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 |
|---|---|---|---|---|
| Set radiation therapy field CPT 77290 | $880.61 | $1,354.79 | $293.68 – $472.14 | 3 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | $17.52 – $40.26 | 2 |
| Set up port xray equipment HCPCS Q0092 | not published | not published | $20.94 – $24.66 | 2 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $0.01 | $0.02 | $0.01 – $0.30 | 2 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $0.40 | $0.61 | $0.05 – $0.05 | 2 |
| Sever cranial nerve CPT 64771 | not published | not published | $457.53 – $661.79 | 2 |
| Sewhfo airplane without jnts cf HCPCS L3976 | not published | not published | $1,834.09 – $1,834.09 | 5 |
| Sewhfo airplane w/jnt(s) cf HCPCS L3978 | not published | not published | $2,165.46 – $2,165.46 | 5 |
| Sewhfo cap desgn w/jnt(s) cf HCPCS L3977 | not published | not published | $2,055.53 – $2,055.53 | 5 |
| Sewhfo cap design without jnt cf HCPCS L3975 | not published | not published | $1,834.09 – $1,834.09 | 5 |
| Sewho airplane without jnts cf HCPCS L3967 | not published | not published | $2,165.46 – $2,165.46 | 5 |
| Sewho airplane w/jnt(s) cf HCPCS L3973 | not published | not published | $2,165.46 – $2,165.46 | 5 |
| Sewho cap design without jnts cf HCPCS L3961 | not published | not published | $1,834.09 – $1,834.09 | 5 |
| Sewho cap design w/jnt(s) cf HCPCS L3971 | not published | not published | $2,055.53 – $2,055.53 | 5 |
| Sewho erbs palsey design abd HCPCS L3962 | not published | not published | $806.80 – $806.80 | 5 |
| Sex chromatin identification CPT 88130 | not published | not published | $11.99 – $21.58 | 8 |
| Sex chromatin identification CPT 88140 | not published | not published | $5.32 – $9.59 | 8 |
| Sex transformation m to f CPT 55970 | not published | not published | $8,809.63 – $8,809.63 | 1 |
| Sf3b1 gene common variants CPT 81347 | not published | not published | $117.11 – $263.50 | 10 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $75.91 – $130.35 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | $30.37 – $52.63 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | $42.23 – $72.75 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | $50.29 – $85.91 | 2 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $64.18 – $110.55 | 2 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | not published | not published | $27.37 – $43.91 | 2 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | not published | not published | $34.07 – $57.21 | 2 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | not published | not published | $42.92 – $73.49 | 2 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | not published | not published | $49.97 – $83.57 | 2 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | not published | not published | $23.07 – $38.92 | 2 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | not published | not published | $34.80 – $59.06 | 2 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | not published | not published | $40.39 – $69.30 | 2 |
| Sheath above knee HCPCS L8410 | not published | not published | $31.15 – $31.15 | 5 |
| Sheath below knee HCPCS L8400 | not published | not published | $25.69 – $25.69 | 5 |
| Sheath upper limb HCPCS L8415 | not published | not published | $29.43 – $29.43 | 5 |
| Shigella antibody CPT 86771 | not published | not published | $8.11 – $29.38 | 10 |
| Shlder disart int lock elbow HCPCS L6300 | not published | not published | $5,536.03 – $5,536.03 | 5 |
| Shldr disar prosth tiss shap HCPCS L6550 | not published | not published | $4,668.36 – $4,668.36 | 5 |
| Shldr disartic myoelectronic HCPCS L6965 | not published | not published | $17,350.79 – $17,350.79 | 5 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $366.62 – $524.27 | 2 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $689.43 – $1,015.36 | 2 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $794.68 – $1,179.74 | 2 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $455.57 – $654.27 | 2 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $421.44 – $626.99 | 2 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $452.30 – $645.14 | 2 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $410.39 – $595.72 | 2 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $449.71 – $652.13 | 2 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $777.47 – $1,153.26 | 2 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $456.64 – $686.20 | 2 |
| Shoe clubfoot wedge HCPCS L3380 | not published | not published | $59.46 – $59.46 | 5 |
| Shoe dennis browne splint bo HCPCS L3640 | not published | not published | $51.86 – $51.86 | 5 |
