Gouverneur Hospital
Gouverneur Hospital in Gouverneur, NY publishes cash prices for 49 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
77 West Barney Street, Gouverneur, NY 13642 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 COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST | $2,772.77 | $4,265.80 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC COMPUTED TOMOGRAPHY_ ABD _ PELVIS_ W CONTRAST | $2,772.77 | $4,265.80 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD_BRAIN WO CONTRAST | $1,597.00 | $2,456.92 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD_BRAIN WO CONTRAST | $1,597.00 | $2,456.92 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $1,309.46 | $2,014.56 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $1,309.46 | $2,014.56 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $474.10 | $729.39 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $474.10 | $729.39 | 35% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $407.64 | $627.14 | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $407.64 | $627.14 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST | $3,043.12 | $4,681.72 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY ANY JOINT WO CONTRAST | $3,043.12 | $4,681.72 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY ANY JOINT WO _ W CONTRAST | $4,929.48 | $7,583.81 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY ANY JOINT WO _ W CONTRAST | $4,929.48 | $7,583.81 | 35% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN INCLUDING BRAIN STEM WO CONTRAST | $2,253.77 | $3,467.34 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN INCLUDING BRAIN STEM WO CONTRAST | $2,253.77 | $3,467.34 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WO _ W CONTRAST | $3,681.54 | $5,663.91 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN WO _ W CONTRAST | $3,681.54 | $5,663.91 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $2,642.74 | $4,065.75 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $2,642.74 | $4,065.75 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION | $305.96 | $470.71 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANT UTERUS_ AFTER 1ST TRIMESTER_ SINGLE OR 1ST GESTATION | $305.96 | $470.71 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $319.04 | $490.83 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $319.04 | $490.83 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED | $3,340.24 | $5,138.83 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY_ AGE 6 OR OLDER_ SLEEP STAGING W 4_MORE PARAMETERS_ TECH ATTENDED | $3,340.24 | $5,138.83 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 HC US ECHOGRAPHY_TRANSVAGINAL | $493.27 | $758.88 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US ECHOGRAPHY_TRANSVAGINAL | $493.27 | $758.88 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE | $944.78 | $1,453.51 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ECHOGRAPHY_ ABDOMINAL_ COMPLETE | $944.78 | $1,453.51 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $414.03 | $636.97 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $414.03 | $636.97 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL _8_ | $120.17 | $184.87 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL _8_ | $120.17 | $184.87 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE | $118.34 | $182.06 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE | $118.34 | $182.06 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC WITH AUTO DIFFERENTIAL | $77.30 | $118.93 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH AUTO DIFFERENTIAL | $77.30 | $118.93 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC _HEMOGRAM _ PLT_ | $77.30 | $118.93 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC _HEMOGRAM _ PLT_ | $77.30 | $118.93 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL _14_ | $254.57 | $391.65 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL _14_ | $254.57 | $391.65 | 35% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $184.97 | $284.57 | 35% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $184.97 | $284.57 | 35% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL _7_ | $149.47 | $229.96 | 35% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL _7_ | $149.47 | $229.96 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA_ FREE | $91.57 | $140.88 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA_ FREE | $91.57 | $140.88 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA_ TOTAL | $58.56 | $90.10 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA_ TOTAL | $58.56 | $90.10 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT | $52.02 | $80.03 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC APTT | $52.02 | $80.03 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $52.02 | $80.03 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $52.02 | $80.03 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE _TSH_ | $135.17 | $207.96 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE _TSH_ | $135.17 | $207.96 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS _ ROUTINE | $80.30 | $123.54 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS _ ROUTINE | $80.30 | $123.54 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS WO MICROSCOPY | $52.76 | $81.17 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS WO MICROSCOPY | $52.76 | $81.17 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIPSTICK_ NON_AUTOMATED | $43.96 | $67.63 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIPSTICK_ NON_AUTOMATED | $43.96 | $67.63 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING | $1,581.07 | $2,432.42 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJECTION EPIDURAL_SUBARACHNOID LUMBAR_SACRAL WITH IMAGING | $1,581.07 | $2,432.42 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL | $2,385.11 | $3,669.40 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ ANESTH__STEROID_TRANSFORAMINAL EPIDURAL_IMAGE GUIDE_FLUOR_CT__LUMBAR_SACARAL_SINGLE LVL | $2,385.11 | $3,669.40 | 35% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH | $4,551.46 | $7,002.24 | 35% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE_ NEEDLE OR PUNCH SINGLE OR MULTIPLE ANY APPROACH | $4,551.46 | $7,002.24 | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC ELECTROCARDIOGRAM COMPLETE | $61.23 | $94.20 | 35% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC ELECTROCARDIOGRAM