT 70496$2,217.14$3,410.99
CT scan of the abdomen and pelvis, with contrast CPT 74177$2,772.77$4,265.80
CT scan of the abdomen and pelvis, without and with contrast CPT 74178$3,267.99$5,027.68
CT scan of the abdomen and pelvis, without contrast CPT 74176$1,900.31$2,923.55
CT scan of the abdomen, without contrast CPT 74150$1,482.01$2,280.01
CT scan of the chest, with contrast CPT 71260$2,729.94$4,199.91
CT scan of the chest, without contrast CPT 71250$1,597.00$2,456.92
CT scan of the head, without contrast CPT 70450$1,597.00$2,456.92
CT scan of the neck (cervical spine), without contrast CPT 72125$1,199.23$1,844.97
CT scan of the pelvis, with contrast CPT 72193$1,309.46$2,014.56
CT scan of the sinuses or face, without contrast CPT 70486$1,199.23$1,844.97
Diagnostic mammogram, both breasts CPT 77066$474.10$729.39
Diagnostic mammogram, one breast CPT 77065$407.64$627.14
Foot X-ray, 3 or more views CPT 73630$228.74$351.91
Hand X-ray, 3 or more views CPT 73130$218.54$336.21
Knee X-ray, 3 views CPT 73562$215.10$330.92
Leg or arm vein ultrasound, both sides CPT 93970$1,032.51$1,588.47
Leg or arm vein ultrasound, one side CPT 93971$634.65$976.38
Lower back X-ray, 2 or 3 views CPT 72100$307.13$472.51
MRI of the abdomen, without and with contrast CPT 74183$3,696.93$5,687.59
MRI of the brain, without and with contrast CPT 70553$3,681.54$5,663.91
MRI of the brain, without contrast CPT 70551$2,253.77$3,467.34
MRI of the knee or other leg joint, without contrast CPT 73721$3,043.12$4,681.72
MRI of the lower back (lumbar spine), without contrast CPT 72148$2,642.74$4,065.75
MRI of the mid back (thoracic spine), without contrast CPT 72146$2,282.34$3,511.29
MRI of the neck (cervical spine), without contrast CPT 72141$2,501.71$3,848.79
MRI of the pelvis, without and with contrast CPT 72197$3,696.93$5,687.59
MRI of the shoulder or other arm joint, without contrast CPT 73221$2,088.20$3,212.62
Neck X-ray, 2 or 3 views CPT 72040$256.87$395.19
Pelvic ultrasound, complete (not pregnancy) CPT 76856$944.78$1,453.51
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805$305.96$470.71
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801$568.22$874.19
Screening mammogram, both breasts CPT 77067$319.04$490.83
Shoulder X-ray, 2 or more views CPT 73030$226.20$348.00
Transvaginal pregnancy ultrasound CPT 76817$717.31$1,103.55
Transvaginal ultrasound CPT 76830$493.27$758.88
Ultrasound of the abdomen, complete CPT 76700$944.78$1,453.51
Ultrasound of the neck or thyroid CPT 76536$707.93$1,089.12
Wrist X-ray, 3 or more views CPT 73110$157.19$241.83
X-ray of the lower back, 4 or more views CPT 72110$414.03$636.97

