Jones Memorial Hospital

191 North Main Street, Wellsville, NY 14895 · Acute care hospital · Emergency room

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

232 of the services we track have a posted price here; 202 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	$1,602.00
Emergency room visit, level 1 (minor) CPT 99281	$168.00
Emergency room visit, level 2 CPT 99282	$302.00
Emergency room visit, level 3 (moderate) CPT 99283	$526.00
Emergency room visit, level 4 CPT 99284	$810.00
Emergency room visit, level 5 (most severe) CPT 99285	$1,166.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$378.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$67.98	$114.00
New patient office visit, about 30 minutes CPT 99203	$106.14	$178.00
New patient office visit, about 45 minutes CPT 99204	$159.81	$268.00
New patient office visit, about 60 minutes CPT 99205	$211.09	$354.00
Office consultation, about 40 minutes CPT 99243	not posted		$87.78 – $87.78
Office consultation, about 60 minutes CPT 99244	not posted		$128.22 – $128.22
Office visit, established patient, about 10 to 19 minutes CPT 99212	$138.00
Office visit, established patient, about 20 to 29 minutes CPT 99213	$138.00
Office visit, established patient, about 30 to 39 minutes CPT 99214	$138.00
Office visit, established patient, about 40 to 54 minutes CPT 99215	$172.33	$289.00
Office visit, established patient, brief (often a nurse) CPT 99211	$100.00
Preventive checkup, new patient, age 18 to 39 CPT 99385	$253.43	$425.00
Preventive checkup, new patient, age 40 to 64 CPT 99386	$268.34	$450.00

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$30.00
Abdominal X-ray, 1 view CPT 74018	$168.00
Ankle X-ray, 3 or more views CPT 73610	$168.00
Bone density scan (DEXA), hips and spine CPT 77080	$202.00
Breast ultrasound, one breast, complete CPT 76641	$202.00
Breast ultrasound, one breast, limited CPT 76642	$168.00
Chest X-ray, 1 view CPT 71045	$168.00
Chest X-ray, 2 views CPT 71046	$168.00
CT angiogram of the chest (checks for lung clots) CPT 71275	$339.00
CT angiogram of the head CPT 70496	$339.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$680.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$680.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$459.00
CT scan of the abdomen, without contrast CPT 74150	$202.00
CT scan of the chest, with contrast CPT 71260	$339.00
CT scan of the chest, without contrast CPT 71250	$202.00
CT scan of the head, without contrast CPT 70450	$202.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$202.00
CT scan of the pelvis, with contrast CPT 72193	$339.00
CT scan of the sinuses or face, without contrast CPT 70486	$202.00
Diagnostic mammogram, both breasts CPT 77066	$136.00
Diagnostic mammogram, one breast CPT 77065	$106.00
Foot X-ray, 3 or more views CPT 73630	$168.00
Hand X-ray, 3 or more views CPT 73130	$168.00
Knee X-ray, 3 views CPT 73562	$168.00
Leg or arm vein ultrasound, both sides CPT 93970	$459.00
Leg or arm vein ultrasound, one side CPT 93971	$202.00
Lower back X-ray, 2 or 3 views CPT 72100	$202.00
MRI of both breasts, without and with contrast CPT 77049	not posted		$222.19 – $2,223.01
MRI of the abdomen, without and with contrast CPT 74183	$680.00
MRI of the brain, without and with contrast CPT 70553	$680.00
MRI of the brain, without contrast CPT 70551	$459.00
MRI of the knee or other leg joint, without contrast CPT 73721	$459.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$459.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$459.00
MRI of the neck (cervical spine), without contrast CPT 72141	$459.00
MRI of the pelvis, without and with contrast CPT 72197	$680.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$459.00
Neck X-ray, 2 or 3 views CPT 72040	$168.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$202.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$126.42	$212.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$202.00
Screening mammogram, both breasts CPT 77067	$112.00
Shoulder X-ray, 2 or more views CPT 73030	$168.00
Transvaginal pregnancy ultrasound CPT 76817	$202.00
Transvaginal ultrasound CPT 76830	$202.00
Ultrasound of the abdomen, complete CPT 76700	$202.00
Ultrasound of the neck or thyroid CPT 76536	$202.00
Wrist X-ray, 3 or more views CPT 73110	$168.00
X-ray of the lower back, 4 or more views CPT 72110	$202.00

