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 |
|---|---|---|---|---|
| Socket insert knee articulat HCPCS L5656 | not published | not published | $593.52 – $593.52 | 5 |
| Socket insert symes HCPCS L5654 | not published | not published | $429.97 – $429.97 | 5 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $681.70 – $681.70 | 5 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $818.06 – $818.06 | 5 |
| Sock fracture or equal each HCPCS L3995 | $76.54 | $117.76 | $49.02 – $49.02 | 5 |
| Sock wool above knee HCPCS L8430 | not published | not published | $31.88 – $31.88 | 5 |
| Sodium 24 hour urine CPT 84300 | $17.59 | $27.06 | $3.37 – $11.32 | 10 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $4.57 | $7.03 | $1.99 – $6.30 | 4 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | not published | not published | $1.03 – $5.32 | 4 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $3.27 | $5.03 | $0.51 – $4.80 | 4 |
| Sodium chloride 3 % ivpb HCPCS J7131 | not published | not published | $0.02 – $0.16 | 3 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $3.56 | $5.47 | $1.94 – $7.63 | 4 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $388.93 | $598.36 | $70.28 – $114.00 | 4 |
| Sodium serum/plasma/whole blood CPT 84295 | $17.41 | $26.79 | $2.75 – $10.82 | 10 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | not published | not published | $0.77 – $0.79 | 2 |
| Soft interface below knee se HCPCS L2820 | $178.91 | $275.25 | $114.60 – $114.60 | 5 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $874.45 – $1,614.37 | 8 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $777.29 – $1,435.00 | 8 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $2,137.53 – $3,946.21 | 8 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $680.13 – $1,255.62 | 8 |
| Solid skin barrier HCPCS A4362 | not published | not published | $4.28 – $4.95 | 6 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $9.03 – $9.03 | 5 |
| Somatosensory testing CPT 95927 | not published | not published | $115.31 – $117.13 | 3 |
| Somatropin injection HCPCS J2941 | not published | not published | $100.83 – $182.17 | 3 |
| So neo gsap dna/dna&rna CPT 81459 | $9,754.50 | $15,006.92 | $1,943.21 – $3,587.46 | 8 |
| So neo gsap dna mcrstl ins CPT 81457 | $2,438.62 | $3,751.73 | $582.97 – $1,076.24 | 8 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $21.87 – $21.87 | 1 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $191.58 – $191.58 | 5 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $22.05 – $22.05 | 1 |
| Sp bone agrft morsel add-on CPT 20937 | not published | not published | $118.65 – $185.42 | 2 |
| Sp bone agrft struct add-on CPT 20938 | not published | not published | $130.85 – $203.27 | 2 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $503.04 – $503.04 | 1 |
| Special physics consult CPT 77370 | $286.81 | $441.24 | $122.28 – $248.83 | 3 |
| Special pump services CPT 99190 | not published | not published | $473.29 – $524.82 | 2 |
| Special pump services CPT 99191 | not published | not published | $330.86 – $367.11 | 2 |
| Special pump services CPT 99192 | not published | not published | $237.01 – $262.32 | 2 |
| Special radiation dosimetry CPT 77331 | $342.80 | $527.39 | $15.76 – $20.94 | 3 |
| Special radiation treatment CPT 77470 | $1,422.46 | $2,188.40 | $27.94 – $64.12 | 3 |
| Special supplies phys/qhp CPT 99070 | not published | not published | $53.12 – $53.12 | 1 |
| Special teletx port plan CPT 77321 | $880.61 | $1,354.79 | $36.50 – $59.78 | 3 |
| Specific gravity body fluid CPT 84315 | $9.62 | $14.80 | $1.74 – $3.94 | 8 |
| Specimen fat stain CPT 89125 | $17.24 | $26.52 | $3.92 – $7.06 | 8 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $726.03 | $1,116.97 | $157.14 – $256.96 | 4 |
| Speech audiometry complete CPT 92556 | not published | not published | $37.86 – $42.44 | 2 |
| Speech evaluation complex CPT 70371 | not published | not published | $50.56 – $72.12 | 3 |
| Speech recep thresh CPT 92555 | not published | not published | $24.22 – $26.77 | 2 |
| Speech Therapy Session (one-on-one) CPT 92507 | $241.41 | $371.40 | $64.01 – $92.29 | 4 |
| Sperm antibody test CPT 89325 | not published | not published | $7.11 – $12.80 | 8 |
| Sperm evaluation test CPT 89329 | not published | not published | $13.05 – $23.51 | 8 |
| Sperm identification CPT 89257 | not published | not published | $161.00 – $161.00 | 1 |
