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 |
|---|---|---|---|---|
| Sickling rbc CPT 85660 | $19.93 | $30.66 | $3.67 – $6.61 | 8 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $55.18 – $92.45 | 2 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $82.84 – $149.24 | 2 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $87.75 – $152.78 | 2 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $51.49 – $85.55 | 2 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $118.59 – $208.73 | 2 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $79.23 – $135.52 | 2 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $113.29 – $200.88 | 2 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $145.43 – $258.02 | 2 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $90.06 – $155.39 | 2 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $92.48 – $160.59 | 2 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $125.52 – $220.82 | 2 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $71.29 – $120.73 | 2 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $16.85 – $22.53 | 3 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $59.76 – $100.18 | 2 |
| Sildenafil citrate, 25 mg HCPCS S0090 | not published | not published | $0.26 – $0.72 | 3 |
| Silicon gel insert w/wo lock HCPCS L6692 | not published | not published | $694.42 – $694.42 | 5 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $99.73 – $161.48 | 3 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | not published | not published | $101.29 – $121.40 | 4 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $17.17 – $26.14 | 3 |
| Single pivot hinge pair HCPCS L6605 | not published | not published | $302.33 – $302.33 | 5 |
| Single transfer toe-hand CPT 26553 | not published | not published | $2,410.37 – $3,622.94 | 2 |
| Sinus CT scan (with and without contrast) CPT 70488 | $799.16 | $1,229.47 | $102.46 – $208.50 | 3 |
| Sinus CT scan (with contrast) CPT 70487 | $799.16 | $1,229.47 | $81.18 – $165.18 | 3 |
| Sinus CT scan (without contrast) CPT 70486 | $499.36 | $768.24 | $72.24 – $147.00 | 3 |
| Sinus/juglr venogram s&i CPT 75860 | $5,491.15 | $8,447.92 | $62.07 – $126.32 | 3 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $268.83 – $407.39 | 2 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $453.57 – $643.99 | 2 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $391.67 – $543.92 | 2 |
| Sinus X-ray (complete) CPT 70220 | $201.75 | $310.38 | $22.31 – $28.74 | 3 |
| Sinus X-ray (limited) CPT 70210 | $201.75 | $310.38 | $19.57 – $24.83 | 3 |
| Sio flex pelvisacral custom HCPCS L0622 | not published | not published | $296.87 – $296.87 | 5 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | not published | not published | $120.32 – $120.32 | 5 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $54,404.11 – $77,820.00 | 3 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $0.74 – $17.08 | 4 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $81.42 – $117.63 | 4 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $371.19 – $371.19 | 5 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $141.36 | $217.47 | $9.00 – $9.00 | 1 |
| Skel musc relaxant 3 or more CPT 80370 | not published | not published | $15.91 – $15.91 | 1 |
| Skin and muscle repair face CPT 15845 | not published | not published | $792.22 – $1,134.12 | 2 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $7.32 – $8.94 | 6 |
| Skin Biopsy CPT 11102 | $497.06 | $764.71 | $25.05 – $43.33 | 2 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $496.63 – $750.64 | 2 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $73.68 – $121.77 | 2 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $549.09 – $829.29 | 2 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $549.76 – $816.55 | 2 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $81.85 – $123.96 | 2 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $3.76 – $5.38 | 2 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $1,915.74 – $2,729.62 | 2 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $3,342.94 – $4,536.43 | 2 |
| Skull X-ray (1 to 3 views) CPT 70250 | $261.20 | $401.84 | $22.03 – $27.93 | 3 |
| Skull X-ray (complete) CPT 70260 | $261.20 | $401.84 | $25.03 – $32.64 | 3 |
| Skyla, 13.5 mg HCPCS J7301 | $2,136.54 | $3,286.99 | $650.32 – $1,072.06 | 3 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $105.93 – $209.77 | 8 |
| Sleep study attended CPT 95807 | not published | not published | $313.04 – $470.22 | 3 |
| Sleep Study (Polysomnography) CPT 95810 | not published | not published | $451.65 – $695.59 | 3 |
| Sleep study unattended CPT 95806 | not published | not published | $47.61 – $182.84 | 3 |
| Sleeve fing rolyan med HCPCS L3933 | $413.35 | $635.92 | $232.89 – $232.89 | 5 |
| Sleeve irr assura 1pc disp HCPCS A4397 | not published | not published | $5.15 – $5.15 | 1 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $2,289.68 – $3,388.96 | 2 |
| Sling arm deluxe w/pad xs HCPCS A4565 | not published | not published | $10.98 – $10.98 | 5 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $67.12 – $67.12 | 5 |
| Slitting of prepuce CPT 54000 | not published | not published | $86.49 – $123.21 | 2 |
| Slitting of prepuce CPT 54001 | not published | not published | $107.10 – $157.87 | 2 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $38.83 – $38.83 | 1 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $104.63 – $104.63 | 1 |
| Slp pure tone screening CPT 92551 | not published | not published | $12.73 – $12.73 | 1 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $51.16 – $97.52 | 3 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $83.56 – $83.56 | 1 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $19,539.46 – $19,539.46 | 1 |
| Small animal inoculation CPT 87003 | not published | not published | $11.22 – $20.21 | 8 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $336.54 | $517.76 | $65.97 – $97.83 | 3 |
| Small bowel endoscopy CPT 44360 | not published | not published | $105.89 – $186.80 | 2 |
| Small bowel endoscopy CPT 44364 | not published | not published | $149.67 – $266.55 | 2 |
| Small bowel endoscopy CPT 44366 | not published | not published | $174.74 – $312.46 | 2 |
| Small bowel endoscopy CPT 44369 | not published | not published | $179.13 – $320.09 | 2 |
| Small bowel endoscopy CPT 44376 | not published | not published | $206.41 – $370.39 | 2 |
| Small bowel endoscopy CPT 44378 | not published | not published | $278.13 – $502.14 | 2 |
| Small bowel endoscopy CPT 44382 | not published | not published | $56.11 – $94.99 | 2 |
| Small bowel endoscopy CPT 44384 | not published | not published | $111.69 – $199.45 | 2 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $140.69 – $249.57 | 2 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $133.54 – $236.84 | 2 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $116.70 – $206.75 | 2 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $216.52 – $389.88 | 2 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $43.97 – $72.95 | 2 |
| Small bowel endoscopy br/wa CPT 44381 | not published | not published | $64.04 – $108.30 | 2 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $195.47 – $346.15 | 2 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $19.49 | $29.99 | $3.59 – $12.13 | 10 |
| Smear gram stain CPT 87205 | $15.44 | $23.76 | $2.85 – $7.72 | 10 |
| Smear nasal eosinophil CPT 89190 | $17.18 | $26.43 | $3.86 – $10.69 | 10 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $21.70 | $33.38 | $3.99 – $13.48 | 10 |
| Smear wet mount CPT 87210 | $17.06 | $26.25 | $3.43 – $7.72 | 10 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $182.62 – $361.62 | 8 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $94.17 – $222.24 | 10 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $28.48 – $56.40 | 8 |
| Snrpn/ube3a gene CPT 81331 | $142.57 | $219.34 | $30.95 – $61.28 | 8 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $1,290.37 – $1,290.37 | 5 |
| So cap design without jnts cf HCPCS L3671 | $1,745.84 | $2,685.90 | $983.68 – $983.68 | 5 |
| Socket insert above knee HCPCS L5658 | not published | not published | $479.22 – $479.22 | 5 |
| Socket insert below knee HCPCS L5655 | $652.18 | $1,003.35 | $417.77 – $417.77 | 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.