Lab tests

Service	Cash price	Gross charge
Basic metabolic panel (blood test) CPT 80048	$66.79	$112.00
Blood culture CPT 87040	$39.36	$66.00
Blood draw (venipuncture) CPT 36415	$13.71	$23.00
BNP test (heart failure) CPT 83880	$69.17	$116.00
C-reactive protein (CRP) test CPT 86140	$14.91	$25.00
Chlamydia test (DNA/NAAT) CPT 87491	$83.48	$140.00
Complete blood count (CBC) with differential CPT 85025	$27.43	$46.00
Complete blood count (CBC), automated CPT 85027	$28.62	$48.00
Comprehensive metabolic panel (blood test) CPT 80053	$41.74	$70.00
COVID-19 PCR test CPT 87635	$73.34	$123.00
D-dimer test (blood clots) CPT 85379	$36.97	$62.00
Drug screen, instrument chemistry CPT 80307	$142.00
Ferritin (iron stores) test CPT 82728	$49.49	$83.00
Free T4 (thyroid) test CPT 84439	$36.97	$62.00
General health panel (blood tests) CPT 80050	$48.00
Glucose (blood sugar) test CPT 82947	$15.50	$26.00
Gonorrhea test (DNA/NAAT) CPT 87591	$83.48	$140.00
Hemoglobin A1c test CPT 83036	$38.76	$65.00
Hepatitis C antibody test CPT 86803	$55.46	$93.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$37.00
Iron test CPT 83540	$24.45	$41.00
Kidney function panel CPT 80069	$10.00
Lipase test (pancreas) CPT 83690	$23.85	$40.00
Lipid panel, cholesterol and triglycerides CPT 80061	$51.88	$87.00
Liver function panel CPT 80076	$23.85	$40.00
Magnesium test CPT 83735	$25.04	$42.00
Obstetric blood test panel CPT 80055	$146.09	$245.00
Partial thromboplastin time (PTT), clotting test CPT 85730	$22.66	$38.00
Pregnancy blood test (hCG), quantitative CPT 84702	$57.24	$96.00
Prothrombin time (PT/INR), clotting test CPT 85610	$16.70	$28.00
PSA (prostate specific antigen), free CPT 84154	$66.79	$112.00
PSA (prostate specific antigen), total CPT 84153	$69.77	$117.00
Rapid strep test CPT 87880	$39.95	$67.00
Sed rate (ESR) test CPT 85652	$15.50	$26.00
TB skin test CPT 86580	$46.00
Thyroid stimulating hormone (TSH) CPT 84443	$65.00	$109.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$67.98	$114.00
Troponin test (heart damage) CPT 84484	$36.97	$62.00
Urinalysis, automated, with microscope CPT 81001	$13.71	$23.00
Urinalysis, automated, without microscope CPT 81003	$16.10	$27.00
Urinalysis, manual, with microscope CPT 81000	$11.93	$20.00
Urinalysis, manual, without microscope CPT 81002	$16.10	$27.00
Urine culture, colony count CPT 87086	$32.20	$54.00
Urine pregnancy test CPT 81025	$48.30	$81.00
Vitamin B12 test CPT 82607	$49.49	$83.00
Vitamin D test CPT 82306	$96.60	$162.00

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$459.00
ECG tracing only (no interpretation) CPT 93005	$112.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,042.00
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$13.71	$23.00
Holter monitor, up to 48 hours CPT 93224	not posted		$60.60 – $266.76
Left heart catheterization CPT 93452	not posted		$741.08 – $10,597.07
Left heart catheterization with coronary angiogram CPT 93458	not posted		$922.59 – $10,597.07
Nuclear stress test (heart perfusion imaging) CPT 78452	not posted		$144.68 – $4,231.88
Treadmill stress test, complete CPT 93015	not posted		$60.60 – $266.76

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$925.46	$1,552.00
Appendix removal, laparoscopic CPT 44970	$568.27	$953.00
Breast biopsy with ultrasound guidance CPT 19083	not posted		$81.34 – $5,398.66
Carpal tunnel release CPT 64721	$428.14	$718.00
Colonoscopy with biopsy CPT 45380	$401.31	$673.00
Colonoscopy with polyp removal (snare) CPT 45385	$422.78	$709.00
Colonoscopy, diagnostic CPT 45378	$317.83	$533.00
Colposcopy with biopsy CPT 57454	$579.00
Cystoscopy (bladder scope) CPT 52000	$206.32	$346.00
Ear tubes, under general anesthesia CPT 69436	$152.06	$255.00
Flexible sigmoidoscopy, diagnostic CPT 45330	$173.52	$291.00
Gallbladder removal, laparoscopic CPT 47562	$623.13	$1,045.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$935.85 – $935.85
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$859.27	$1,441.00
Hysteroscopy with biopsy or polyp removal CPT 58558	$1,163.38	$1,951.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$410.85	$689.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$6,710.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$1,512.00 – $1,512.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$6,168.00
Lower colon endoscopy with ultrasound CPT 45391	not posted		$170.67 – $3,911.52
Nasal endoscopy, diagnostic CPT 31231	$177.70	$298.00
Prostate biopsy CPT 55700	$226.59	$380.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$1,053.76 – $34,746.27
Removal of a breast lump, open surgery CPT 19120	$490.75	$823.00
Rotator cuff repair, arthroscopic CPT 29827	$13,581.00
Screening colonoscopy, average risk HCPCS G0121	$84.08	$141.00
Screening colonoscopy, high risk HCPCS G0105	$158.02	$265.00
Septoplasty (nasal septum repair) CPT 30520	$633.27	$1,062.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$2,474.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$812.53 – $812.53
Tonsil and adenoid removal, under age 12 CPT 42820	$279.07	$468.00
Total hip replacement CPT 27130	$1,215.86	$2,039.00
Total knee replacement CPT 27447	$1,214.07	$2,036.00
Upper endoscopy (EGD) with biopsy CPT 43239	$1,782.00
Upper endoscopy (EGD), diagnostic CPT 43235	$1,782.00
Vasectomy CPT 55250	$314.25	$527.00

