Clifton Springs Hospital and Clinic
2 Coulter Road, Clifton Springs, NY · Rochesterregional · · NPI 1366505463
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $105.94 | $162.98 | $15.15 – $35.14 | 10 |
| 17-hydroxypregnenolone CPT 84143 | $82.55 | $127.00 | $15.20 – $51.32 | 10 |
| 17-ketosteroids CPT 83586 | $46.32 | $71.26 | $8.52 – $21.35 | 10 |
| 1pc ost pch drain hgh output HCPCS A4435 | not published | not published | $8.21 – $8.21 | 5 |
| 1 pc ost pouch w filter HCPCS A5056 | not published | not published | $6.02 – $6.66 | 6 |
| 1 pc ost pou w built-in conv HCPCS A5057 | not published | not published | $13.68 – $13.68 | 5 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | not published | not published | $67.95 – $119.99 | 2 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | not published | not published | $654.52 – $1,138.71 | 2 |
| 1st psyc collab care mgmt CPT 99492 | $203.93 | $313.74 | $68.83 – $195.47 | 2 |
| 1st/sbsq psyc collab care CPT 99494 | $87.29 | $134.29 | $30.22 – $76.67 | 2 |
| 2019-ncov diagnostic p HCPCS U0001 | $100.26 | $154.24 | $21.77 – $43.10 | 8 |
| 24 hr ambulatory b/p monitor CPT 93786 | $335.52 | $516.18 | $19.31 – $31.17 | 3 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,494.22 | $2,298.80 | $283.51 – $283.51 | 1 |
| 2d tte w or without fol w/con,co HCPCS C8923 | not published | not published | $162.64 – $162.64 | 1 |
| 2nd order venous cath CPT 36012 | not published | not published | $126.04 – $195.82 | 2 |
| 3d ech img cgen car anomal CPT 93319 | $587.18 | $903.35 | $17.34 – $35.28 | 3 |
| 3-d radiotherapy plan CPT 77295 | $3,221.39 | $4,955.98 | $212.35 – $335.54 | 3 |
| 3d recon without postprocess indpndt CPT 76376 | $312.06 | $480.10 | $13.03 – $26.51 | 3 |
| 4-bar link above knee w/swng HCPCS L5614 | not published | not published | $2,028.06 – $2,028.06 | 5 |
| 5% dextrose and 0.45% saline HCPCS S5010 | not published | not published | $3.06 – $9.48 | 3 |
| 5% dextrose with potassium HCPCS S5012 | not published | not published | $4.56 – $5.62 | 3 |
| 5' nucleotidase - sendout CPT 83915 | $40.37 | $62.11 | $7.43 – $13.38 | 8 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $160.48 | $246.89 | $14.70 – $19.00 | 3 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $269.62 | $414.80 | $133.95 – $133.95 | 1 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $282.54 | $434.68 | $140.34 – $140.34 | 1 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $294.61 | $453.24 | $146.05 – $146.05 | 1 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $247.12 | $380.19 | $120.73 – $120.73 | 1 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $259.43 | $399.12 | $128.90 – $128.90 | 1 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $258.55 | $397.77 | $128.47 – $128.47 | 1 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $284.42 | $437.57 | $140.97 – $140.97 | 1 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $333.37 | $512.88 | $169.29 – $169.29 | 1 |
| Aa graft w/bp/aortic root replace 33863 CPT 33863 | not published | not published | $2,356.11 – $3,491.26 | 2 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $126.91 | $195.25 | $43.38 – $62.50 | 4 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $43.44 | $66.83 | $8.01 – $14.41 | 8 |
| Abciximab injection HCPCS J0130 | not published | not published | $1,117.10 – $1,117.10 | 1 |
| Abd aorta w/runoff s&i CPT 75630 | $5,491.15 | $8,447.92 | $52.53 – $106.89 | 3 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | not published | not published | $911.15 – $1,326.16 | 2 |
| Abd/low ext cath 1st CPT 36245 | $390.25 | $600.38 | $169.59 – $267.26 | 2 |
| Abd/low ext cath 2nd CPT 36246 | $1,081.39 | $1,663.67 | $180.50 – $284.63 | 2 |
| Abd/low ext cath 3rd CPT 36247 | $545.10 | $838.61 | $212.92 – $340.09 | 2 |
| Abd/low ext cath addl CPT 36248 | $295.68 | $454.89 | $34.39 – $55.90 | 2 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $666.26 | $1,025.02 | $153.29 – $283.95 | 3 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $323.71 | $498.02 | $97.01 – $153.12 | 3 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $799.16 | $1,229.47 | $158.95 – $318.91 | 3 |
| Abdominal CT scan (with contrast) CPT 74160 | $799.16 | $1,229.47 | $140.12 – $259.25 | 3 |
| Abdominal CT scan (without contrast) CPT 74150 | $499.36 | $768.24 | $66.51 – $135.34 | 3 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,510.60 | $2,324.00 | $191.35 – $345.44 | 3 |
| Abdominal MRI (with contrast) CPT 74182 | not published | not published | $180.44 – $325.00 | 3 |
| Abdominal MRI (without contrast) CPT 74181 | $956.04 | $1,470.83 | $103.83 – $211.28 | 3 |
| Abdominal pad HCPCS L1270 | not published | not published | $89.03 – $89.03 | 5 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,670.68 | $2,570.28 | $77.18 – $122.88 | 2 |
