Nicholas H Noyes Memorial Hospital

111 Clara Barton Street, Dansville, NY 14437 · (585) 335-6001

Acute Care HospitalsVoluntary non-profit - PrivateCMS rating 3/5Rochester, NY metro Website ↗

Price file

Prices published

File dated 2026-01-01

5,126 price rows for 68 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · metro median $31

$22

cash

$6 to $16

37 negotiated rates

$45

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $669

$528

cash

$65 to $1,036

47 negotiated rates

$1,057

list

CT scan of the head, no contrast

CPT 70450 · metro median $304

$158

cash

$73 to $310

47 negotiated rates

$315

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $438

$264

cash

$103 to $521

47 negotiated rates

$527

list

Cataract surgery with lens implant

CPT 66984 · metro median $3,221

$3,221

cash

$1,012 to $6,851

19 negotiated rates

$5,402

list

Cesarean delivery with prenatal and postpartum care

CPT 59510

—

cash

$877 to $6,416

48 negotiated rates

—

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$5,134 to $13,487

12 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · metro median $127

$48

cash

$15 to $49

83 negotiated rates

$97

list

Colonoscopy (diagnostic)

CPT 45378 · metro median $798

$798

cash

$86 to $2,761

118 negotiated rates

$1,338

list

Colonoscopy with biopsy

CPT 45380 · metro median $822

$822

cash

$134 to $3,552

118 negotiated rates

$1,378

list

Colonoscopy with polyp removal

CPT 45385 · metro median $817

$547

cash

$122 to $3,552

118 negotiated rates

$917

list

Complete blood count (CBC) with differential

CPT 85025 · metro median $28

$14

cash

$3 to $11

37 negotiated rates

$27

list

Comprehensive metabolic panel (blood test)

CPT 80053 · metro median $38

$40

cash

$7 to $23

37 negotiated rates

$79

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $311

$208

cash

$59 to $220

47 negotiated rates

$415

list

Electrocardiogram (ECG) with interpretation

CPT 93000 · metro median $24

$24

cash

$10 to $35

79 negotiated rates

$40

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 2 lines · metro median $234

$100

cash

$35 to $440

103 negotiated rates

$200

list

Family psychotherapy with the patient

CPT 90847 · lowest of 3 lines · metro median $294

$82

cash

$51 to $497

103 negotiated rates

$163

list

Family psychotherapy without the patient

CPT 90846 · lowest of 3 lines · metro median $294

$58

cash

$31 to $497

103 negotiated rates

$117

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$273 to $17,946

71 negotiated rates

—

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 2 lines · metro median $127

$62

cash

$15 to $49

83 negotiated rates

$106

list

Group psychotherapy

CPT 90853 · lowest of 3 lines · metro median $171

$28

cash

$11 to $284

103 negotiated rates

$57

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$10,329 to $27,134

12 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$4,175 to $10,967

12 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$6,644 to $17,453

12 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 3 lines · metro median $874

$639

cash

$192 to $10,628

71 negotiated rates

$1,072

list

Knee arthroscopy with meniscus repair

CPT 29881 · lowest of 2 lines · metro median $1,821

$1,821

cash

$256 to $9,713

71 negotiated rates

$3,054

list

Laser treatment after cataract surgery (YAG)

CPT 66821

—

cash

$448 to $1,633

19 negotiated rates

—

list

Left heart catheterization

CPT 93452

—

cash

$3,318 to $9,623

17 negotiated rates

—

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines · metro median $48

$23

cash

$6 to $18

37 negotiated rates

$39

list

Liver function panel

CPT 80076 · metro median $30

$28

cash

$6 to $16

37 negotiated rates

$56

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $907

$528

cash

$303 to $1,136

47 negotiated rates

$1,057

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · metro median $592

$358

cash

$244 to $1,136

47 negotiated rates

$715

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · metro median $592

$358

cash

$244 to $1,136

47 negotiated rates

$715

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $592

$358

cash

$244 to $1,136

47 negotiated rates

$715

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$13,073 to $34,342

12 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · metro median $1,448

$277

cash

$42 to $2,625

118 negotiated rates

$464

list

New patient office visit (about 30 minutes)

