Ira Davenport Memorial Hospital
Ira Davenport Memorial Hospital in Bath, NY publishes cash prices for 45 common procedures listed here, from its own machine-readable price file updated Mar 27, 2026. Click a procedure to compare it with other hospitals nearby.
7571 State Route 54, Bath NY14810 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast | $1,366.71 | $6,833.54 | 80% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Scan,Head/Brain,W/O Contrast Matl - CT Head WO Contrast | $459.19 | $2,295.94 | 80% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Scan of Pelvis Contrast - CT Pelvis W Contrast | $735.19 | $3,675.96 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Dx Mammo Incl Cad Bi - Mammo Breast Diagnostic Bilateral | $248.09 | $1,240.45 | 80% |
| Diagnostic mammogram, one breast CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic | $176.13 | $880.64 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Ext Low Jnt W/O Con | $957.15 | $4,785.75 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI, Joint of Leg. Combo - MR Hip W and WO IV Contrast | $1,585.90 | $7,929.48 | 80% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain - MRI Brain WO Contrast | $938.18 | $4,690.88 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Combo - MRI Brain W WO Contrast | $1,308.25 | $6,541.24 | 80% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, Lumbar Spine - MRI Lumbar Spine WO Contrast | $1,066.48 | $5,332.39 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 Wks Sngl Fetus - US OB 14+ Weeks Single or First | $69.09 | $345.44 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening | $143.34 | $716.70 | 80% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,078.16 | $5,390.82 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 HC Echography,Transvaginal - US Pelvis Transvaginal | $197.62 | $988.09 | 80% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen | $327.98 | $1,639.92 | 80% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $173.28 | $866.38 | 80% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel Calcium Total - Bundled Charge | $51.98 | $259.91 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel - Bundled Charge | $73.02 | $365.09 | 80% |
| Complete blood count (CBC) with differential CPT 85025 HC Complete Cbc & Auto Diff Wbc - Additional Charge | $31.36 | $156.78 | 80% |
| Complete blood count (CBC), no differential CPT 85027 HC Complete Cbc - Additional Charge | $21.45 | $107.27 | 80% |
| Complete blood count (CBC), no differential CPT 85027 HC Complete Cbc - Cbc | $21.45 | $107.27 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Metabolic Panel,Comprehensive - Bundled Charge | $75.92 | $379.59 | 80% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel - Bundled Charge | $47.85 | $239.26 | 80% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel - Bundled Charge | $75.09 | $375.45 | 80% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Assay of Prostate Specific Antigen Free | $39.67 | $198.37 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa Screening | $65.60 | $328.00 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa | $65.60 | $328.00 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial - Additional Charge | $10.50 | $52.50 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial - Aptt | $25.17 | $125.83 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Prothrombin Mixing Study | $18.98 | $94.91 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Protime-Inr | $18.98 | $94.91 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $78.80 | $394.00 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis, Auto, W/Scope - Bundled Charge | $16.09 | $80.44 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis, Auto, W/Scope - Urinalysis Microscopic | $16.09 | $80.44 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis, Auto, W/O Scope - Urinalysis Chem Only | $12.60 | $63.00 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Nonauto W/O Scope | $12.60 | $63.00 | 80% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 HC Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq - Colonoscopy | $941.43 | $4,707.17 | 80% |
| Colonoscopy, diagnostic CPT 45378 HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy | $451.66 | $2,258.28 | 80% |
| Left heart catheterization, diagnostic one side CPT 93452 HC Cath Left Heart Cath Inject Vetriculography, Image Supervise/ | $2,531.03 | $12,655.14 | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $454.26 | $2,271.32 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $167.57 | $837.84 | 80% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Leve | $464.94 | $2,324.70 | 80% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Transoral Biopsy Single/Multiple - Egd | $748.59 | $3,742.96 | 80% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Esophagogastroduodenoscopy Transoral Diagnostic | $748.59 | $3,742.96 | 80% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Electrocardiogram Complete | $67.25 | $336.26 | 80% |
| New patient office visit, about 30 minutes CPT 99203 HC Office Outpatient New 30 Minutes | $65.60 | $328.00 | 80% |
| New patient office visit, about 45 minutes CPT 99204 HC Office Outpatient New 45 Minutes | $87.05 | $435.25 | 80% |
| New patient office visit, about 60 minutes CPT 99205 HC Office Outpatient New 60 Minutes | $94.89 | $474.46 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC Preventive Visit,New,18-39 | $42.81 | $214.03 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC Preventive Visit,New,40-64 | $55.86 | $279.30 | 80% |
Source file: https://CayugaHealth.pt.panaceainc.com/MRFDownload/CayugaHealth/idmh