Medicine & Surgery
Laparoscopic cholecystectomy
CPT 47562
$7,374 - $31,006
from 2 insurers · median $19,190
Blue Cross$31,006
Insurer A*est.$7,374
Medicare $6,176
Typical for a hospital with this service line
Critical Access HospitalVoluntary Non-Profit - Private
Gouverneur Hospital
Saint Lawrence Health System · Gouverneur, NY
77 West Barney Street, Gouverneur, NY 13642(315) 287-1000
26
In-network payers
164
Disclosed rate categories
25
Beds
About this hospital
Gouverneur Hospital is a 25-bed voluntary non-profit - private hospital in Gouverneur, NY, affiliated with Saint Lawrence Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 26 in-network payers and 164 disclosed rate categories.
CCN (Medicare provider number)
331315
NPI
1629409925
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
25
Insurance Accepted
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthCenteneEMI Health
Prices for common services
The 24 services Gouverneur Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Gynecology
Laparoscopic hysterectomy with tube or ovary removal, uterus up to 250 g
CPT 58571
$55,330
negotiated rate
Blue Cross$55,330
Medicare $10,860
Typical for a hospital with this service line
Digestive procedures
Laparoscopic repair of an initial inguinal hernia
CPT 49650
$13,565 - $31,006
from 2 insurers · median $22,286
Blue Cross$31,006
Insurer A*est.$13,565
Medicare $6,176
Typical for a hospital with this service line
CT imaging
CT abdomen and pelvis with contrast
CPT 74177
$109 - $2,559
from 3 insurers · median $483
Aetna$483
Insurer A*$109
Insurer B*est.$2,559
Medicare $356Nearby hospitals $1,21560% below nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Cataract removal with lens insertion
CPT 66984
$4,807 - $12,121
from 2 insurers · median $8,464
Blue Cross$12,121
Insurer A*est.$4,807
Medicare $2,358
Typical for a hospital with this service line
Medicine & Surgery
Tonsillectomy and adenoidectomy, patient under age 12
CPT 42820
$5,385 - $31,438
from 2 insurers · median $18,412
Blue Cross$31,438
Insurer A*est.$5,385
Medicare $6,048
Typical for a hospital with this service line
Gynecology
Laparoscopic removal of an ovary or fallopian tube
CPT 58661
$8,670 - $31,006
from 2 insurers · median $19,838
Blue Cross$31,006
Insurer A*est.$8,670
Medicare $6,176
Typical for a hospital with this service line
Digestive procedures
Upper GI endoscopy with biopsy
CPT 43239
$4,243
negotiated rate
Blue Cross$4,243
Medicare $927
Typical for a hospital with this service line
CT imaging
CT head or brain without contrast
CPT 70450
$97 - $1,474
from 3 insurers · median $306
Aetna$306
Insurer A*$97
Insurer B*est.$1,474
Medicare $107Nearby hospitals $135127% above nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Laparoscopic radical prostatectomy
CPT 55866
$20,607 - $55,330
from 2 insurers · median $37,968
Blue Cross$55,330
Insurer A*est.$20,607
Medicare $10,860
Typical for a hospital with this service line
Mammography
Screening mammography, bilateral
CPT 77067
$98 - $253
from 3 insurers · median $194
Aetna$194
Insurer A*$98
Insurer B*est.$253
Medicare $92Nearby hospitals $15426% above nearby hospitals
Typical for a hospital with this service line
Digestive procedures
Laparoscopic gallbladder removal with bile-duct imaging
CPT 47563
$7,931 - $31,006
from 2 insurers · median $19,469
Blue Cross$31,006
Insurer A*est.$7,931
Medicare $6,176
Typical for a hospital with this service line
Gynecology
Hysteroscopy with sampling of the uterine lining
CPT 58558
$3,570 - $15,715
from 2 insurers · median $9,642
Blue Cross$15,715
Insurer A*est.$3,570
Medicare $3,307
Typical for a hospital with this service line
Orthopedics and pain
Arthroscopic ACL reconstruction
CPT 29888
$13,220 - $37,965
from 2 insurers · median $25,592
UnitedHealthcareest.$13,220
Insurer A*$37,965
Medicare $7,413
Typical for a hospital with this service line
CT imaging
CT angiography of chest blood vessels
CPT 71275
$141 - $2,273
from 3 insurers · median $570
Aetna$570
Insurer A*$141
Insurer B*est.$2,273
Medicare $179Nearby hospitals $29792% above nearby hospitals
Typical for a hospital with this service line
Orthopedics and pain
Lower-back disc decompression, one interspace
CPT 63030
$7,390 - $37,965
from 2 insurers · median $22,677
UnitedHealthcareest.$7,390
Insurer A*$37,965
Medicare $7,413
Typical for a hospital with this service line
Urology
Shock-wave treatment of kidney stones
CPT 50590
$10,494 - $18,329
from 2 insurers · median $14,411
Blue Cross$18,329
Insurer A*est.$10,494
Medicare $3,601
Typical for a hospital with this service line
Medicine & Surgery
Arthroscopic knee meniscectomy
CPT 29881
$5,681 - $17,243
from 2 insurers · median $11,462
Blue Cross$17,243
Insurer A*est.$5,681
Medicare $3,343
Typical for a hospital with this service line
X-ray and bone density
Chest X-ray, two views
CPT 71046
$43 - $219
from 2 insurers · median $131
Aetna$43
Insurer A*est.$219
Medicare $89Nearby hospitals $40226% above nearby hospitals
Typical for a hospital with this service line
Gynecology
Sling surgery for stress urinary incontinence
CPT 57288
$9,069 - $26,234
from 2 insurers · median $17,652
Blue Cross$26,234
Insurer A*est.$9,069
Medicare $5,111
Typical for a hospital with this service line
Cardiology and vascular testing
Ultrasound of veins in one limb or a limited bilateral study
CPT 93971
$94 - $871
from 3 insurers · median $630
UnitedHealthcareest.$630
Insurer A*$94
Insurer B*est.$871
