Nicholas H Noyes Memorial Hospital

111 Clara Barton Street, Dansville, NY 14437 · Acute care hospital · Emergency room

These are Nicholas H Noyes 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.

228 of the services we track have a posted price here; 184 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	$1,246.00
Emergency room visit, level 1 (minor) CPT 99281	$130.00
Emergency room visit, level 2 CPT 99282	$234.00
Emergency room visit, level 3 (moderate) CPT 99283	$410.00
Emergency room visit, level 4 CPT 99284	$630.00
Emergency room visit, level 5 (most severe) CPT 99285	$907.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$418.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$83.48	$140.00
New patient office visit, about 30 minutes CPT 99203	$113.30	$190.00
New patient office visit, about 45 minutes CPT 99204	$143.11	$240.00
New patient office visit, about 60 minutes CPT 99205	$172.93	$290.00
Office consultation, about 60 minutes CPT 99244	not posted		$64.28 – $399.82
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$250.00
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$250.00
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$365.00
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$250.00
Office visit, established patient, brief (often a nurse) CPT 99211	$125.00
Preventive checkup, new patient, age 18 to 39 CPT 99385	$153.25	$257.00
Preventive checkup, new patient, age 40 to 64 CPT 99386	$191.41	$321.00

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$58.00
Abdominal X-ray, 1 view CPT 74018	$130.00
Ankle X-ray, 3 or more views CPT 73610	$130.00
Bone density scan (DEXA), hips and spine CPT 77080	$102.56	$172.00
Breast ultrasound, one breast, complete CPT 76641	$158.00
Breast ultrasound, one breast, limited CPT 76642	$211.09	$354.00
Chest X-ray, 1 view CPT 71045	$130.00
Chest X-ray, 2 views CPT 71046	$130.00
CT angiogram of the chest (checks for lung clots) CPT 71275	$264.00
CT angiogram of the head CPT 70496	$264.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$528.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$528.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$358.00
CT scan of the abdomen, without contrast CPT 74150	$158.00
CT scan of the chest, with contrast CPT 71260	$264.00
CT scan of the chest, without contrast CPT 71250	$158.00
CT scan of the head, without contrast CPT 70450	$158.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$158.00
CT scan of the pelvis, with contrast CPT 72193	$264.00
CT scan of the sinuses or face, without contrast CPT 70486	$158.00
Diagnostic mammogram, both breasts CPT 77066	$208.00
Diagnostic mammogram, one breast CPT 77065	$176.00
Foot X-ray, 3 or more views CPT 73630	$130.00
Hand X-ray, 3 or more views CPT 73130	$130.00
Knee X-ray, 3 views CPT 73562	$130.00
Leg or arm vein ultrasound, both sides CPT 93970	$304.71	$511.00
Leg or arm vein ultrasound, one side CPT 93971	$218.00
Lower back X-ray, 2 or 3 views CPT 72100	$102.56	$172.00
MRI of both breasts, without and with contrast CPT 77049	not posted		$182.20 – $1,136.25
MRI of the abdomen, without and with contrast CPT 74183	$528.00
MRI of the brain, without and with contrast CPT 70553	$528.00
MRI of the brain, without contrast CPT 70551	$358.00
MRI of the knee or other leg joint, without contrast CPT 73721	$358.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$358.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$358.00
MRI of the neck (cervical spine), without contrast CPT 72141	$358.00
MRI of the pelvis, without and with contrast CPT 72197	$528.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$358.00
Neck X-ray, 2 or 3 views CPT 72040	$130.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$162.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$377.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$158.00
Screening mammogram, both breasts CPT 77067	$166.00
Shoulder X-ray, 2 or more views CPT 73030	$130.00
Transvaginal pregnancy ultrasound CPT 76817	$170.00
Transvaginal ultrasound CPT 76830	$218.00
Ultrasound of the abdomen, complete CPT 76700	$328.00
Ultrasound of the neck or thyroid CPT 76536	$322.00
Wrist X-ray, 3 or more views CPT 73110	$130.00
X-ray of the lower back, 4 or more views CPT 72110	$102.56	$172.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$22.00
Blood culture CPT 87040	$32.00
Blood draw (venipuncture) CPT 36415	$10.00
BNP test (heart failure) CPT 83880	$48.00
C-reactive protein (CRP) test CPT 86140	$10.00
Chlamydia test (DNA/NAAT) CPT 87491	$48.00
Complete blood count (CBC) with differential CPT 85025	$14.00
Complete blood count (CBC), automated CPT 85027	$15.00
Comprehensive metabolic panel (blood test) CPT 80053	$40.00
COVID-19 PCR test CPT 87635	$42.00
D-dimer test (blood clots) CPT 85379	not posted		$7.13 – $22.90
Drug screen, instrument chemistry CPT 80307	$74.00
Ferritin (iron stores) test CPT 82728	$32.00
Free T4 (thyroid) test CPT 84439	$27.00
General health panel (blood tests) CPT 80050	$30.00
Glucose (blood sugar) test CPT 82947	$11.00
Gonorrhea test (DNA/NAAT) CPT 87591	$63.21	$106.00
Hemoglobin A1c test CPT 83036	$22.00
Hepatitis C antibody test CPT 86803	$46.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$26.00
Iron test CPT 83540	$16.00
Kidney function panel CPT 80069	$10.00
Lipase test (pancreas) CPT 83690	$22.00
Lipid panel, cholesterol and triglycerides CPT 80061	$23.26	$39.00
Liver function panel CPT 80076	$28.00
Magnesium test CPT 83735	$26.83	$45.00
Obstetric blood test panel CPT 80055	not posted		$33.47 – $65.40
Partial thromboplastin time (PTT), clotting test CPT 85730	$19.08	$32.00
Pregnancy blood test (hCG), quantitative CPT 84702	$51.88	$87.00
Prothrombin time (PT/INR), clotting test CPT 85610	$12.00
PSA (prostate specific antigen), free CPT 84154	$50.09	$84.00
PSA (prostate specific antigen), total CPT 84153	$62.00
Rapid strep test CPT 87880	$23.26	$39.00
Sed rate (ESR) test CPT 85652	$11.00
TB skin test CPT 86580	$40.00
Thyroid stimulating hormone (TSH) CPT 84443	$45.92	$77.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$218.00
Troponin test (heart damage) CPT 84484	$48.00
Urinalysis, automated, with microscope CPT 81001	$8.00
Urinalysis, automated, without microscope CPT 81003	$9.54	$16.00
Urinalysis, manual, with microscope CPT 81000	$4.00
Urinalysis, manual, without microscope CPT 81002	$8.00
Urine culture, colony count CPT 87086	$18.00
Urine pregnancy test CPT 81025	$17.00
Vitamin B12 test CPT 82607	$51.00
Vitamin D test CPT 82306	$94.81	$159.00