COMPLETE | $61.23 | $94.20 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $279.24 | $429.60 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC OASAS FAMILY PSYCHOTHERAPY W_PATIENT PRESENT 50 MINS | $279.24 | $429.60 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $279.24 | $429.60 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OMH FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $279.24 | $429.60 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ W PATIENT PRESENT | $279.24 | $429.60 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC OASAS FAMILY PSYCHOTHERAPY W_PATIENT PRESENT 50 MINS | $279.24 | $429.60 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT | $209.24 | $321.91 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $209.24 | $321.91 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 HC OMH FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $209.24 | $321.91 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OMH FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $209.24 | $321.91 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC OASAS_ FAMILY PSYCHOTHERAPY WO PATIENT PRESENT | $209.24 | $321.91 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY _CONJOINT PSYCHOTHERAPY_ WO PATIENT PRESENT | $209.24 | $321.91 | 35% |
| Group psychotherapy session CPT 90853 HC OASAS GROUP PSYCHOTHERAPY | $108.47 | $166.88 | 35% |
| Group psychotherapy session CPT 90853 HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP | $108.47 | $166.88 | 35% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ | $206.48 | $317.66 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC OASAS GROUP PSYCHOTHERAPY | $108.47 | $166.88 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC OMH GROUP PSYCHOTHERAPY_ OTHER THAN OF A MULTI_FAMILY GROUP | $108.47 | $166.88 | 35% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY _OTHER THAN OF A MULTIPLE_FAMILY GROUP_ | $206.48 | $317.66 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC BHN E_M NEW PATIENT LEVEL 3 | $113.86 | $175.17 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OMH E_M NEW PATIENT LEVEL 3 | $113.86 | $175.17 | 35% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES | $225.26 | $346.55 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC BHN E_M NEW PATIENT LEVEL 3 | $113.86 | $175.17 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OMH E_M NEW PATIENT LEVEL 3 | $113.86 | $175.17 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE_OUTPATIENT NEW LOW MDM 30 MINUTES | $225.26 | $346.55 | 35% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES | $294.06 | $452.40 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE_OUTPATIENT NEW MODERATE MDM 45 MINUTES | $294.06 | $452.40 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 5 | $236.93 | $364.51 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OMH E_M NEW PATIENT LEVEL 5 | $236.93 | $364.51 | 35% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES | $281.87 | $433.65 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OMH E_M MED MANAGEMENT NEW PATIENT LEVEL 5 | $236.93 | $364.51 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OMH E_M NEW PATIENT LEVEL 5 | $236.93 | $364.51 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE_OUTPATIENT NEW HIGH MDM 60 MINUTES | $281.87 | $433.65 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $61.54 | $94.67 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $61.54 | $94.67 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $61.54 | $94.67 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISE_ EA 15MIN_ 1 OR MORE AREAS | $61.54 | $94.67 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS | $112.46 | $173.02 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 18 THROUGH 39 YEARS | $112.46 | $173.02 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS | $131.23 | $201.89 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC INITIAL PREVENTIVE E_M_ NEW PATIENT_ AGE 40 THROUGH 64 YEARS | $131.23 | $201.89 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC OMH PSYCHOTHERAPY_ 30 MINS_ W PATIENT AND_OR FAMILY MEMBER | $209.24 | $321.91 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS | $209.24 | $321.91 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER | $209.24 | $321.91 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OMH PSYCHOTHERAPY_ 30 MINS_ W PATIENT AND_OR FAMILY MEMBER | $209.24 | $321.91 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY 30 MINUTES WITH PATIENT AND_OR FAMILY MEMBER | $209.24 | $321.91 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ UP TO 44 MINS | $209.24 | $321.91 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER | $188.60 | $290.16 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC OMH PSYCHOTHERAPY_ 45 MINS_ W PATIENT AND_OR FAMILY MEMBER | $196.14 | $301.76 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC BHN PSYCHOTHERAPY 45MINS | $196.14 | $301.76 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ 45_ MINS | $196.14 | $301.76 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY 45 MINUTES W PATIENT AND_OR FAMILY MEMBER | $188.60 | $290.16 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC OASAS INDIVIDUAL COUNSELING _ PSYCHOTHERAPY_ 45_ MINS | $196.14 | $301.76 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC BHN PSYCHOTHERAPY 45MINS | $196.14 | $301.76 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC OMH PSYCHOTHERAPY_ 45 MINS_ W PATIENT AND_OR FAMILY MEMBER | $196.14 | $301.76 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER | $196.14 | $301.76 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY 60 MINUTES W PATIENT | $349.25 | $537.31 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC OMH PSYCHOTHERAPY_ 60 MINS_ W PATIENT AND_OR FAMILY MEMBER | $196.14 | $301.76 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY 60 MINUTES W PATIENT | $349.25 | $537.31 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE | $158.91 | $244.47 | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE_ 40 MIN FACE_TO_FACE | $158.91 | $244.47 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE | $298.91 | $459.86 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OFFICE CONSULT_ NEW_ESTABLISHED PATIENT_ MODERATE TO HIGH_ 60 MIN FACE_TO_FACE | $298.91 | $459.86 | 35% |
Source file: https://msc.rochesterregional.org/practitionerPortal/docs/MRF2026/464249555_gouverneur-hospital_standardcharges.csv