Pregnancy and birth

Service	Cash price	Gross charge
C-section delivery, routine care including prenatal and postpartum CPT 59510	$2,498.50	$4,190.00
Fetal non-stress test CPT 59025	$382.00
IUD insertion CPT 58300	$225.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	$2,354.79	$3,949.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	$2,256.40	$3,784.00

Hospital stays

Service	Cash price	Gross charge	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$10,026.57
C-section, without complications MS-DRG 788	$10,854.64
Chest pain MS-DRG 313	$8,252.76
COPD flare-up, with major complications MS-DRG 190	$12,477.00
COPD flare-up, without complications MS-DRG 192	$7,402.90
Fainting (syncope) MS-DRG 312	$9,904.54
Gastrointestinal bleeding, with complications MS-DRG 378	$11,093.25
Heart failure, with major complications MS-DRG 291	$14,395.72
Heart failure, without complications MS-DRG 293	$6,574.83
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$106,997.77
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$21,424.50
Irregular heartbeat, without complications MS-DRG 310	$6,575.92
Kidney failure, with complications MS-DRG 683	$9,950.30
Kidney or urinary tract infection, without major complications MS-DRG 690	$9,227.92
Neck (cervical) spinal fusion, without complications MS-DRG 473	$27,007.43
Normal newborn care MS-DRG 795	$2,584.85
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$8,886.89
Pneumonia, with complications MS-DRG 194	$9,188.70
Pneumonia, with major complications MS-DRG 193	$14,729.13
Pneumonia, without complications MS-DRG 195	$7,255.81
Psychoses (inpatient psychiatric stay) MS-DRG 885	$15,626.93
Sepsis, with major complications MS-DRG 871	$21,572.68
Sepsis, without major complications MS-DRG 872	$11,557.41
Skin infection (cellulitis), without major complications MS-DRG 603	$9,896.91
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$8,902.14
Stroke, with complications or clot-busting drug MS-DRG 65	$11,415.77
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$13,926.12
Vaginal delivery, without complications MS-DRG 807	$7,753.74
Weight loss surgery, without complications MS-DRG 621	$16,842.88

Pain and spine

Service	Cash price	Gross charge
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$561.00
Lower back nerve root injection with imaging guidance CPT 64483	$228.98	$384.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$239.12	$401.00
Lower back spinal injection (epidural), without imaging CPT 62322	$124.63	$209.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$2,625.00 – $2,625.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$30.30 – $435.19
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$1,198.00 – $1,198.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$297.00

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$297.00
Sleep study with CPAP titration CPT 95811	$1,934.00
Sleep study, overnight in a sleep lab CPT 95810	$1,934.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$297.00

Therapy

Service	Cash price	Gross charge
Manual therapy, 15 minutes CPT 97140	$56.00
Physical therapy evaluation, low complexity CPT 97161	$96.60	$162.00
Physical therapy evaluation, moderate complexity CPT 97162	$132.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$62.00
Therapeutic activities, 15 minutes CPT 97530	$69.00

Mental health

Service	Cash price	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted	$97.75 – $580.19
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted	$97.75 – $580.19
Group psychotherapy CPT 90853	not posted	$40.25 – $332.07
Psychiatric diagnostic evaluation CPT 90791	not posted	$78.81 – $580.19
Psychotherapy, 30 minutes CPT 90832	not posted	$32.65 – $580.19
Psychotherapy, 45 minutes CPT 90834	not posted	$41.80 – $580.19
Psychotherapy, 60 minutes CPT 90837	not posted	$61.15 – $580.19

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$135.00
IV hydration, each additional hour CPT 96361	$87.00
IV hydration, first hour CPT 96360	$400.00
IV push injection of a drug, first CPT 96374	$400.00
IV push injection, each additional drug CPT 96375	$87.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted	$1.77
Dexamethasone injection, per 1 mg HCPCS J1100	not posted	$1.19
Fentanyl injection, per 0.1 mg HCPCS J3010	$1.54
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$4.79 – $4.79
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	not posted	$6.19
Midazolam (Versed) injection, per 1 mg HCPCS J2250	not posted	$1.03
Morphine injection, up to 10 mg HCPCS J2270	$2.86
Saline IV solution, 1000 ml HCPCS J7030	not posted		$1.99 – $8.76

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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