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$358.00
ECG tracing only (no interpretation) CPT 93005	$88.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$811.00
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$23.85	$40.00
Holter monitor, up to 48 hours CPT 93224	not posted		$55.22 – $136.35
Left heart catheterization CPT 93452	not posted		$3,318.42 – $9,623.41
Left heart catheterization with coronary angiogram CPT 93458	not posted		$3,318.42 – $9,623.41
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,931.00
Treadmill stress test, complete CPT 93015	not posted		$57.97 – $136.35

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$3,451.98	$5,789.00
Appendix removal, laparoscopic CPT 44970	not posted		$6,188.16 – $17,945.66
Breast biopsy with ultrasound guidance CPT 19083	not posted		$1,690.56 – $4,902.63
Carpal tunnel release CPT 64721	$865.83	$1,452.00
Colonoscopy with biopsy CPT 45380	$821.70	$1,378.00
Colonoscopy with polyp removal (snare) CPT 45385	$546.81	$917.00
Colonoscopy, diagnostic CPT 45378	$797.85	$1,338.00
Colposcopy with biopsy CPT 57454	not posted		$311.92 – $904.57
Cystoscopy (bladder scope) CPT 52000	not posted		$713.75 – $2,069.87
Ear tubes, under general anesthesia CPT 69436	not posted		$1,588.19 – $4,605.75
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted		$951.90 – $2,760.50
Gallbladder removal, laparoscopic CPT 47562	not posted		$6,188.16 – $17,945.66
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$10,880.62 – $31,553.80
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$3,313.50 – $9,609.15
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$6,188.16 – $17,945.66
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$5,220.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$3,608.15 – $10,463.62
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$4,800.00
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,224.87 – $3,552.13
Nasal endoscopy, diagnostic CPT 31231	not posted		$204.32 – $592.52
Prostate biopsy CPT 55700	not posted		$448.00 – $839.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$10,880.62 – $31,553.80
Removal of a breast lump, open surgery CPT 19120	not posted		$4,007.81 – $11,622.65
Rotator cuff repair, arthroscopic CPT 29827	$10,567.00
Screening colonoscopy, average risk HCPCS G0121	$463.33	$777.00
Screening colonoscopy, high risk HCPCS G0105	$449.61	$754.00
Septoplasty (nasal septum repair) CPT 30520	not posted		$3,393.68 – $9,841.67
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$3,344.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$6,059.49 – $17,572.54
Total hip replacement CPT 27130	$3,991.04	$6,693.00
Total knee replacement CPT 27447	$3,874.76	$6,498.00
Upper endoscopy (EGD) with biopsy CPT 43239	$617.83	$1,036.10
Upper endoscopy (EGD), diagnostic CPT 43235	$472.87	$793.00
Vasectomy CPT 55250	not posted		$2,139.70 – $6,205.13