Lab tests

ServiceCash priceGross chargeInsurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048$120.17$184.87
Blood culture CPT 87040$109.88$169.05
Blood draw (venipuncture) CPT 36415$20.14$30.99
BNP test (heart failure) CPT 83880$303.66$467.17
C-reactive protein (CRP) test CPT 86140$86.81$133.56
Chlamydia test (DNA/NAAT) CPT 87491$111.72$171.88
Complete blood count (CBC) with differential CPT 85025$77.30$118.93
Complete blood count (CBC), automated CPT 85027$77.30$118.93
Comprehensive metabolic panel (blood test) CPT 80053$254.57$391.65
COVID-19 PCR test CPT 87635$73.26$112.70
D-dimer test (blood clots) CPT 85379$205.50$316.16
Drug screen, instrument chemistry CPT 80307$121.17$186.42
Ferritin (iron stores) test CPT 82728$150.92$232.18
Free T4 (thyroid) test CPT 84439$70.33$108.20
General health panel (blood tests) CPT 80050$47.43$72.97
Glucose (blood sugar) test CPT 82947$55.68$85.66
Gonorrhea test (DNA/NAAT) CPT 87591$111.72$171.88
Hemoglobin A1c test CPT 83036$117.60$180.92
Hepatitis C antibody test CPT 86803$45.40$69.85
HIV-1/HIV-2 antigen and antibody test CPT 87389$76.65$117.93
Iron test CPT 83540$16.13$24.82
Kidney function panel CPT 80069$184.97$284.57
Lipase test (pancreas) CPT 83690$93.80$144.30
Lipid panel, cholesterol and triglycerides CPT 80061$118.34$182.06
Liver function panel CPT 80076$149.47$229.96
Magnesium test CPT 83735$108.80$167.38
Obstetric blood test panel CPT 80055not posted$46.38 – $621.83
Partial thromboplastin time (PTT), clotting test CPT 85730$52.02$80.03
Pregnancy blood test (hCG), quantitative CPT 84702$184.97$284.57
Prothrombin time (PT/INR), clotting test CPT 85610$52.02$80.03
PSA (prostate specific antigen), free CPT 84154$91.57$140.88
PSA (prostate specific antigen), total CPT 84153$58.56$90.10
Rapid strep test CPT 87880$40.44$62.21
Sed rate (ESR) test CPT 85652$8.14$12.52
TB skin test CPT 86580$32.96$50.71
Thyroid stimulating hormone (TSH) CPT 84443$135.17$207.96
Tissue exam by a pathologist (biopsy specimen) CPT 88305$432.21$664.94
Troponin test (heart damage) CPT 84484$100.37$154.42
Urinalysis, automated, with microscope CPT 81001$80.30$123.54
Urinalysis, automated, without microscope CPT 81003$52.76$81.17
Urinalysis, manual, with microscope CPT 81000not posted$3.90 – $52.28
Urinalysis, manual, without microscope CPT 81002$43.96$67.63
Urine culture, colony count CPT 87086$72.55$111.62
Urine pregnancy test CPT 81025$84.24$129.60
Vitamin B12 test CPT 82607$123.09$189.37
Vitamin D test CPT 82306$142.85$219.77

Heart

ServiceCash priceGross chargeInsurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880$508.19$781.83
ECG tracing only (no interpretation) CPT 93005$250.90$386.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306$1,373.26$2,112.70
Electrocardiogram (ECG/EKG) with interpretation CPT 93000$61.23$94.20
Nuclear stress test (heart perfusion imaging) CPT 78452not posted$305.59 – $305.59

Surgery

ServiceCash priceGross chargeInsurer rates (min – max)
Prostate biopsy CPT 55700$4,551.46$7,002.24

Pregnancy and birth

ServiceCash priceGross chargeInsurer rates (min – max)
IUD insertion CPT 58300$174.64$268.67

Pain and spine

ServiceCash priceGross chargeInsurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610$667.15$1,026.39
Lower back nerve root injection with imaging guidance CPT 64483$2,385.11$3,669.40
Lower back spinal injection (epidural), with imaging guidance CPT 62323$1,581.07$2,432.42

Sleep

ServiceCash priceGross chargeInsurer rates (min – max)
Sleep study with CPAP titration CPT 95811$2,292.97$3,527.65
Sleep study, overnight in a sleep lab CPT 95810$3,340.24$5,138.83

Lungs

ServiceCash priceGross chargeInsurer rates (min – max)
Spirometry (breathing test) CPT 94010$356.86$549.02

Therapy

ServiceCash priceGross chargeInsurer rates (min – max)
Manual therapy, 15 minutes CPT 97140$84.52$130.03
Physical therapy evaluation, low complexity CPT 97161$133.76$205.78
Physical therapy evaluation, moderate complexity CPT 97162$151.66$233.33
Physical therapy, therapeutic exercise, 15 minutes CPT 97110$61.54$94.67
Therapeutic activities, 15 minutes CPT 97530$44.64$68.67

Mental health

ServiceCash priceGross chargeInsurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847$279.24$429.60
Family psychotherapy, without the patient, 50 minutes CPT 90846$209.24$321.91
Group psychotherapy CPT 90853$206.48$317.66
Psychiatric diagnostic evaluation CPT 90791$349.99$538.44
Psychotherapy, 30 minutes CPT 90832$209.24$321.91
Psychotherapy, 45 minutes CPT 90834$196.14$301.76
Psychotherapy, 60 minutes CPT 90837$349.25$537.31

Infusions and injections

ServiceCash priceGross chargeInsurer rates (min – max)
Injection under the skin or into a muscle CPT 96372$184.33$283.59
IV hydration, each additional hour CPT 96361$171.19$263.37
IV hydration, first hour CPT 96360$349.45$537.61
IV push injection of a drug, first CPT 96374$267.03$410.82
IV push injection, each additional drug CPT 96375$122.05$187.77

Drugs

ServiceCash priceGross chargeInsurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696not posted? – $1.64
Fentanyl injection, per 0.1 mg HCPCS J3010not posted? – $1.27
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170not posted$3.80 – $3.80
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885not posted$1.46
Morphine injection, up to 10 mg HCPCS J2270not posted$3.36 – $4.63
Saline IV solution, 1000 ml HCPCS J7030$4.24$6.53

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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