How many shoppable procedure prices are published for Gouverneur Hospital?

Gouverneur Hospital in Gouverneur, NY currently has 108 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Gouverneur Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Gouverneur Hospital's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 4/1/2026

Gouverneur Hospital

77 West Barney Street, Gouverneur, NY 13642 · 108 Priced Procedures

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.91×vs. Fair Market Price

Typical commercial prices here are 9% below the fair benchmark (0.91×) after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 24% of the Time

File Completeness60

Price Logic88

Peer Alignment78

Clean Billing72

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Gouverneur Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.1× Medicare, p50 0.95× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 1.00× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#28 of 92 in NY · 29th State Percentile#729 of 3,385 in U.S. · 21st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 9% below peer Fair BaseRate (0.91×)
Self-pay cash beats commercial insurance on 24% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (69/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (13.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
Commercial insurance median sits at 0.95× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.3× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 7,323) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.1× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.91× Divergence

1.0× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+5% Upper Tail

Q25 0.68× · Q50 0.95× · Q75 1.00×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.4× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.2× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.5× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.3× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

24% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 69/100Fair

Procedure Prices at Gouverneur Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 108 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sleep study (overnight, in lab) CPT Code: `95810`	$3,340	$3,340	$1,021	3.3×
Injection procedure for pain management HCPCS Code: `G0260`	$1,895	$1,895	$855	2.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,373	$1,373	$583	2.4×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,033	$1,033	$272	3.8×
Blood transfusion CPT Code: `36430`	$966	$966	$498	1.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,682	$510	$511	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$404	$404	$201	2.0×
Rabies immune globulin HCPCS Code: `90375`	—	$402	$322	1.2×
MRI, lower back (no contrast) CPT Code: `72148`	$2,643	$331	$338	1.0×
MRI, brain (no contrast) CPT Code: `70551`	$2,254	$331	$343	1.0×
MRI, knee or other leg joint CPT Code: `73721`	$3,043	$327	$369	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$251	$251	$64	3.9×
X-ray, chest (two views) CPT Code: `71046`	$276	$276	$93	3.0×
X-ray, chest (single view) CPT Code: `71045`	$205	$205	$92	2.2×
X-ray, pelvis CPT Code: `72170`	$227	$227	$110	2.1×
CT scan, sinuses CPT Code: `70486`	$1,199	$197	$166	1.2×
CT scan, chest (no contrast) CPT Code: `71250`	$1,597	$197	$167	1.2×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,199	$197	$168	1.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,199	$197	$169	1.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,107	$199	$258	0.8×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,773	$204	$448	0.5×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$170	$151	1.1×
New patient office visit (30-44 min) CPT Code: `99203`	$225	$142	$110	1.3×
CT scan, pelvis CPT Code: `72192`	$759	$156	$163	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$2,091	$164	$242	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$474	$126	$148	0.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$945	$106	$134	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$1,597	$126	$160	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,900	$129	$303	0.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$181	$149	$123	unverified
Care planning with family CPT Code: `90887`	—	$95	$107	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$327	$110	$185	0.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$84	$84	$35	2.4×
Prosthetic fitting and training CPT Code: `97761`	$95	$82	$45	1.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$193	$101	$87	1.2×
Screening mammogram (both breasts) CPT Code: `77067`	$319	$103	$123	0.8×
Ultrasound, pelvis CPT Code: `76856`	$945	$80	$130	0.6×
Family therapy session CPT Code: `90847`	$279	$92	$173	0.5×
Psychotherapy session (60 minutes) CPT Code: `90837`	$273	$80	$181	0.4×
Speech therapy (language evaluation) CPT Code: `92507`	$84	$84	$86	unverified
Typhoid vaccine HCPCS Code: `90675`	$512	$455	$347	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$192	$203	0.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$163	$163	$20	unverified
Drug screening test HCPCS Code: `G0480`	$158	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$184	$133	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$177	$104	$111	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$61	$61	$25	2.4×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$56	$69	$38	1.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$62	$69	$38	1.8×
Occupational therapy (self-care training) CPT Code: `97535`	$77	$67	$38	1.8×
Speech therapy (group session) CPT Code: `92508`	—	$47	$27	1.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$62	$60	$35	1.7×
Physical therapy (manual therapy) CPT Code: `97140`	$70	$56	$34	1.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$184	$53	$56	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$708	$76	$132	0.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$728	$68	$126	0.5×
Psychotherapy session (45 minutes) CPT Code: `90834`	$192	$73	$166	0.4×
Physical therapy (gait training) CPT Code: `97116`	$45	$60	$33	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$52	$33	$37	0.9×
Review of medical records for care CPT Code: `90889`	—	$52	$114	0.5×
Neurobehavioral status check CPT Code: `96116`	—	$72	$231	0.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$72	$27	$14	1.9×
Community mental health services HCPCS Code: `H0038`	$15	$15	$16	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$43	$33	$49	0.7×
Flu vaccine injection HCPCS Code: `G0008`	$21	$21	$48	0.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$21	$21	$49	0.4×
Psychological testing evaluation CPT Code: `96136`	$229	$45	$128	0.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$45	$45	$40	unverified
Orthotic fitting and training CPT Code: `97760`	$62	$62	$51	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$255	$11	$11	1.0×
Blood test, vitamin D CPT Code: `82306`	$143	$30	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$80	$3	$3	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$151	$14	$14	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$123	$15	$16	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$118	$13	$14	0.9×
Blood test, liver function panel CPT Code: `80076`	$149	$8	$9	0.9×
X-ray, hip CPT Code: `73502`	$266	$33	$93	0.4×
X-ray, lower back CPT Code: `72110`	$414	$36	$112	0.3×
Blood test, calcium CPT Code: `82310`	$68	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$56	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$56	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$118	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$94	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$109	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$62	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$59	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$55	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$77	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$52	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$27	$9	$9	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$59	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$135	$17	$18	0.9×
Hepatitis C antibody test CPT Code: `86803`	$45	$14	$15	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$31	$23	$25	0.9×
Culture, blood CPT Code: `87040`	$110	$10	$11	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$120	$8	$9	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$47	$32	$39	0.8×
Blood test, amylase CPT Code: `82150`	$66	$6	$7	0.9×
Group therapy session CPT Code: `90853`	$157	$30	$100	0.3×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$52	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	$37	$2	$3	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$247	$25	$93	0.3×
X-ray, hand CPT Code: `73130`	$219	$21	$93	0.2×
X-ray, ankle CPT Code: `73610`	$233	$21	$93	0.2×
X-ray, shoulder CPT Code: `73030`	$226	$20	$92	0.2×
X-ray, foot CPT Code: `73630`	$229	$20	$92	0.2×
Blood antibody screen CPT Code: `86850`	$56	$10	$46	0.2×
Psychological testing by technician CPT Code: `96138`	—	$29	$395	0.1×

