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Ira Davenport Memorial Hospital

Bath, NY · CMS ID: 330144

This hospital has pricing data for 33 procedures ranging from $8 to $9,117.

Procedures (33)

C-Section Delivery

59510
Cash Price
(No Insurance)
$8
Gross Charge
$8
Insurance Negotiated Rates
Healthnow - All Plans$3

Chest X-Ray 1 View

71045
Cash Price
(No Insurance)
$343
Gross Charge
$343
Insurance Negotiated Rates
Blue Cross Blue Shield$34

Chest X-Ray 2 Views

71046
Cash Price
(No Insurance)
$426
Gross Charge
$426
Insurance Negotiated Rates
Blue Cross Blue Shield$34

Complete Blood Count (CBC)

85025
Cash Price
(No Insurance)
$149
Gross Charge
$149
Insurance Negotiated Rates
Blue Cross Blue Shield$8

Comprehensive Metabolic Panel

80053
Cash Price
(No Insurance)
$362
Gross Charge
$362
Insurance Negotiated Rates
Blue Cross Blue Shield$11

CT Abdomen/Pelvis with Contrast

74177
Cash Price
(No Insurance)
$6,508
Gross Charge
$6,508
Insurance Negotiated Rates
Blue Cross Blue Shield$353

CT Abdomen/Pelvis without Contrast

74176
Cash Price
(No Insurance)
$4,904
Gross Charge
$4,904
Insurance Negotiated Rates
Blue Cross Blue Shield$286

CT Chest Low Dose

71271
Cash Price
(No Insurance)
$2,304
Gross Charge
$2,304
Insurance Negotiated Rates
Blue Cross Blue Shield$126

CT Chest with Contrast

71260
Cash Price
(No Insurance)
$2,621
Gross Charge
$2,621
Insurance Negotiated Rates
Blue Cross Blue Shield$211

ER Visit Level 3

99283
Cash Price
(No Insurance)
$695
Gross Charge
$695
Insurance Negotiated Rates
Blue Cross Blue Shield$328

ER Visit Level 4

99284
Cash Price
(No Insurance)
$1,088
Gross Charge
$1,088
Insurance Negotiated Rates
Blue Cross Blue Shield$504

ER Visit Level 5

99285
Cash Price
(No Insurance)
$1,480
Gross Charge
$1,480
Insurance Negotiated Rates
UnitedHealthcare$696

Fetal Non-Stress Test

59025
Cash Price
(No Insurance)
$1,446
Gross Charge
$1,446
Insurance Negotiated Rates
Blue Cross Blue Shield$48

Hemoglobin A1C

83036
Cash Price
(No Insurance)
$212
Gross Charge
$212
Insurance Negotiated Rates
Blue Cross Blue Shield$8

Knee Replacement

27447
Cash Price
(No Insurance)
$7,795
Gross Charge
$7,795
Insurance Negotiated Rates
Fidelis Care - Exchange - All Plans$4,287

Knee X-Ray

73560
Cash Price
(No Insurance)
$1,007
Gross Charge
$1,007
Insurance Negotiated Rates
Blue Cross Blue Shield$34

Lipid Panel

80061
Cash Price
(No Insurance)
$348
Gross Charge
$348
Insurance Negotiated Rates
Blue Cross Blue Shield$13

Mammogram Diagnostic

77066
Cash Price
(No Insurance)
$1,042
Gross Charge
$1,042
Insurance Negotiated Rates
Blue Cross Blue Shield$121

Mammogram Screening

77067
Cash Price
(No Insurance)
$564
Gross Charge
$564
Insurance Negotiated Rates
Blue Cross Blue Shield$119

MRI Brain

70551
Cash Price
(No Insurance)
$2,976
Gross Charge
$2,976
Insurance Negotiated Rates
Blue Cross Blue Shield$286

MRI Brain with Contrast

70553
Cash Price
(No Insurance)
$6,230
Gross Charge
$6,230
Insurance Negotiated Rates
Blue Cross Blue Shield$423

MRI Cervical Spine

72141
Cash Price
(No Insurance)
$4,528
Gross Charge
$4,528
Insurance Negotiated Rates
Blue Cross Blue Shield$286

MRI Knee

73721
Cash Price
(No Insurance)
$9,117
Gross Charge
$9,117
Insurance Negotiated Rates
Blue Cross Blue Shield$286

MRI Lumbar Spine

72148
Cash Price
(No Insurance)
$5,078
Gross Charge
$5,078
Insurance Negotiated Rates
Blue Cross Blue Shield$286

MRI Shoulder

73221
Cash Price
(No Insurance)
$8,696
Gross Charge
$8,696
Insurance Negotiated Rates
Blue Cross Blue Shield$286

Office Visit Level 3

99213
Cash Price
(No Insurance)
$312
Gross Charge
$312
Insurance Negotiated Rates
Blue Cross Blue Shield$62

Office Visit Level 4

99214
Cash Price
(No Insurance)
$342
Gross Charge
$342
Insurance Negotiated Rates
Fidelis Care - Exchange - All Plans$83

Shoulder X-Ray

73030
Cash Price
(No Insurance)
$956
Gross Charge
$956
Insurance Negotiated Rates
Blue Cross Blue Shield$34

TSH (Thyroid)

84443
Cash Price
(No Insurance)
$375
Gross Charge
$375
Insurance Negotiated Rates
Blue Cross Blue Shield$17

Ultrasound Abdomen

76700
Cash Price
(No Insurance)
$1,562
Gross Charge
$1,562
Insurance Negotiated Rates
Blue Cross Blue Shield$126

Ultrasound Pelvis

76856
Cash Price
(No Insurance)
$1,088
Gross Charge
$1,088
Insurance Negotiated Rates
Blue Cross Blue Shield$126

Ultrasound Transvaginal

76830
Cash Price
(No Insurance)
$941
Gross Charge
$941
Insurance Negotiated Rates
Blue Cross Blue Shield$126

Urinalysis

81001
Cash Price
(No Insurance)
$77
Gross Charge
$77
Insurance Negotiated Rates
Blue Cross Blue Shield$3