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 |
|---|---|---|---|---|
| Revision orbitofacial bones CPT 21275 | not published | not published | $625.72 – $938.80 | 2 |
| Revision/removal of kneecap CPT 27424 | not published | not published | $574.46 – $831.02 | 2 |
| Revision tips CPT 37183 | not published | not published | $267.87 – $430.82 | 2 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $1,177.00 – $1,807.59 | 2 |
| Revis reconst shoulder joint CPT 23474 | not published | not published | $1,268.03 – $1,952.23 | 2 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $103.97 – $209.56 | 2 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $103.97 – $265.90 | 2 |
| Revj fem anast autog vn grf CPT 35884 | not published | not published | $911.87 – $1,363.71 | 2 |
| Revj fem anast nonautog grf CPT 35883 | $9,733.81 | $14,975.09 | $876.93 – $1,329.28 | 2 |
| Revj mstdc rsltg compl mstdc CPT 69601 | not published | not published | $744.79 – $1,151.09 | 2 |
| Revj mstdc rsltg tympanplsty CPT 69604 | not published | not published | $811.39 – $1,235.05 | 2 |
| Revj open gstr rstcv px CPT 43848 | not published | not published | $1,450.85 – $2,429.55 | 2 |
| Revj prior hypspad repair CPT 54352 | not published | not published | $1,042.99 – $1,611.97 | 2 |
| Rev mastoidectomy rsltg modf rad mstdc 69602 CPT 69602 | not published | not published | $794.83 – $1,207.60 | 2 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $248.26 – $412.78 | 2 |
| Rev/rmvl gstr nstim eltrd CPT 43882 | not published | not published | $1,033.10 – $1,033.10 | 1 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $111.96 – $161.99 | 2 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | not published | not published | $142.01 – $172.78 | 2 |
| Rev rplcm arthrp 1ntrspc crv CPT 22861 | not published | not published | $1,786.64 – $2,450.22 | 2 |
| Rev rplcm rthrp 1ntrspc lmbr CPT 22862 | not published | not published | $1,803.15 – $2,388.83 | 2 |
| Rev/rplcmt sk-mnt crnl nstm CPT 61891 | not published | not published | $580.14 – $669.66 | 2 |
| Rev rplc/rmv thrc vrt tethrg CPT 22838 | not published | not published | $1,399.69 – $1,853.31 | 2 |
| Rev/rplct hpglsl nstm ary pg CPT 64583 | not published | not published | $614.50 – $813.78 | 2 |
| Revsc opn/prq tib/pero stent CPT 37234 | not published | not published | $318.69 – $318.69 | 1 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | not published | not published | $10.42 – $11.00 | 3 |
| Rf abltj nrv nrvtg si jt CPT 64625 | not published | not published | $146.77 – $221.35 | 2 |
| Rheumatoid factor qualitative CPT 86430 | $20.51 | $31.56 | $4.09 – $11.09 | 10 |
| Rheumatoid factor quantitative CPT 86431 | $20.51 | $31.56 | $3.79 – $11.81 | 10 |
| Rh ig IV CPT 90386 | not published | not published | $11.66 – $36.21 | 2 |
| Rh ig minidose im CPT 90385 | not published | not published | $29.84 – $35.22 | 2 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | not published | not published | $978.51 – $1,301.78 | 2 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $10.25 | $15.77 | $4.83 – $11.66 | 4 |
| Rho d immune globulin 50 mcg HCPCS J2788 | $1.44 | $2.22 | $22.93 – $35.22 | 4 |
| Rho(d) immune globulin h, sd HCPCS J2792 | not published | not published | $22.24 – $43.19 | 4 |
| Rho d immune globulin inj HCPCS J2790 | $171.83 | $264.36 | $77.16 – $91.88 | 4 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $82.83 – $91.88 | 2 |
| R hrt cath chd abnl nt cnj CPT 93594 | $6,095.95 | $9,378.39 | $306.57 – $306.57 | 1 |
| R hrt cath chd nml nt cnj CPT 93593 | $6,095.95 | $9,378.39 | $194.98 – $194.98 | 1 |
| Rhythm ecg with report CPT 93040 | not published | not published | $12.35 – $25.13 | 3 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $275.16 | $423.33 | $23.67 – $30.45 | 3 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $275.16 | $423.33 | $29.67 – $38.72 | 3 |
| Rib cartilage graft CPT 21230 | not published | not published | $542.17 – $831.65 | 2 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $106.49 – $106.49 | 5 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $2,061.00 – $2,416.80 | 3 |
| Rib X-ray (3 views, both sides) CPT 71110 | $275.16 | $423.33 | $23.94 – $31.18 | 3 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | not published | not published | $0.15 – $0.17 | 2 |
| Right heart cath congenital CPT 93530 | not published | not published | $679.24 – $679.24 | 1 |
| Right ventric recording CPT 93603 | not published | not published | $70.04 – $92.86 | 2 |
| Rilonacept injection HCPCS J2793 | not published | not published | $21.82 – $28.72 | 3 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $7.26 – $7.26 | 5 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $293.49 – $293.49 | 5 |