Showing top 25 high-impact procedures of 108 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 13.1%

Audit a Bill or Quote at Gouverneur Hospital (Zero PHI Required)

CMS CCN: 331315

CPT 95810

Select Procedure to Audit:

Fair BaseRate™ $1,021

Medicare Rate $877

Self-Pay Cash $3,340

Insurer Median $3,340

1. Amount on Your Bill or Quote ($) Pre-filled with Gouverneur Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $671 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $671

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (13.1% of gross = $671).

Step 2 · Cash vs. Insurance Arbitrage Save $1,799 Paying Cash

Self-Pay Cash Rate ($3,340) Beats Your Bill

Gouverneur Hospital's published 45 CFR § 180 self-pay cash rate is $3,340 (vs. $3,340 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$4,118 Above Fair BaseRate

Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)

Your bill ($5,139) is $4,118 above the denoised Fair BaseRate ($1,021) and 5.9× the $877 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 464249555

Filing Period: 201409

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (13.1% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite69/100

Median ER Wait74 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Gouverneur Hospital.

Price Index: 1.00× regional baseline

Quality: 56/100 CMS composite

Median Household Income$61,900U.S. Census ACS

Local Uninsured Share5.9%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 331315 EIN 464249555

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 331315) ↗ Verify IRS Form 990 (EIN 464249555) ↗ CMS HCRIS Cost Reports ↗

Published MRF File464249555_gouverneur-hospital_standardcharges.csv

Publication / Vintage4/1/2026 · 8.62 MB

Validated Rate Rows237 (CMS v3.0.0)

File Integrity DigestVerified · CCN 331315

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy