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 |
|---|---|---|---|---|
| Rsect hip tum incl femur CPT 27078 | not published | not published | $1,495.77 – $2,302.58 | 2 |
| Rsv assay w/optic CPT 87807 | $30.86 | $47.47 | $8.74 – $29.48 | 10 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $17.60 – $22.56 | 2 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $41.95 – $65.23 | 2 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $42.50 – $65.23 | 2 |
| Rtm tx mgmt 1st 20 min CPT 98980 | not published | not published | $21.69 – $37.77 | 2 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | not published | not published | $21.41 – $37.65 | 2 |
| Rubella antibody igg CPT 86762 | $52.10 | $80.15 | $6.82 – $32.38 | 10 |
| Rubeola ag if CPT 87283 | not published | not published | $14.43 – $72.96 | 8 |
| Rubeola antibody igg CPT 86765 | $46.60 | $71.70 | $8.59 – $28.98 | 10 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $199.68 – $395.41 | 8 |
| Russell viper venom diluted CPT 85613 | $34.67 | $53.34 | $6.16 – $17.77 | 10 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $7,107.68 | $10,934.90 | $555.75 – $1,100.50 | 8 |
| Sach foot, replacement HCPCS L5971 | not published | not published | $248.63 – $248.63 | 5 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | not published | not published | $35.80 – $37.64 | 4 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $275.16 | $423.33 | $23.13 – $29.38 | 3 |
| Safety plan interven HCPCS G0560 | not published | not published | $33.69 – $67.29 | 2 |
| Salivary gland function exam CPT 78232 | not published | not published | $69.03 – $91.69 | 3 |
| Salivary gland imaging CPT 78230 | not published | not published | $111.60 – $170.53 | 3 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $68.76 – $97.43 | 3 |
| Salmonella antibody CPT 86768 | not published | not published | $8.79 – $20.56 | 10 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $623.82 – $912.89 | 2 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $79.64 – $138.59 | 2 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $1.17 – $1.17 | 1 |
| Sargramostim injection HCPCS J2820 | not published | not published | $37.71 – $72.58 | 4 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $24.43 – $61.72 | 8 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $136.50 – $191.92 | 2 |
| Sarscov coronavirus ag ia CPT 87426 | $120.26 | $185.01 | $26.25 – $61.06 | 10 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $18.56 – $84.35 | 10 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $297.65 – $533.25 | 2 |
| Sbrt management CPT 77435 | not published | not published | $534.03 – $1,086.68 | 3 |
| Sbsq ic vlbw inf<1,500 gm CPT 99478 | not published | not published | $97.44 – $170.00 | 2 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | not published | not published | $117.14 – $166.85 | 3 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | not published | not published | $25.20 – $85.58 | 4 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | not published | not published | $50.40 – $113.05 | 4 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | not published | not published | $25.20 – $54.48 | 3 |
| Sbsq psyc collab care mgmt CPT 99493 | $203.93 | $313.74 | $75.09 – $160.29 | 2 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | not published | not published | $116.58 – $192.35 | 3 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | not published | not published | $76.26 – $124.48 | 3 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $323.71 | $498.02 | $81.99 – $153.12 | 3 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $323.71 | $498.02 | $78.17 – $128.73 | 3 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $323.71 | $498.02 | $95.85 – $142.37 | 3 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $323.71 | $498.02 | $80.08 – $134.57 | 3 |
| Scan proc cranial extra CPT 61782 | not published | not published | $119.08 – $195.63 | 2 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $170.28 – $257.01 | 2 |
| Scan proc spinal CPT 61783 | not published | not published | $165.42 – $254.17 | 2 |
| Scap thorac prosth tiss shap HCPCS L6570 | not published | not published | $5,706.06 – $5,706.06 | 5 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | not published | not published | $87.12 – $137.47 | 2 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $346.25 – $487.71 | 2 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $10.10 – $22.25 | 8 |
