Visits & medical services prices at Gouverneur Hospital
Gouverneur, NY · every code in this section with a posted price and a Medicare benchmark.
161 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) | $106.68 | $164.13 | 2.1× |
| Advncd Care Plan 30 Min (99497) | $113.32 | $174.34 | 0.9× |
| Airway Inhalation Treatment (94640) range across 4 matching MRF lines |
$395.85–$479.95 | $609–$738.39 | varies |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) | $212.56 | $327.01 | 1.3× |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) | $323 | $496.92 | 1.9× |
| Analyze neurostim no prog (95970) | $343.19 | $527.98 | 2.1× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $24.62 | $37.88 | 1.7× |
| Application Modality 1/> Areas Infrared (97026) | $32.32 | $49.73 | 4.8× |
| Behavral qualit analys voice (92524) | $183.09 | $281.67 | 1.7× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $490.70 | $754.92 | 1.1× |
| Canalith repositioning proc (95992) range across 2 matching MRF lines |
$56.18–$87.82 | $86.43–$135.10 | varies |
| Cardiopulmonary resuscitation (92950) range across 2 matching MRF lines |
$391.05–$687.49 | $601.62–$1,057.67 | varies |
| Cardioversion (92960) | $884.72 | $1,361.10 | 1.1× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) | $19.06 | $29.33 | 0.7× |
| Cbt 1st hour (94644) | $218.17 | $335.64 | 1.3× |
| Chemo Hormon Antineopl Sq/Im (96402) | $184.33 | $283.59 | 2.1× |
| Chemo Ia Push (96420) | $731.71 | $1,125.71 | 1.8× |
| Chest Wall Manipulation (94668) | $245 | $376.93 | 1.5× |
| Color/duplex Doppler, complete (93975) | $574.12 | $883.26 | 1.9× |
| Color/duplex Doppler, limited (93976) | $502.61 | $773.25 | 3.9× |
| Community/Work Reintegration Trainj Ea 15 Min (97537) | $96.64 | $148.67 | 3.0× |
| Continuous Pulse Ox (94762) | $214.69 | $330.29 | 1.3× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $187.93 | $289.12 | 0.7× |
| Cpt initial (94667) | $66.67 | $102.57 | 0.4× |
| Critical care first hour (99291) | $1,619.98 | $2,492.27 | 1.6× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 3 matching MRF lines |
$170.78–$419.48 | $262.74–$645.35 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) | $641.21 | $986.48 | 2.2× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,032.51 | $1,588.47 | 3.5× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) range across 2 matching MRF lines |
$545.76–$634.65 | $839.63–$976.38 | varies |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,032.51 | $1,588.47 | 3.5× |
| Dup-scan xtr veins unilateral/limited study (93971) | $634.65 | $976.38 | 4.9× |
| Duplex up extrem art bilat (93930) | $908.46 | $1,397.63 | 3.1× |
| Duplex up extrem art unilat/ltd (93931) | $291.05 | $447.77 | 2.2× |
| Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) | $335.65 | $516.38 | 2.1× |
| ECG/monitoring and analysis (93271) | $250.63 | $385.58 | 2.1× |
| Echo Heart Xthoracic,Limited (93308) range across 2 matching MRF lines |
$519.19–$1,378.79 | $798.76–$2,121.21 | varies |
| Echo transesophageal (93312) | $1,977.68 | $3,042.59 | 2.9× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $1,977.68 | $3,042.59 | 2.9× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $1,621.45 | $2,494.54 | 2.4× |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) | $250.63 | $385.58 | 2.1× |
| Electrical Stimulation Ea 15 Min (97032) | $24.62 | $37.88 | 1.7× |
| Electrocardiogram Tracing (93005) | $250.90 | $386 | 3.4× |
| Emergency Dept Visit Level 2 (99282) | $332.48 | $511.50 | 1.7× |
| Emergency Dept Visit Level 3 (99283) | $369.10 | $567.85 | 1.1× |
| Emergency Dept Visit Level 4 (99284) | $663.54 | $1,020.83 | 1.3× |
| Er level 1 (99281) | $206.39 | $317.52 | 2.0× |
| Er level v (99285) | $927.69 | $1,427.21 | 1.2× |
| Evaluate pt use of inhaler (94664) range across 2 matching MRF lines |
$82.06–$558.13 | $126.25–$858.66 | varies |
| Evaluate Speech Production (92522) | $348.02 | $535.42 | 3.1× |
| Evaluate Swallowing Function (92610) | $131.54 | $202.37 | 1.6× |
| External ECG rec>48hr<7d recording (93242) | $135.81 | $208.94 | 2.9× |
| External ECG rec>48hr<7d scanning alys w/report (93243) | $253.70 | $390.31 | 1.5× |