CPT 99203 · metro median $183

$113

cash

$25 to $335

106 negotiated rates

$190

list

New patient office visit (about 45 minutes)

CPT 99204 · metro median $224

$143

cash

$41 to $408

106 negotiated rates

$240

list

New patient office visit (about 60 minutes)

CPT 99205 · metro median $281

$173

cash

$53 to $539

103 negotiated rates

$290

list

PSA test (prostate)

CPT 84153 · lowest of 2 lines · metro median $67

$62

cash

$13 to $41

37 negotiated rates

$124

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 2 lines · metro median $22

$14

cash

$4 to $14

37 negotiated rates

$28

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 2 lines · metro median $70

$42

cash

$23 to $48

19 negotiated rates

$84

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · metro median $324

$377

cash

$33 to $310

47 negotiated rates

$754

list

Preventive visit, new patient age 18 to 39

CPT 99385 · lowest of 2 lines · metro median $323

$32

cash

$30 to $317

86 negotiated rates

$64

list

Preventive visit, new patient age 40 to 64

CPT 99386 · lowest of 2 lines · metro median $374

$38

cash

$37 to $366

86 negotiated rates

$75

list

Prostate biopsy

CPT 55700

—

cash

$57 to $839

29 negotiated rates

—

list

Prostate removal (laparoscopic)

CPT 55866

—

cash

$733 to $31,554

56 negotiated rates

—

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 2 lines · metro median $14

cash

$3 to $9

83 negotiated rates

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 3 lines · metro median $227

$53

cash

$18 to $497

105 negotiated rates

$106

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 3 lines · metro median $297

$83

cash

$27 to $497

105 negotiated rates

$166

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 3 lines · metro median $294

$107

cash

$41 to $497

105 negotiated rates

$214

list

Removal of a breast lump (biopsy by excision)

CPT 19120

—

cash

$153 to $11,623

118 negotiated rates

—

list

Screening mammogram (both breasts)

CPT 77067 · metro median $284

$166

cash

$59 to $220

47 negotiated rates

$332

list

Shoulder arthroscopy with decompression

CPT 29826 · lowest of 3 lines · metro median $290

$301

cash

$119 to $1,003

57 negotiated rates

$505

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 2 lines · metro median $1,019

$206

cash

$85 to $2,549

116 negotiated rates

$345

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $915

$532

cash

$41 to $2,625

118 negotiated rates

$892

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 2 lines · metro median $838

$210

cash

$47 to $2,095

118 negotiated rates

$353

list

TSH test (thyroid)

CPT 84443 · lowest of 2 lines · metro median $61

$38

cash

$7 to $23

83 negotiated rates

$77

list

Tonsils and adenoids removal (under age 12)

CPT 42820

—

cash

$117 to $17,573

54 negotiated rates

—

list

Transvaginal ultrasound

CPT 76830 · lowest of 3 lines · metro median $151

$55

cash

$25 to $310

110 negotiated rates

$93

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines · metro median $288

$191

cash

$22 to $310

143 negotiated rates

$321

list

Upper endoscopy (EGD)

CPT 43235 · metro median $1,077

$473

cash

$67 to $2,692

118 negotiated rates

$793

list

Upper endoscopy with biopsy

CPT 43239 · metro median $1,077

$618

cash

$84 to $2,692

114 negotiated rates

$1,036

list

Urinalysis with microscope

CPT 81001 · metro median $12

cash

$2 to $7

37 negotiated rates

$17

list

Vaginal delivery after a previous cesarean

CPT 59610

—

cash

$817 to $6,073

48 negotiated rates

—

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$3,610 to $9,484

12 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400

—

cash

$774 to $5,817

48 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines · metro median $256

$103

cash

$9 to $310

146 negotiated rates

$172

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.urmc.rochester.edu/getmedia/016bb4df-9b94-41b6-a803-c44ad94a879c/160743979-NICHOLAS-H-NOYES-MEMORIAL-HOSPITAL-standardcharges.csv
NICHOLAS H NOYES MEMORIAL HOSPITAL · parsed · tall v3.0.0 · file dated 2026-01-01 · 124.6 MB · 5126 price rows read · read Nov 2026