| Shoe heel new leather standa HCPCS L3455 | not published | not published | $48.83 – $48.83 | 5 |
| Shoe heel new rubber standar HCPCS L3460 | not published | not published | $41.16 – $41.16 | 5 |
| Shoe heel pad & depress for HCPCS L3480 | not published | not published | $74.74 – $74.74 | 5 |
| Shoe heel sach cushion type HCPCS L3450 | not published | not published | $126.64 – $126.64 | 5 |
| Shoe heel thomas extend to b HCPCS L3470 | not published | not published | $74.74 – $74.74 | 5 |
| Shoe heel thomas with wedge HCPCS L3465 | not published | not published | $70.16 – $70.16 | 5 |
| Shoe lift elev heel/sole neo HCPCS L3310 | not published | not published | $97.63 – $97.63 | 5 |
| Shoe metatarsal bar between HCPCS L3410 | not published | not published | $111.35 – $111.35 | 5 |
| Shoe metatarsal bar wedge ro HCPCS L3400 | not published | not published | $48.83 – $48.83 | 5 |
| Shoe outflare wedge HCPCS L3390 | not published | not published | $59.46 – $59.46 | 5 |
| Shoe sole wedge between sole HCPCS L3370 | not published | not published | $59.46 – $59.46 | 5 |
| Shoe sole wedge outside sole HCPCS L3360 | not published | not published | $42.72 – $42.72 | 5 |
| Shoe wedge sach HCPCS L3340 | not published | not published | $102.26 – $102.26 | 5 |
| Sho heel count plast reinfor HCPCS L3430 | not published | not published | $192.22 – $192.22 | 5 |
| Sho insert w arch toe filler HCPCS L5000 | $965.64 | $1,485.60 | $618.56 – $618.56 | 5 |
| Sho lift taper to metatarsal HCPCS L3300 | not published | not published | $62.55 – $62.55 | 5 |
| Shortening of hand tendon CPT 26479 | not published | not published | $551.86 – $715.29 | 2 |
| Shortening of thigh bone CPT 27465 | not published | not published | $1,055.32 – $1,394.50 | 2 |
| Shorten/lengthen thighs CPT 27468 | not published | not published | $1,496.22 – $1,496.22 | 1 |
| Shorten radius or ulna CPT 25390 | not published | not published | $576.58 – $857.67 | 2 |
| Shorten radius & ulna CPT 25392 | not published | not published | $762.18 – $1,109.75 | 2 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $98.09 | $150.91 | $12.73 – $33.10 | 3 |
| Shoulder abduction joint pai HCPCS L6640 | not published | not published | $457.23 – $457.23 | 5 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $201.75 | $310.38 | $17.12 – $25.84 | 3 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $797.84 – $1,180.16 | 2 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $275.16 | $423.33 | $13.03 – $20.06 | 3 |
| Shoulder flexion-abduction j HCPCS L6645 | not published | not published | $395.10 – $395.10 | 5 |
| Shoulder harness HCPCS L5699 | not published | not published | $232.85 – $232.85 | 5 |
| Shoulder lock actuator HCPCS L6647 | not published | not published | $624.04 – $624.04 | 5 |
| Shoulder MRI (with and without contrast) CPT 73223 | $1,510.60 | $2,324.00 | $231.47 – $422.51 | 3 |
| Shoulder MRI (with contrast) CPT 73222 | $2,278.18 | $3,504.89 | $193.81 – $346.73 | 3 |
| Shoulder MRI (without contrast) CPT 73221 | $956.04 | $1,470.83 | $115.83 – $235.71 | 3 |
| Shoulder prosthesis removal CPT 23334 | not published | not published | $797.36 – $1,192.09 | 2 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $938.19 – $1,422.36 | 2 |
| Shoulder universal joint HCPCS L6650 | not published | not published | $474.60 – $474.60 | 5 |
| Shoulder X-ray CPT 73030 | $201.75 | $310.38 | $19.74 – $26.14 | 3 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $201.75 | $310.38 | $11.66 – $16.05 | 3 |
| Shrinker prosth above knee HCPCS L8460 | not published | not published | $81.59 – $81.59 | 5 |
| Shrinker prosth below knee HCPCS L8440 | $103.41 | $159.09 | $66.24 – $66.24 | 5 |
| Shrinker upper limb HCPCS L8465 | not published | not published | $59.71 – $59.71 | 5 |
| Shunt as-aort to pulm art CPT 33755 | not published | not published | $1,023.51 – $1,458.51 | 2 |
| Shunt central w/prostc graft CPT 33764 | not published | not published | $1,023.51 – $1,458.51 | 2 |
| Shunt desc aorta to pulm art CPT 33762 | not published | not published | $982.31 – $1,420.65 | 2 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $275.16 | $423.33 | $50.41 – $75.51 | 3 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $967.46 – $1,398.55 | 2 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $1,019.13 – $1,476.68 | 2 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $1,085.37 – $1,576.75 | 2 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $8.14 – $14.66 | 8 |
| Sialography s&i CPT 70390 | not published | not published | $76.07 – $106.60 | 3 |
| Sialolithotomy 42330 CPT 42330 | not published | not published | $123.62 – $184.05 | 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.