| Abdominal Ultrasound (complete) CPT 76700 | $323.71 | $498.02 | $62.63 – $90.68 | 3 |
| Abdominal Ultrasound (limited) CPT 76705 | $323.71 | $498.02 | $47.95 – $73.67 | 3 |
| Abdominal X-ray (2 views) CPT 74019 | $275.16 | $423.33 | $20.67 – $42.05 | 3 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $275.16 | $423.33 | $28.04 – $35.84 | 3 |
| Abdominal X-ray (single view) CPT 74018 | $201.75 | $310.38 | $17.12 – $34.84 | 3 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $872.06 – $1,307.00 | 2 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,706.90 | $2,626.00 | $58.45 – $82.96 | 2 |
| Abduct control hip semi-flex HCPCS L1630 | not published | not published | $194.72 – $194.72 | 5 |
| Abduction bar jointed adjust HCPCS L2300 | not published | not published | $412.52 – $412.52 | 5 |
| Abduction bar-straight HCPCS L2310 | not published | not published | $141.37 – $141.37 | 5 |
| Abduction rotation bar shoe HCPCS L3140 | not published | not published | $106.80 – $106.80 | 5 |
| Abduct rotation bar without shoe HCPCS L3150 | not published | not published | $97.63 – $97.63 | 5 |
| Abl1 gene CPT 81170 | $879.38 | $1,352.90 | $199.68 – $449.30 | 10 |
| Ablat 1/+thyr ndul addl prq rf CPT 60661 | not published | not published | $156.60 – $205.81 | 2 |
| Ablate arrhythmia add on CPT 93655 | not published | not published | $211.81 – $540.39 | 2 |
| Ablate atria lmtd endo 33265 CPT 33265 | not published | not published | $1,050.27 – $1,504.36 | 2 |
| Ablate atria w/bypass exten 33256 CPT 33256 | not published | not published | $1,483.73 – $2,148.70 | 2 |
| Ablate atria without bypass ext CPT 33255 | not published | not published | $1,259.36 – $1,808.68 | 2 |
| Ablate atria x10sv add-on 33258 CPT 33258 | not published | not published | $517.02 – $723.02 | 2 |
| Ablate atria x10sv endo 33266 CPT 33266 | not published | not published | $1,411.92 – $2,044.83 | 2 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | not published | not published | $250.98 – $395.24 | 2 |
| Ablate bone tumor(s) perq CPT 20982 | $11,101.16 | $17,078.71 | $264.95 – $415.14 | 2 |
| Ablate heart dysrhythm focus CPT 93650 | not published | not published | $403.71 – $749.92 | 2 |
| Ablate heart dysrhythm focus CPT 33250 | not published | not published | $1,130.45 – $1,604.89 | 2 |
| Ablate heart dysrhythm focus CPT 33251 | not published | not published | $1,242.67 – $1,795.10 | 2 |
| Ablate heart dysrhythm focus CPT 33261 | not published | not published | $1,245.70 – $1,788.62 | 2 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $150.67 – $213.79 | 2 |
| Ablate inf turbinate superf 30801 CPT 30801 | not published | not published | $115.07 – $158.59 | 2 |
| Ablate pulm tumor perq crybl CPT 32994 | not published | not published | $316.63 – $500.58 | 2 |
| Ablate pulm tumor perq rf CPT 32998 | not published | not published | $316.49 – $499.89 | 2 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $19,890.17 | $30,600.26 | not published | 0 |
| Ablation cryo adrenal tumor CPT 60699 | $11,865.51 | $18,254.63 | not published | 0 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $8,911.31 | $13,709.71 | not published | 0 |
| Ablation cryo pq liver tumor(s) CPT 47383 | not published | not published | $333.86 – $518.33 | 2 |
| Ablation cryo retro lymph node CPT 38999 | $798.20 | $1,228.00 | not published | 0 |
| Ablation cryo thigh/knee CPT 27599 | $544.83 | $838.20 | not published | 0 |
| Ablation ire liver 1+ tumor(s) w/image pq CPT 47384 | not published | not published | $352.14 – $352.14 | 1 |
| Ablation of upper extremity nerves rf CPT 64999 | $691.50 | $1,063.84 | not published | 0 |
| Abltj 1/+thyr ndul 1lobe prq CPT 60660 | not published | not published | $228.91 – $296.87 | 2 |
| Abltj mal prst8 tiss hifu CPT 55880 | not published | not published | $727.66 – $1,070.23 | 2 |
| Ablt trurl prst8 tis thrm Ultrasound CPT 55881 | not published | not published | $355.86 – $459.90 | 2 |
| Ablt trurl prst8 tis trnsdcr CPT 55882 | not published | not published | $436.05 – $564.15 | 2 |
| Abobotulinumtoxina HCPCS J0586 | $18.61 | $28.63 | $8.69 – $10.31 | 4 |
| Abortion CPT 59850 | not published | not published | $285.00 – $378.69 | 2 |
| Abortion (mpr) CPT 59866 | not published | not published | $171.09 – $229.77 | 2 |
| Above elbow prosth tiss shap HCPCS L6500 | not published | not published | $3,914.18 – $3,914.18 | 5 |
| Above knee cushion socket HCPCS L5648 | not published | not published | $895.76 – $895.76 | 5 |
| Above knee flex cover system HCPCS L5964 | not published | not published | $1,248.09 – $1,248.09 | 5 |
| Above knee hydracadence HCPCS L5610 | not published | not published | $2,534.66 – $2,534.66 | 5 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.