Hospital Rochester, NY

Nicholas H. Noyes Memorial Hospital

Nicholas H. Noyes Memorial Hospital in Dansville, NY publishes cash prices for 58 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.

111 Clara Barton Street, Dansville, NY 14437 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT Abdomen & Pelvis W/Contrast Material $528.00
CT scan of the head or brain, no contrast dye CPT 70450 HB CT Head/Brain W/O Contrast Material $158.00
CT scan of the pelvis, with contrast dye CPT 72193 HB CT Pelvis W/Contrast Material $264.00
Diagnostic mammogram, both breasts both sides CPT 77066 HB Diagnostic Mammography Computer-Aided Detcj Bi $208.00
Diagnostic mammogram, one breast CPT 77065 HB Diagnostic Mammography Computer-Aided Detcj Uni $176.00
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HB MRI Any Jt Lower Extrem W/O Contrast Matrl $358.00
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HB MRI Any Jt Lower Extrem W/O & W/Contrast Matrl $528.00
MRI of the brain, no contrast dye CPT 70551 HB MRI Brain Brain Stem W/O Contrast Material $358.00
MRI of the brain, with and without contrast dye CPT 70553 HB MRI Brain Brain Stem W/O W/Contrast Material $528.00
MRI of the lower back, no contrast dye CPT 72148 HB MRI Spinal Canal Lumbar W/O Contrast Material $358.00
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB US Preg Uterus After 1st Trimest 1/1st Gestation $377.00
Screening mammogram, both breasts both sides CPT 77067 HB Screening Mammography Bi 2-View Breast Inc Cad $166.00
Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL $55.46 $93.00 40%
Transvaginal pelvic ultrasound CPT 76830 HB Ultrasound Transvaginal $158.00
Transvaginal pelvic ultrasound CPT 76830 HB Ultrasound Transvaginal (Pro) $218.00
Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL $55.46 $93.00 40%
Ultrasound of the abdomen, complete CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $191.41 $321.00 40%
Ultrasound of the abdomen, complete CPT 76700 HB US Abdominal Real Time W/Image Documentation $328.00
Ultrasound of the abdomen, complete inpatient CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION $191.41 $321.00 40%
X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $102.56 $172.00 40%
X-ray of the lower back, 4 or more views CPT 72110 HB Radex Spine Lumbosacral Minimum 4 Views $158.00
X-ray of the lower back, 4 or more views inpatient CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $102.56 $172.00 40%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 HB Basic Metabolic Panel Calcium Total $22.00
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL $23.26 $39.00 40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB Lipid Panel $31.00
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL $23.26 $39.00 40%
Complete blood count (CBC) with differential CPT 85025 HB Blood Count Complete Auto&Auto Difrntl Wbc $14.00
Complete blood count (CBC), no differential CPT 85027 HB Blood Count Complete Automated $15.00
Comprehensive metabolic panel (blood test) CPT 80053 HB Comprehensive Metabolic Panel $40.00
Kidney function blood test panel CPT 80069 HB Renal Function Panel $10.00
Liver function blood test panel CPT 80076 HB Hepatic Function Panel $28.00
PSA (prostate-specific antigen) blood test, free CPT 84154 HB Assay of Prostate Specific Antigen Free $42.00
PSA (prostate-specific antigen) blood test, free CPT 84154 HB Prostate Specific Antigen Free $42.00
PSA (prostate-specific antigen) blood test, free CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE $50.09 $84.00 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE $50.09 $84.00 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 HB Prostate Health Index $62.00
PSA (prostate-specific antigen) blood test, total CPT 84153 HB Assay of Prostate Specific Antigen Total $62.00
Partial thromboplastin time (PTT) clotting test CPT 85730 HB Thromboplastin Time Partial Plasma/Whole Blood $14.00
Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD $19.08 $32.00 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD $19.08 $32.00 40%
Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME $3.58 $6.00 40%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $12.00
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME $3.58 $6.00 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB Assay of Thyroid Stimulating Hormone Tsh $38.00
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH $45.92 $77.00 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH $45.92 $77.00 40%
Urinalysis with microscope exam, automated CPT 81001 HB Urnls Dip Stick/Tablet Reagent Auto Microscopy $8.00
Urinalysis with microscope exam, manual CPT 81000 HB Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy $4.00
Urinalysis without microscope exam, automated CPT 81003 HB Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy $8.00
Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY $9.54 $16.00 40%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY $9.54 $16.00 40%
Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $4.17 $7.00 40%
Urinalysis without microscope exam, manual CPT 81002 HB Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp $8.00
Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP $4.17 $7.00 40%

