Gouverneur Hospital
77 West Barney Street, Gouverneur, NY · Rochesterregional · · NPI 1629409925
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Aspa gene CPT 81200 | not published | not published | $45.83 – $614.54 | 3 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $4,551.46 | $7,002.24 | not published | 0 |
| Aspirate pleura without imaging 32554 CPT 32554 | $845.41 | $1,300.63 | not published | 0 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $1,637.71 | $2,519.55 | not published | 0 |
| Assay acid phosphatase CPT 84060 | not published | not published | $5.08 – $99.37 | 4 |
| Assay alkaline phosphatase CPT 84078 | $17.45 | $26.85 | $5.08 – $107.43 | 4 |
| Assay blood catecholamines CPT 82383 | not published | not published | $18.58 – $378.22 | 4 |
| Assay chondroitin sulfate CPT 82485 | not published | not published | $20.03 – $268.58 | 3 |
| Assay dir meas fr estradiol CPT 82681 | not published | not published | $27.10 – $363.39 | 4 |
| Assay duodenal fluid trypsin CPT 84485 | not published | not published | $6.98 – $93.64 | 3 |
| Assay free hydroxyproline CPT 83500 | not published | not published | $21.97 – $294.59 | 4 |
| Assay malate dehydrogenase CPT 83775 | not published | not published | $7.15 – $95.86 | 3 |
| Assay myeloperoxidase CPT 83876 | not published | not published | $19.10 – $661.50 | 4 |
| Assay neurflmnt light chain CPT 83884 | not published | not published | $112.74 – $1,511.71 | 3 |
| Assay of adp & amp CPT 82030 | not published | not published | $25.03 – $335.56 | 3 |
| Assay of androsterone CPT 82160 | not published | not published | $24.78 – $332.31 | 3 |
| Assay of blood lipoprotein CPT 83719 | not published | not published | $12.37 – $165.83 | 3 |
| Assay of bradykinin CPT 82286 | not published | not published | $5.01 – $67.11 | 3 |
| Assay of breath ethanol CPT 82075 | $36.91 | $56.78 | $29.10 – $390.19 | 3 |
| Assay of cathepsin-d CPT 82387 | not published | not published | $17.52 – $234.89 | 3 |
| Assay of chloramphenicol CPT 82415 | not published | not published | $12.29 – $164.79 | 3 |
| Assay of corticosterone CPT 82528 | not published | not published | $21.84 – $292.90 | 3 |
| Assay of digoxin free CPT 80163 | not published | not published | $10.61 – $172.72 | 4 |
| Assay of endocrine hormone CPT 84235 | not published | not published | $69.09 – $926.43 | 3 |
| Assay of estrogen CPT 84233 | not published | not published | $37.88 – $1,142.98 | 4 |
| Assay of etiocholanolone CPT 82696 | not published | not published | $25.45 – $341.28 | 3 |
| Assay of feces for trypsin CPT 84490 | not published | not published | $9.63 – $129.15 | 3 |
| Assay of feces porphyrins CPT 84126 | not published | not published | $37.94 – $508.67 | 3 |
| Assay of feces/urobilinogen CPT 84577 | not published | not published | $16.30 – $218.50 | 3 |
| Assay of fluoride CPT 82735 | not published | not published | $17.98 – $241.13 | 3 |
| Assay of galactose CPT 82760 | not published | not published | $10.86 – $145.67 | 4 |
| Assay of gdh enzyme CPT 82965 | not published | not published | $8.88 – $171.03 | 4 |
| Assay of glucosidase CPT 82963 | not published | not published | $20.84 – $279.37 | 4 |
| Assay of glutathione CPT 82978 | $32.64 | $50.22 | $14.99 – $200.95 | 3 |
| Assay of haptoglobins CPT 83012 | not published | not published | $26.08 – $349.74 | 3 |
| Assay of idh enzyme CPT 83570 | not published | not published | $8.58 – $115.10 | 3 |
| Assay of interleukin-6 (il-6) CPT 83529 | $36.49 | $56.14 | $10.46 – $224.62 | 4 |
| Assay of intrinsic factor CPT 83528 | not published | not published | $19.23 – $257.78 | 3 |
| Assay of lap enzyme CPT 83670 | not published | not published | $9.52 – $127.59 | 3 |
| Assay of leflunomide CPT 80193 | not published | not published | $23.37 – $501.65 | 4 |
| Assay of lrh hormone CPT 83727 | not published | not published | $16.67 – $223.58 | 4 |
| Assay of methemalbumin CPT 83857 | not published | not published | $10.42 – $139.69 | 3 |
| Assay of neonatal thyroxine CPT 84437 | not published | not published | $6.28 – $84.15 | 3 |
| Assay of osteocalcin CPT 83937 | not published | not published | $28.95 – $388.24 | 3 |
| Assay of phenylketones CPT 84035 | not published | not published | $3.86 – $51.76 | 3 |
| Assay of pregnanediol CPT 84135 | not published | not published | $20.63 – $276.64 | 3 |
| Assay of pregnanetriol CPT 84138 | not published | not published | $20.42 – $273.78 | 3 |
| Assay of procainamide CPT 80190 | not published | not published | $58.20 – $780.37 | 3 |
| Assay of procainamide w/metab CPT 80192 | not published | not published | $16.25 – $217.85 | 3 |