Pregnancy and birth

Service	Cash price	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted	$876.78 – $6,416.42
Fetal non-stress test CPT 59025	$298.00
IUD insertion CPT 58300	not posted	$35.96 – $272.26
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted	$817.26 – $6,073.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$773.59 – $5,817.45

Hospital stays

Service	Cash price	Gross charge	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$9,882.59
C-section, without complications MS-DRG 788	$10,676.65
Chest pain MS-DRG 313	$8,181.64
COPD flare-up, with major complications MS-DRG 190	$12,232.37
COPD flare-up, without complications MS-DRG 192	$7,366.68
Fainting (syncope) MS-DRG 312	$9,765.57
Gastrointestinal bleeding, with complications MS-DRG 378	$10,905.46
Heart failure, with major complications MS-DRG 291	$14,072.29
Heart failure, without complications MS-DRG 293	$6,572.63
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$102,870.86
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$20,812.37
Irregular heartbeat, without complications MS-DRG 310	$6,573.67
Kidney failure, with complications MS-DRG 683	$9,809.45
Kidney or urinary tract infection, without major complications MS-DRG 690	$9,116.74
Neck (cervical) spinal fusion, without complications MS-DRG 473	$26,165.99
Normal newborn care MS-DRG 795	$2,746.52
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$8,789.72
Pneumonia, with complications MS-DRG 194	$9,079.13
Pneumonia, with major complications MS-DRG 193	$14,392.00
Pneumonia, without complications MS-DRG 195	$7,225.63
Psychoses (inpatient psychiatric stay) MS-DRG 885	$15,252.92
Sepsis, with major complications MS-DRG 871	$20,954.46
Sepsis, without major complications MS-DRG 872	$11,350.55
Skin infection (cellulitis), without major complications MS-DRG 603	$9,758.26
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$8,804.34
Stroke, with complications or clot-busting drug MS-DRG 65	$11,214.73
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$13,621.97
Vaginal delivery, without complications MS-DRG 807	$7,703.11
Weight loss surgery, without complications MS-DRG 621	$16,418.93

Pain and spine

Service	Cash price	Gross charge
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$436.00
Lower back nerve root injection with imaging guidance CPT 64483	$276.68	$464.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,024.00
Lower back spinal injection (epidural), without imaging CPT 62322	$531.90	$892.00

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$3,221.21	$5,402.00
Eye exam, new patient, comprehensive CPT 92004	not posted		$30.30 – $395.20
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted		$562.97 – $1,632.62

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$25.25 – $381.95

Sleep

Service	Cash price	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$221.02 – $640.95
Sleep study with CPAP titration CPT 95811	$1,505.00
Sleep study, overnight in a sleep lab CPT 95810	$1,505.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$232.00

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$44.00
Physical therapy evaluation, low complexity CPT 97161	$98.00
Physical therapy evaluation, moderate complexity CPT 97162	$98.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$42.00
Therapeutic activities, 15 minutes CPT 97530	$27.00

Mental health

Service	Cash price	Gross charge
Family psychotherapy, with the patient, 50 minutes CPT 90847	$181.28	$304.00
Family psychotherapy, without the patient, 50 minutes CPT 90846	$174.12	$292.00
Group psychotherapy CPT 90853	$123.00
Psychiatric diagnostic evaluation CPT 90791	$252.83	$424.00
Psychotherapy, 30 minutes CPT 90832	$122.24	$205.00
Psychotherapy, 45 minutes CPT 90834	$161.00	$270.00
Psychotherapy, 60 minutes CPT 90837	$237.92	$399.00

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$106.00
IV hydration, each additional hour CPT 96361	$91.00
IV hydration, first hour CPT 96360	$312.00
IV push injection of a drug, first CPT 96374	$312.00
IV push injection, each additional drug CPT 96375	$68.00

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	$1.23
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	$5.37
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$2.35
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$1.42
Morphine injection, up to 10 mg HCPCS J2270	not posted		$3.04 – $3.04
Saline IV solution, 1000 ml HCPCS J7030	not posted		$1.99 – $1.99

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.

Check a bill from this hospital