Schuyler Hospital, Inc.
Schuyler Hospital, Inc. in Montour Falls, NY publishes cash prices for 40 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.
220 Steuben Street, Montour Falls, NY 14865 Collected Sep 23, 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 | $709.38 | $3,546.90 | 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 | $338.10 | $1,690.50 | 80% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Scan of Pelvis Contrast - CT Pelvis W Contrast | $418.95 | $2,094.75 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Dx Mammo Incl Cad Bi - Mammo Breast Diagnostic Bilateral | $110.67 | $553.35 | 80% |
| Diagnostic mammogram, one breast CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic | $78.33 | $391.65 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Ext Low Jnt W/O Con | $259.14 | $1,295.70 | 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 | $402.57 | $2,012.85 | 80% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain - MRI Brain WO Contrast | $616.98 | $3,084.90 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Combo - MR Pituitary W/WO IV Contrast | $866.46 | $4,332.30 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Combo - MRI Brain W WO Contrast | $866.46 | $4,332.30 | 80% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, Lumbar Spine - MRI Lumbar Spine WO Contrast | $635.25 | $3,176.25 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 Wks Sngl Fetus - US OB 14+ Weeks Single or First | $146.79 | $733.95 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening | $98.07 | $490.35 | 80% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $764.19 | $3,820.95 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 HC Echography,Transvaginal - US Pelvis Transvaginal | $138.81 | $694.05 | 80% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen | $207.48 | $1,037.40 | 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 | $123.27 | $616.35 | 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 | $34.44 | $172.20 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel - Bundled Charge | $35.49 | $177.45 | 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 | $17.85 | $89.25 | 80% |
| Complete blood count (CBC), no differential CPT 85027 HC Complete Cbc - Cbc | $17.85 | $89.25 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Metabolic Panel,Comprehensive - Bundled Charge | $46.83 | $234.15 | 80% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel - Bundled Charge | $40.74 | $203.70 | 80% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel - Bundled Charge | $56.28 | $281.40 | 80% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Assay of Prostate Specific Antigen Free | $47.88 | $239.40 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa | $47.88 | $239.40 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa Screening | $47.88 | $239.40 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial - Ptt Crrt System | $16.80 | $84.00 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial - Aptt | $16.80 | $84.00 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Protime-Inr | $8.19 | $40.95 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Additional Charge | $8.19 | $40.95 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Protime-Inr, Fingerstick | $8.19 | $40.95 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Prothrombin Mixing Study | $8.19 | $40.95 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $58.59 | $292.95 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Assay Thyroid Stim Hormone - POCT Thyroid Stimulating Hormone | $58.59 | $292.95 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis, Auto, W/Scope - Urinalysis Microscopic | $22.05 | $110.25 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis, Auto, W/Scope - Bundled Charge | $22.05 | $110.25 | 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 - POCT Urinalysis Dipstick | $4.83 | $24.15 | 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 | $875.91 | $4,379.55 | 80% |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy Single/Multiple - Colonoscopy | $879.06 | $4,395.30 | 80% |
| Colonoscopy, diagnostic CPT 45378 HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy | $821.31 | $4,106.55 | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $441.21 | $2,206.05 | 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 | $818.79 | $4,093.95 | 80% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Esophagogastroduodenoscopy Transoral Diagnostic | $832.86 | $4,164.30 | 80% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Preventive checkup, new patient aged 18–39 CPT 99385 HC Preventive Visit,New,18-39 | $25.83 | $129.15 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC Preventive Visit,New,40-64 | $26.25 | $131.25 | 80% |
Source file: https://cayugahealth.pt.panaceainc.com/MRFDownload/CayugaHealth/schuylerhospital