Surgery and procedures

ProcedureCash price List priceOff list
Cataract surgery with lens implant CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $3,221.21 $5,402.00 40%
Cataract surgery with lens implant inpatient CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP $3,221.21 $5,402.00 40%
Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $546.81 $917.00 40%
Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $546.81 $917.00 40%
Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $821.70 $1,378.00 40%
Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $821.70 $1,378.00 40%
Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $797.85 $1,338.00 40%
Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $797.85 $1,338.00 40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $639.23 $1,072.00 40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HB Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible (Pro) $977.00
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HB Repair Ing Hernia,5+Y/O,Reducibl $5,220.00
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE $639.23 $1,072.00 40%
Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG $1,821.10 $3,054.00 40%
Knee arthroscopy with meniscus trim CPT 29881 HB PR Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg $4,800.00
Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG $1,821.10 $3,054.00 40%
Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $210.49 $353.00 40%
Lower-back epidural injection, with imaging guidance CPT 62323 HB Plc Cath Interlaminar Lmbr/Sac W/Img $1,024.00
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $210.49 $353.00 40%
Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $531.90 $892.00 40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $531.90 $892.00 40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $276.68 $464.00 40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $276.68 $464.00 40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $301.13 $505.00 40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HB Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls (Pro) $318.00
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HB Shoulder Scope Bone Shaving $3,344.00
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS $301.13 $505.00 40%
Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $3,991.04 $6,693.00 40%
Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $3,991.04 $6,693.00 40%
Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $3,874.76 $6,498.00 40%
Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS $3,874.76 $6,498.00 40%
Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $617.83 $1,036.10 40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $617.83 $1,036.10 40%
Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $472.87 $793.00 40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $472.87 $793.00 40%

Doctor visits and therapy

ProcedureCash price List priceOff list
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $23.85 $40.00 40%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R $23.85 $40.00 40%
Family therapy with the patient, 50 minutes CPT 90847 HB Fam Psychotherapy W/Pt Present (Pro) $82.00
Family therapy with the patient, 50 minutes CPT 90847 HB Family Psychotherapy W/Patient Present $110.00
Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $181.28 $304.00 40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $181.28 $304.00 40%
Family therapy without the patient, 50 minutes CPT 90846 HB Fam Psychotherapy W/O Pt Present (Pro) $58.00
Family therapy without the patient, 50 minutes CPT 90846 HB Family Psychotherapy W/O Patient Present $110.00
Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $174.12 $292.00 40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $174.12 $292.00 40%
Group psychotherapy session CPT 90853 HB Group Psychotherapy (Pro) $28.00
Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY $42.93 $72.00 40%
Group psychotherapy session CPT 90853 HB Group Psychotherapy $123.00
Group psychotherapy session inpatient CPT 90853 PR GROUP PSYCHOTHERAPY $42.93 $72.00 40%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $113.30 $190.00 40%
New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $113.30 $190.00 40%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $143.11 $240.00 40%
New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $143.11 $240.00 40%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $172.93 $290.00 40%
New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $172.93 $290.00 40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB Therapeutic Px 1/> Areas Each 15 Min Exercises $42.00
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB Ot Therapeutic Px 1/> Areas Ea 15 Min Exercises $42.00
Preventive checkup, new patient aged 18–39 CPT 99385 HB Initial Preventive Medicine New Pt Age 18-39yrs $32.00
Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $153.25 $257.00 40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS $153.25 $257.00 40%
Preventive checkup, new patient aged 40–64 CPT 99386 HB Initial Preventive Medicine New Patient 40-64yrs $38.00
Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $191.41 $321.00 40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS $191.41 $321.00 40%
Psychotherapy session, 30 minutes CPT 90832 HB Psychotherapy Patient 30 Minutes (Pro) $53.00
Psychotherapy session, 30 minutes CPT 90832 HB Psychotherapy Patient 30 Minutes $110.00
Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES $122.24 $205.00 40%
Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES $122.24 $205.00 40%
Psychotherapy session, 45 minutes CPT 90834 HB Psychotherapy Patient 45 Minutes (Pro) $83.00
Psychotherapy session, 45 minutes CPT 90834 HB Psychotherapy Patient 45 Minutes $110.00
Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES $161.00 $270.00 40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES $161.00 $270.00 40%
Psychotherapy session, 60 minutes CPT 90837 HB Psychotherapy Patient 60 Minutes (Pro) $107.00
Psychotherapy session, 60 minutes CPT 90837 HB Psychotherapy Patient 60 Minutes $110.00
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES $237.92 $399.00 40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES $237.92 $399.00 40%

Source file: https://www.urmc.rochester.edu/getmedia/016bb4df-9b94-41b6-a803-c44ad94a879c/160743979-NICHOLAS-H-NOYES-MEMORIAL-HOSPITAL-standardcharges.csv