| External ECG rec>7d<15d recording (93246) | $207.44 | $319.14 | 4.4× |
| External ECG rec>7d<15d scanning alys w/report (93247) | $253.70 | $390.31 | 1.5× |
| External Ecg Scanning Analysis Report (93226) | $207.44 | $319.14 | 2.8× |
| Extracranial Bilat Study (93880) | $508.19 | $781.83 | 1.7× |
| F-up/limited tthrc echo congenital car anomaly (93304) | $1,236.10 | $1,901.69 | 1.8× |
| Group Therapeutic Procedures (97150) | $56.01 | $86.17 | 3.1× |
| Holter monitor recording (93225) | $207.44 | $319.14 | 1.2× |
| Icd Device Interrogate (93289) | $93.42 | $143.73 | 2.0× |
| Icm Device Eval (93290) | $93.42 | $143.73 | 2.0× |
| Im Adm Intransl/Oral 1 Vaccine (90473) | $50.30 | $77.38 | 0.6× |
| Immunization administration (90471) | $62.26 | $95.78 | 0.7× |
| Iontophoresis 15 min (97033) | $51.10 | $78.62 | 2.7× |
| Irrig Drug Delivery Device (96523) range across 5 matching MRF lines |
$116.79–$141.04 | $179.68–$216.98 | varies |
| IV infusion hydration each additional hour (96361) | $171.19 | $263.37 | 2.9× |
| IV infusion hydration initial 31 min-1 hour (96360) | $349.45 | $537.61 | 1.3× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $110.58 | $170.13 | 1.2× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $106.48 | $163.82 | 1.8× |
| IV push initial (96374) | $267.03 | $410.82 | 1.0× |
| Lung Function Test (Mbc/Mvv) (94200) | $87.78 | $135.04 | 1.2× |
| Mechanical chest wall oscillation per session (94669) | $152.39 | $234.45 | 0.6× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $68.39 | $105.21 | 2.2× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $38.33 | $58.97 | 1.0× |
| Methacholine challenge (94070) | $774.40 | $1,191.39 | 1.7× |
| Motion Fluoroscopy/Swallow (92611) | $218.48 | $336.13 | 2.4× |
| Multiple Family Group Psychotherapy (90849) | $381.50 | $586.92 | 1.7× |
| Muscle Test One Limb (95860) | $334.27 | $514.26 | 2.0× |
| Nasopharyngoscopy (92511) range across 3 matching MRF lines |
$377.18–$438.61 | $580.28–$674.79 | varies |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) | $443.10 | $681.70 | 1.8× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) | $859.90 | $1,322.92 | 1.7× |
| Nerve Conduction Studies 1-2 Studies (95907) | $464.35 | $714.38 | 1.7× |
| Nerve Conduction Studies 3-4 Studies (95908) | $687.21 | $1,057.25 | 2.5× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) | $408.76 | $628.86 | 2.5× |
| Neuromuscular Reeducation (97112) | $56.18 | $86.43 | 1.7× |
| Oral Function Therapy (92526) | $83.87 | $129.03 | 1.0× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $58.77 | $90.42 | 1.2× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) | $61.54 | $94.67 | 1.3× |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) | $66.57 | $102.41 | 2.5× |
| Osteopathic manipulative tx 3-4 body regions (98926) | $67.89 | $104.45 | 2.5× |
| Ot Contrast Bath Ea 15 Min (97034) | $43.16 | $66.40 | 3.1× |
| Ot eval high complexity (97167) | $153.10 | $235.54 | 1.5× |
| Ot Eval Low Complex (97165) | $133.76 | $205.78 | 1.3× |
| Ot Eval Moderate Complexity (97166) | $136.94 | $210.68 | 1.4× |
| Ot manual therapy 15 min (97140) range across 2 matching MRF lines |
$56.18–$84.52 | $86.43–$130.03 | varies |
| Ot paraffin bath (97018) | $32.32 | $49.73 | 5.4× |
| Ot Prosthetic Training, Each 15 Min (97761) range across 2 matching MRF lines |
$60.02–$130.62 | $92.34–$200.95 | varies |
| Ot Re-Eval Est Plan Care (97168) | $78.47 | $120.72 | 1.1× |
| Peripheral arterial disease rehab per session (93668) | $171.48 | $263.82 | 2.3× |
| Physical Performance Test (97750) | $61.54 | $94.67 | 1.8× |
| Pm device eval in person (93288) range across 2 matching MRF lines |
$84.86–$93.42 | $130.56–$143.73 | varies |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $2,292.97 | $3,527.65 | 2.1× |
| Prepj& antigen allergen immunotherapy 5 insect (95149) | $51.97 | $79.96 | 0.6× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) | $46.69 | $71.83 | 0.8× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) | $72.08 | $110.89 | 1.2× |
| Psych diag eval w/med srvcs (90792) range across 3 matching MRF lines |
$227.08–$349.99 | $349.35–$538.44 | varies |