Medicare $107Nearby hospitals $273131% above nearby hospitals
Typical for a hospital with this service line
CT imaging
CT of the abdomen and pelvis, without contrast
CPT 74176
$69 - $1,754
from 3 insurers · median $307
Aetna$307
Insurer A*$69
Insurer B*est.$1,754
Medicare $244Nearby hospitals $98469% below nearby hospitals
Typical for a hospital with this service line
Lung function and sleep
Attended overnight sleep study
CPT 95810
$2,651 - $5,407
from 3 insurers · median $3,668
Blue Cross$5,407
Insurer A*est.$2,651
Insurer B*est.$3,668
Medicare $877Nearby hospitals $561554% above nearby hospitals
Typical for a hospital with this service line
MRI imaging
MRI brain before and after contrast
CPT 70553
$505 - $3,398
from 3 insurers · median $640
Aetna$640
Insurer A*$505
Insurer B*est.$3,398
Medicare $356Nearby hospitals $1,42955% below nearby hospitals
Typical for a hospital with this service line
How the insurers pay at Gouverneur Hospital
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 23 | 502% | 0 | 6 |
| Insurer B* | 22 | 212% | 0 | 0 |
| Insurer C* | 9 | 210% | 9 | 0 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Gouverneur Hospital.
Location
77 West Barney Street, Gouverneur, NY 13642
(315) 287-1000
Comparable hospitals nearby
The nearest hospitals of similar type and size. Their rates are compared with Gouverneur Hospital for the same insurers and services above.
River Hospital
Alexandria Bay, NY · 22 mi · 15 bedsView rates
▼ Rates typically 56% lower than Gouverneur Hospital (22 services)
Carthage Area Hospital
Carthage, NY · 25 mi · 25 bedsView rates
Rates about the same as Gouverneur Hospital (9 services)
Clifton-Fine Hospital
Star Lake, NY · 25 mi · 20 bedsView rates
▼ Rates typically 55% lower than Gouverneur Hospital (22 services)
Lewis County General Hospital
Lowville, NY · 38 mi · 31 bedsView rates
▼ Rates typically 45% lower than Gouverneur Hospital (9 services)
Elizabethtown Community Hospital
Elizabethtown, NY · 93 mi · 25 bedsView rates
▲ Rates typically 43% higher than Gouverneur Hospital (10 services)
Little Falls Hospital
Little Falls, NY · 95 mi · 25 bedsView rates
▼ Rates typically 22% lower than Gouverneur Hospital (12 services)
Oconnor Hospital
Delhi, NYView rates
Cobleskill Regional Hospital
Cobleskill, NYView rates
Cuba Memorial Hospital Inc
Cuba, NYView rates
Frequently asked questions
About Gouverneur Hospital's rates and hospital price transparency.
How much does an MRI cost at Gouverneur Hospital?
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Gouverneur Hospital range from $505 to $3,398 across 3 insurers. Aetna's rate is $640. The median at nearby comparable hospitals is $1,429. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a CT scan cost at Gouverneur Hospital?
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Gouverneur Hospital range from $109 to $2,559 across 3 insurers. Aetna's rate is $483. The median at nearby comparable hospitals is $1,215. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a mammogram cost at Gouverneur Hospital?
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Gouverneur Hospital range from $98 to $253 across 3 insurers. Aetna's rate is $194. The median at nearby comparable hospitals is $154. What a patient pays depends on their plan's deductible, coinsurance and network status.
How many beds does Gouverneur Hospital have?
Gouverneur Hospital has 25 beds. Facility type: Critical Access Hospital.
Where is Gouverneur Hospital and what is its phone number?
Gouverneur Hospital is located at 77 West Barney Street, Gouverneur, NY 13642. Its main phone number is (315) 287-1000.
What is Gouverneur Hospital's CCN (Medicare provider number)?
Gouverneur Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 331315.
What is Gouverneur Hospital's NPI number?
The National Provider Identifier (NPI) on file for Gouverneur Hospital is 1629409925.
What health system is Gouverneur Hospital part of?
Gouverneur Hospital is affiliated with Saint Lawrence Health System.
Which insurance plans are in network at Gouverneur Hospital?
Gouverneur Hospital lists 26 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
What price transparency data is available for Gouverneur Hospital?
164 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
What is a hospital price transparency MRF?
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
What is a chargemaster review?
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
Running price transparency at a hospital like this one?
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
Publish a CMS-compliant machine-readable file
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
CMS v3 example: standard_charge_information[0]
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}- CMS template layout, in JSON or CSV
- Gross, discounted cash, payer-specific and de-identified min / max charges
- cms-hpt.txt file and homepage footer link
- Refreshed when your contracts change
Get your chargemaster right for billing and payer contracts
Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers
CodingPricingPayer contractsCompliance
- CPT, HCPCS, revenue code and modifier errors flagged line by line
- Missing, duplicate and outdated charge lines identified
- Charges set below payer allowables caught before lesser-of clauses cut payment
- Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
- Your negotiated rates benchmarked against peer hospitals for the same payers