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Gouverneur Hospital

Gouverneur, New York · Critical Access · Voluntary non-profit - Private · CCN 331315

700%

median commercial rate vs. Medicare here

procedures with published commercial rates

Procedure	Commercial median	Medicare	% of Medicare	Est. cost*	Plan rates
Basic metabolic panelCPT 80048	$59	$8	700%	—	2
Complete blood count with differentialCPT 85025	$54	$8	700%	—	2
Complete blood count, automatedCPT 85027	$45	$6	700%	—	2
Comprehensive metabolic panelCPT 80053	$74	$11	700%	—	2
Family psychotherapy, with patientCPT 90847	$92	$181	51%	—	2
Family psychotherapy, without patientCPT 90846	$88	$181	49%	—	2
Group psychotherapyCPT 90853	$30	$104	29%	—	2
Kidney function panelCPT 80069	$61	$9	700%	—	2
Lipid panelCPT 80061	$94	$13	700%	—	2
Liver function panelCPT 80076	$57	$8	700%	—	2
Obstetric blood test panelCPT 80055	$335	$48	700%	—	2
Office visit, established patient, level 3CPT 99213	$101	—	—	—	2
Office visit, established patient, level 4CPT 99214	$149	—	—	—	2
Office visit, new patient, level 3CPT 99203	$142	—	—	—	2
Office visit, new patient, level 4CPT 99204	$216	—	—	—	2
Office visit, new patient, level 5CPT 99205	$272	—	—	—	2
PSA (prostate specific antigen), totalCPT 84153	$129	$18	700%	—	2
Partial thromboplastin timeCPT 85730	$42	$6	700%	—	2
Physical therapy, therapeutic exerciseCPT 97110	$60	—	—	—	1
Prothrombin timeCPT 85610	$30	$4	700%	—	2
Psychotherapy, 30 minutesCPT 90832	$34	$181	19%	—	2
Psychotherapy, 45 minutesCPT 90834	$73	$181	40%	—	2
Psychotherapy, 60 minutesCPT 90837	$80	$181	44%	—	2
Thyroid stimulating hormone (TSH)CPT 84443	$118	$17	700%	—	2
Urinalysis, automated, with microscopyCPT 81001	$22	$3	700%	—	2
Urinalysis, automated, without microscopyCPT 81003	$16	$2	700%	—	2
Urinalysis, manual, with microscopyCPT 81000	$28	$4	700%	—	2
Urinalysis, manual, without microscopyCPT 81002	$24	$3	700%	—	2

Click any column to sort. *Estimated from this hospital’s federal cost-report cost-to-charge ratio; approximate, least precise for imaging and labs (~). Sources and method on the methodology page. To put this hospital beside others, open it in the explorer.

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Rexroad Analytics · Data: hospital machine-readable files (45 CFR 180, schema v3.0) retrieved September 28 – October 6, 2026; Medicare benchmarks from CMS claims data and fee schedules; cost estimates from FY2026 CMS cost-report ratios, labeled as estimates. Not medical, legal, or benefits advice. Full methodology → · The American Healthcare Conundrum →