| Scr c/v cyto,autosys and md HCPCS G0141 | not published | not published | $14.37 – $17.16 | 2 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $17.16 – $38.33 | 8 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $29.30 – $52.76 | 8 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $17.65 – $31.79 | 8 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $18.02 – $32.46 | 8 |
| Screen cerv/vag thin layer HCPCS G0123 | $73.31 | $112.79 | $13.50 – $24.31 | 8 |
| Screen c/v thin layer by md HCPCS G0124 | not published | not published | $14.37 – $19.93 | 2 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $136.40 – $189.07 | 2 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $136.19 – $188.79 | 2 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $57.57 | $88.57 | $3.71 – $21.66 | 8 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $102.30 | $157.39 | $17.13 – $33.92 | 8 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $135.87 | $209.03 | $11.78 – $55.62 | 8 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | not published | not published | $16.04 – $28.90 | 8 |
| Screening Mammogram CPT 77067 | $276.63 | $425.58 | $74.42 – $151.44 | 4 |
| Screening pap smear by phys HCPCS P3001 | not published | not published | $14.37 – $17.16 | 2 |
| Screening prostate cancer PSA HCPCS G0103 | $66.59 | $102.44 | $16.61 – $23.17 | 8 |
| Screen pap by tech w md supv HCPCS P3000 | $42.95 | $66.08 | $10.10 – $22.25 | 8 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $39.10 | $60.15 | $1.39 – $3.26 | 2 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $323.71 | $498.02 | $56.14 – $87.15 | 3 |
| Sc ther infusion reset pump CPT 96371 | not published | not published | $46.12 – $71.82 | 2 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | not published | not published | $649.64 – $907.09 | 2 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | not published | not published | $177.30 – $273.39 | 2 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | not published | not published | $4.30 – $7.04 | 2 |
| Sedimentation rate erythrocyte automated CPT 85652 | $9.76 | $15.02 | $1.81 – $4.54 | 10 |
| Seg acet and eth estr yearly HCPCS J7294 | not published | not published | $2,323.73 – $2,633.40 | 3 |
| Segmentectomy 32484 CPT 32484 | $15,583.72 | $23,974.95 | $1,096.95 – $1,581.09 | 2 |
| Select picture audiometry CPT 92583 | not published | not published | $50.14 – $54.75 | 2 |
| Self-adher band w>=3" <5"/yd HCPCS A6454 | not published | not published | $1.12 – $1.12 | 5 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $104.03 | $160.04 | $16.89 – $28.37 | 4 |
| Self-meas bp 2 readg bid 30d CPT 99474 | not published | not published | $6.73 – $17.76 | 2 |
| Self-meas bp pt educaj/train CPT 99473 | not published | not published | $12.48 – $12.83 | 2 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | not published | not published | $17.03 – $17.03 | 1 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | not published | not published | $12.62 – $12.62 | 1 |
| Semen analysis HCPCS G0027 | not published | not published | $5.59 – $7.80 | 8 |
| Semen analysis presence/motility CPT 89321 | $43.62 | $67.10 | $5.98 – $15.46 | 10 |
| Semen analysis w/count CPT 89310 | not published | not published | $5.74 – $10.33 | 8 |
| Sensorimotor examination CPT 92060 | not published | not published | $22.85 – $30.50 | 3 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $60.17 – $74.07 | 2 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $293.45 – $467.93 | 2 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $50.70 – $230.40 | 8 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $539.46 – $752.77 | 2 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $490.06 – $702.17 | 2 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $573.69 – $830.20 | 2 |
| Serial casting application 97139app CPT 97139 | not published | not published | $13.00 – $14.51 | 2 |
| Serial tonometry CPT 92100 | not published | not published | $21.99 – $40.18 | 2 |
| Sermorelin acetate injection HCPCS Q0515 | not published | not published | $1.44 – $1.44 | 1 |
| Serpina1 gene CPT 81332 | $157.96 | $243.02 | $37.54 – $98.21 | 10 |
| Sertraline (zoloft) - sendout CPT 80332 | $366.41 | $563.71 | $13.35 – $13.35 | 1 |
| Set radiation therapy field CPT 77280 | $342.80 | $527.39 | $154.14 – $264.50 | 3 |
| Set radiation therapy field CPT 77285 | $880.61 | $1,354.79 | $279.15 – $443.27 | 3 |
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.