| Assay of progesterone CPT 84234 | not published | not published | $24.69 – $843.84 | 4 |
| Assay of prostaglandin CPT 84150 | $114.71 | $176.47 | $40.52 – $543.27 | 3 |
| Assay of PSA complexed CPT 84152 | $55.57 | $85.49 | $17.84 – $239.18 | 4 |
| Assay of quinine CPT 84228 | not published | not published | $11.28 – $151.26 | 3 |
| Assay of rbc pg6d enzyme CPT 84085 | not published | not published | $9.16 – $122.78 | 3 |
| Assay of salicylate CPT 80179 | $41.36 | $63.63 | $18.08 – $242.44 | 3 |
| Assay of semen fructose CPT 82757 | not published | not published | $16.82 – $225.53 | 3 |
| Assay of sialic acid CPT 84275 | not published | not published | $13.04 – $174.80 | 4 |
| Assay of silica CPT 84285 | not published | not published | $24.45 – $327.89 | 3 |
| Assay of somatostatin CPT 84307 | not published | not published | $17.73 – $237.75 | 3 |
| Assay of thiocyanate CPT 84430 | not published | not published | $11.28 – $151.26 | 3 |
| Assay of troponin qual CPT 84512 | not published | not published | $5.25 – $131.23 | 4 |
| Assay of tyrosine CPT 84510 | $35.26 | $54.24 | $10.31 – $138.26 | 4 |
| Assay of urine sulfate CPT 84392 | $15.11 | $23.25 | $5.33 – $71.40 | 3 |
| Assay of urine urobilinogen CPT 84580 | not published | not published | $9.26 – $124.21 | 3 |
| Assay of urine urobilinogen CPT 84583 | $12.79 | $19.67 | $5.87 – $78.69 | 3 |
| Assay phosphatidylglycerol CPT 84081 | not published | not published | $8.05 – $214.86 | 4 |
| Assay phosphohexose enzymes CPT 84087 | not published | not published | $8.88 – $139.56 | 4 |
| Assay rbc glutathione CPT 82979 | not published | not published | $9.16 – $122.78 | 3 |
| Assay toxin or antitoxin CPT 87230 | not published | not published | $9.49 – $256.74 | 4 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | not published | not published | $203.87 – $203.87 | 1 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | not published | not published | $3.43 – $55.54 | 4 |
| Ast/sgot CPT 84450 | $70.33 | $108.20 | $5.02 – $67.37 | 4 |
| Asxl1 full gene sequence CPT 81175 | not published | not published | $656.20 – $8,798.69 | 3 |
| Asxl1 gene target seq alys CPT 81176 | not published | not published | $234.64 – $3,146.20 | 3 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | not published | not published | $89.39 – $98.49 | 2 |
| Atn1 gene detc abnor alleles CPT 81177 | not published | not published | $83.83 – $1,781.85 | 4 |
| Atomic absorption CPT 82190 | not published | not published | $15.42 – $206.80 | 3 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | not published | not published | $0.11 – $0.74 | 2 |
| Atxn10 gene detc abnor allel CPT 81183 | not published | not published | $83.83 – $1,781.85 | 4 |
| Atxn1 gene detc abnor allele CPT 81178 | not published | not published | $83.83 – $1,781.85 | 4 |
| Atxn2 gene detc abnor allele CPT 81179 | not published | not published | $83.83 – $1,781.85 | 4 |
| Atxn3 gene detc abnor allele CPT 81180 | not published | not published | $83.83 – $1,781.85 | 4 |
| Atxn7 gene detc abnor allele CPT 81181 | not published | not published | $83.83 – $1,781.85 | 4 |
| Atxn8os gen detc abnor allel CPT 81182 | not published | not published | $83.83 – $1,781.85 | 4 |
| Audit/dast 15-30 min CPT 99408 | $170.10 | $261.70 | $21.87 – $21.87 | 1 |
| Audit/dast over 30 min CPT 99409 | $303.09 | $466.29 | $43.51 – $43.51 | 1 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | $1,639.27 | $2,521.95 | $815.43 – $10,933.66 | 3 |
| Automated diff wbc count CPT 85004 | $12.62 | $19.41 | $3.20 – $84.15 | 4 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | not published | not published | $97.14 – $105.24 | 2 |
| Avul nail plate addl CPT 11732 | $194.73 | $299.59 | not published | 0 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $443.10 | $681.70 | not published | 0 |
| Azacitidine injection HCPCS J9025 | not published | not published | $0.32 – $1.54 | 2 |
| Azathioprine 50 mg tablet HCPCS J7500 | not published | not published | $1.01 – $3.77 | 2 |
| Azathioprine parenteral HCPCS J7501 | not published | not published | $240.00 – $300.00 | 2 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | not published | not published | $2.22 – $5.82 | 2 |
| Azithromycin dihydrate, oral HCPCS Q0144 | not published | not published | $23.71 – $29.13 | 2 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | not published | not published | $2.48 – $2.48 | 1 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $174.80 – $186.92 | 2 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $39.56 – $53.82 | 2 |
| Baclofen eval charges CPT 97750 | $61.54 | $94.67 | $68.60 – $68.60 | 1 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.