| Psychiatric diagnostic evaluation (90791) range across 9 matching MRF lines |
$303.09–$349.99 | $466.29–$538.44 | varies |
| Psychological tst eval svc phys/qhp first hour (96130) | $343.10 | $527.84 | 1.3× |
| Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) | $229.07 | $352.42 | 1.4× |
| Psytx Crisis Initial 60 Min (90839) | $299.99 | $461.52 | 1.4× |
| Pt Eval High Complex (97163) | $169.56 | $260.86 | 1.7× |
| Pt eval low complex 20 min (97161) | $133.76 | $205.78 | 1.4× |
| Pt Eval Mod Complex (97162) | $151.66 | $233.33 | 1.5× |
| Pt gait training 15 min (97116) | $44.64 | $68.67 | 1.5× |
| Pt group caregiver training (97552) | $15.92 | $24.49 | 0.7× |
| Pt mechanical traction (97012) | $32.32 | $49.73 | 2.3× |
| Pt Re-Eval Est Plan Care (97164) | $86.90 | $133.70 | 1.3× |
| Pt-focused hlth risk assmt score doc stnd instrm (96160) | $65.88 | $101.36 | 1.4× |
| Pulm function test by gas (94727) | $256.02 | $393.87 | 0.9× |
| Pulmonary service/procedure (94799) | $337.49 | $519.21 | 2.1× |
| Pulmonary Stress Testing (94618) | $212.56 | $327.01 | 1.3× |
| Pure Tone Audiometry Air (92552) | $61.35 | $94.39 | 0.4× |
| Rapid Desensitization Procedure Each Hour (95180) | $557.97 | $858.41 | 1.0× |
| Refill/Maint Portable Pump (96521) | $506.88 | $779.81 | 1.9× |
| Refill/Maint Pump/Resvr Syst (96522) | $576.66 | $887.17 | 2.2× |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) | $82.64 | $127.14 | 1.8× |
| Remote 30 Day Ecg Rev/Report (93270) | $225.34 | $346.68 | 4.8× |
| Remote 30 Day Ecg Tech Supp (93229) | $307.13 | $472.51 | 0.7× |
| Respiratory flow volume loop (94375) | $192.13 | $295.58 | 0.7× |
| Rhythm Ecg 1-3 Leads Tracing Only W/O I&R (93041) range across 2 matching MRF lines |
$55.37–$116.79 | $85.18–$179.68 | varies |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $389.72 | $599.57 | 1.6× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) | $152.29 | $234.29 | 3.2× |
| Self Care Mngment Training (97535) range across 2 matching MRF lines |
$56.18–$96.92 | $86.43–$149.11 | varies |
| Sensory Integration Ea 15 Min (97533) | $64.75 | $99.61 | 1.1× |
| Slp caregiver training 1st 30 min (97550) | $38.23 | $58.81 | 0.7× |
| Speech sound lang comprehen (92523) | $169.99 | $261.53 | 0.8× |
| Spirometry (94010) | $356.86 | $549.02 | 1.3× |
| Standardized Cognitive Performance Testing (96125) | $197.70 | $304.15 | 1.9× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) range across 2 matching MRF lines |
$72.64–$96.92 | $111.76–$149.11 | varies |
| Ther Ivntj Ea Addl 15 Min (97130) | $96.92 | $149.11 | 4.6× |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) | $117.88 | $181.35 | 3.2× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $84.52 | $130.03 | 2.8× |
| Ther/Proph/Diag Inj Ia (96373) | $66.68 | $102.58 | 0.3× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 7 matching MRF lines |
$51.97–$184.33 | $79.96–$283.59 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $338.08 | $520.12 | 1.3× |
| Therapeutic Activities (97530) | $44.64 | $68.67 | 1.3× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) | $1,123.87 | $1,729.03 | 2.4× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) | $72.82 | $112.03 | 1.6× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $72.82 | $112.03 | 1.6× |
| Trans Care Mgmt 14 Day Disch (99495) | $296.56 | $456.25 | 1.8× |
| Trans Care Mgmt 7 Day Disch (99496) | $320.85 | $493.61 | 1.9× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) | $291.05 | $447.77 | 2.2× |
| Tte w/doppler, complete (93306) | $1,373.26 | $2,112.70 | 2.0× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) | $83.87 | $129.03 | 1.1× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $122.05 | $187.77 | 2.1× |
| Upr/L Xtremity Art 2 Levels (93922) | $284.91 | $438.33 | 1.7× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $356.86 | $549.02 | 1.3× |
| Vasopneumatic device (97016) | $54.18 | $83.35 | 4.5× |
| Vent Mgmt Inpat Init Day (94002) | $363.36 | $559.01 | 0.5× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) | $373.74 | $574.99 | 0.5× |
| Wheelchair Mgmt Ea 15 Min (97542) | $93.74 | $144.21 | 3.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.