| Ring flange plastic/leather HCPCS L1100 | not published | not published | $187.61 – $187.61 | 5 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,324.91 | $2,038.33 | $848.70 – $848.70 | 5 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | not published | not published | $5.09 – $7.26 | 6 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | not published | not published | $14.53 – $18.27 | 4 |
| Risk ascvd tst once pr 12 mo HCPCS G0537 | not published | not published | $6.73 – $14.11 | 2 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $24.90 | $38.31 | $8.01 – $13.42 | 4 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $198.47 | $305.34 | $73.28 – $112.74 | 4 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $36.39 – $56.37 | 4 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | not published | not published | $30.15 – $101.47 | 4 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $18.53 – $86.02 | 4 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $102.71 | $158.02 | $13.27 – $86.02 | 4 |
| R & l heart cath congenital CPT 93531 | not published | not published | $1,407.57 – $1,407.57 | 1 |
| R & l heart cath congenital CPT 93532 | not published | not published | $1,673.74 – $1,673.74 | 1 |
| R & l heart cath congenital CPT 93533 | not published | not published | $1,499.25 – $1,499.25 | 1 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | $6,095.95 | $9,378.39 | $446.43 – $446.43 | 1 |
| R&l hrt cath chd nml nt cnj CPT 93596 | $6,095.95 | $9,378.39 | $335.18 – $335.18 | 1 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | not published | not published | $845.94 – $1,219.18 | 2 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $1,522.71 | $2,342.63 | $65.86 – $104.56 | 2 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | $521.14 – $835.05 | 2 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $268.63 – $377.20 | 2 |
| Rmvl fb upr arm/elbow deep CPT 24201 | not published | not published | $320.20 – $403.90 | 2 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | not published | not published | $189.45 – $291.30 | 2 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $3,619.96 | $5,569.17 | $117.04 – $155.51 | 2 |
| Rmvl hpglsl nstim ary pg CPT 64584 | not published | not published | $520.76 – $685.56 | 2 |
| Rmvl i-artic rx delivery dev 20705 CPT 20705 | not published | not published | $86.74 – $135.80 | 2 |
| Rmvl icd by tv extr CPT 33244 | not published | not published | $622.96 – $960.73 | 2 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | not published | not published | $278.29 – $431.97 | 2 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | not published | not published | $288.88 – $450.62 | 2 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | not published | not published | $267.76 – $414.72 | 2 |
| Rmvl icd pulse gen only CPT 33241 | not published | not published | $160.83 – $239.46 | 2 |
| Rmvl imed rx delivery device CPT 20703 | not published | not published | $73.51 – $113.64 | 2 |
| Rmvl left heart vent thor inscn ecmo CPT 33989 | not published | not published | $366.56 – $542.41 | 2 |
| Rmvl lung xcp tot pneumonectomy sleeve lob 32486 CPT 32486 | not published | not published | $1,763.04 – $2,601.39 | 2 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $1,562.18 | $2,403.35 | $121.61 – $177.54 | 2 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | not published | not published | $148.87 – $197.09 | 2 |
| Rmvl perm pm pulse gen CPT 33233 | not published | not published | $172.84 – $256.53 | 2 |
| Rmvl perq right heart vad CPT 33997 | not published | not published | $113.52 – $173.05 | 2 |
| Rmvl phrnc nrv stim pg only CPT 33280 | not published | not published | $156.19 – $198.71 | 2 |
| Rmvl phrnc nrv stim sys CPT 33278 | not published | not published | $404.81 – $538.71 | 2 |
| Rmvl phrnc nrv stim transvns CPT 33279 | not published | not published | $250.58 – $325.72 | 2 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | not published | not published | $268.02 – $416.63 | 2 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | not published | not published | $245.46 – $376.30 | 2 |
| Rmvl pq iabp CPT 33968 | not published | not published | $24.18 – $37.67 | 2 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | not published | not published | $133.95 – $219.99 | 2 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | not published | not published | $936.73 – $1,408.60 | 2 |
| Rmvl sq defib electrode CPT 33272 | not published | not published | $252.37 – $386.06 | 2 |
| Rmvl subq card rhythm mntr CPT 33286 | not published | not published | $60.67 – $97.13 | 2 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | not published | not published | $356.24 – $422.08 | 2 |
| Rmvl tongs/halo anthr indiv CPT 20665 | not published | not published | $71.26 – $104.78 | 2 |
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.