Gouverneur Hospital prices. From its own published file.

Gouverneur Hospital in Gouverneur, NY publishes its standard charges as required by federal rule. Here's what it lists for common services, and how to check your bill against it.

5,274prices published

Apr 2026file last updated

$2,773cash price for ct abdomen and pelvis with contrast (list $4,266)

Common services

Service	Cash price	List price	Insurers pay
Emergency visit, moderate (level 3) `99283`	$369	$568	$144–$144
Emergency visit, high (level 4) `99284`	$664	$1,021	$144–$144
Emergency visit, highest (level 5) `99285`	$928	$1,427	$144–$144
Comprehensive metabolic panel `80053`	$255	$392	$10.10–$137
Basic metabolic panel `80048`	$120	$185	$7.32–$110
Complete blood count (CBC) `85025`	$77.30	$119	$3.20–$101
Blood draw (venipuncture) `36415`	$20.14	$30.99	$9.06–$121
Urinalysis `81001`	$80.30	$124	$3.07–$41.23
Troponin (heart test) `84484`	$100	$154	$8.13–$162
EKG tracing `93005`	$251	$386	—
Chest X-ray, 2 views `71046`	$276	$425	—
CT head without contrast `70450`	$1,597	$2,457	$126–$126
CT abdomen and pelvis with contrast `74177`	$2,773	$4,266	$204–$204
MRI lower back without contrast `72148`	$2,643	$4,066	$331–$331
Ultrasound, abdomen `76700`	$945	$1,454	$106–$106
IV push, single drug `96374`	$267	$411	—
IV fluids, first hour `96360`	$349	$538	—
Ketorolac injection, 15 mg `J1885`	$0.95	$1.46	$0.50–$1.97
Ondansetron injection `J2405`	$0.29	$0.45	$0.09–$0.22

Cash price: the discounted price for self-pay patients. List price: the hospital's gross charge. Insurers pay: the lowest and highest rates it lists for insurance plans. Source: Gouverneur Hospital price transparency page.

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Common billing problems to look for

Billed above the posted cash priceIf you're paying yourself, ask the hospital to apply its published cash price.
Panels billed inside panelsA basic metabolic panel (80048) billed with a comprehensive one (80053) on the same day.
Duplicate linesThe same service billed twice without explanation.
No itemized billYou can ask for every line with its code, date and amount.