| Sperm isolation complex CPT 89261 | not published | not published | $127.49 – $127.49 | 1 |
| Sperm isolation simple CPT 89260 | not published | not published | $44.57 – $44.57 | 1 |
| Sperm washing 58323 CPT 58323 | not published | not published | $8.49 – $12.89 | 2 |
| Sphenoid sinus surgery CPT 31051 | not published | not published | $521.74 – $726.91 | 2 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | not published | not published | $563.73 – $957.76 | 2 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $78.57 – $122.22 | 2 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,161.14 | $1,786.37 | $61.19 – $101.79 | 2 |
| Spine X-ray (single view, one level) CPT 72020 | $201.75 | $310.38 | $13.03 – $17.52 | 3 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $98.57 – $169.29 | 2 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $60.48 – $104.11 | 2 |
| Spleen imaging CPT 78185 | not published | not published | $112.96 – $170.93 | 3 |
| Splenectomy total open 38100 CPT 38100 | not published | not published | $870.65 – $1,279.59 | 2 |
| Splice spleen/kidney veins CPT 37181 | not published | not published | $1,728.33 – $2,571.06 | 2 |
| Splicing of ureters CPT 50770 | not published | not published | $852.77 – $1,311.64 | 2 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $814.88 | $1,253.66 | $459.14 – $459.14 | 5 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $86.65 | $133.31 | $55.50 – $55.50 | 5 |
| Splint finger fold over sm HCPCS L3924 | $152.70 | $234.93 | $97.81 – $97.81 | 5 |
| Splint finger frog med HCPCS L3927 | $59.55 | $91.61 | $38.15 – $38.15 | 5 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $2.89 | $4.45 | $2.50 – $2.68 | 6 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $152.70 | $234.93 | $97.81 – $97.81 | 5 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $505.04 – $777.11 | 2 |
| Split blood or products CPT 86985 | not published | not published | $4.24 – $4.24 | 1 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $88.17 – $88.17 | 5 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | not published | not published | $97.24 – $149.09 | 2 |
| Spontaneous nystagmus study CPT 92531 | not published | not published | $21.82 – $21.82 | 1 |
| Sprchoroidal spc njx rx agt CPT 67516 | not published | not published | $66.51 – $92.81 | 2 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $785.31 – $785.31 | 5 |
| Sputum specimen collection CPT 89220 | $961.42 | $1,479.10 | $12.07 – $17.12 | 2 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $3,600.00 – $4,500.00 | 3 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $1,064.77 – $1,507.70 | 2 |
| Srs cranial lesion simple CPT 61796 | not published | not published | $806.59 – $1,106.60 | 2 |
| Srs cran les complex addl CPT 61799 | not published | not published | $218.17 – $331.66 | 2 |
| Srs cran les simple addl CPT 61797 | not published | not published | $158.25 – $239.53 | 2 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $106.29 – $239.15 | 10 |
| Srs linear based CPT 77372 | not published | not published | $761.50 – $1,178.02 | 3 |
| Srs multisource CPT 77371 | not published | not published | $1,178.14 – $1,411.60 | 2 |
| Srs spinal lesion CPT 63620 | not published | not published | $885.96 – $1,222.79 | 2 |
| Srs spinal lesion addl CPT 63621 | not published | not published | $182.53 – $276.11 | 2 |
| Staggered spondaic word test CPT 92572 | not published | not published | $42.28 – $49.32 | 2 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $263.85 – $263.85 | 5 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $345.81 | $532.02 | $75.10 – $122.39 | 4 |
| Stance phase only HCPCS L5858 | not published | not published | $22,336.47 – $22,336.47 | 5 |
| Standard control cable extra HCPCS L6655 | not published | not published | $97.87 – $97.87 | 5 |
| Staph a dna amp probe CPT 87640 | $77.79 | $119.68 | $21.64 – $48.69 | 10 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $201.26 – $201.26 | 5 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $61.92 – $61.92 | 5 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $61.92 – $61.92 | 5 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $329.97 | $507.64 | $86.21 – $140.79 | 3 |
| Stem cells total count CPT 86367 | $196.95 | $303.00 | $15.24 – $93.34 | 10 |
| Stenger test pure tone CPT 92565 | not published | not published | $18.21 – $18.94 | 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.