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 |
|---|---|---|---|---|
| Stenger test speech CPT 92577 | not published | not published | $16.34 – $18.48 | 2 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | not published | not published | $811.25 – $811.25 | 1 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $6,505.20 | $10,008.00 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $5,928.00 | $9,120.00 | not published | 0 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | not published | not published | $552.78 – $552.78 | 1 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | not published | not published | $237.47 – $237.47 | 1 |
| Stent placemt retro carotid CPT 37217 | not published | not published | $793.02 – $1,200.02 | 2 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | not published | not published | $780.98 – $780.98 | 1 |
| Stereoscopic x-ray guidance HCPCS G6002 | not published | not published | $53.69 – $60.74 | 2 |
| Stereotactic bx aspir/exc burr intracranial les 61750 CPT 61750 | not published | not published | $1,102.08 – $1,538.01 | 2 |
| Stereotactic radiation trmt CPT 77432 | not published | not published | $353.32 – $718.97 | 3 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.15 – $0.15 | 5 |
| Sterile needle HCPCS A4215 | not published | not published | $0.31 – $0.31 | 1 |
| Sterile water/saline, 10 ml HCPCS A4216 | $0.01 | $0.02 | $0.55 – $1.11 | 6 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $3.80 – $4.70 | 6 |
| Sternal debridement CPT 21627 | not published | not published | $451.97 – $596.42 | 2 |
| Sternal pad HCPCS L1050 | not published | not published | $95.68 – $95.68 | 5 |
| St evaluate speech sound production CPT 92522 | $352.99 | $543.06 | $75.78 – $124.93 | 4 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $288.16 | $443.32 | $76.30 – $104.89 | 3 |
| Stimulants synthetic CPT 80371 | $138.17 | $212.57 | $11.96 – $11.96 | 1 |
| Stimulation of spinal cord CPT 63610 | not published | not published | $435.16 – $634.68 | 2 |
| Stocking sup grips 4 pre ots HCPCS L0982 | not published | not published | $18.71 – $18.71 | 5 |
| Stoma absorptive cover HCPCS A5083 | not published | not published | $0.92 – $0.92 | 5 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $812.30 | $1,249.69 | $207.31 – $333.14 | 3 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $105.52 – $248.75 | 2 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $155.46 – $155.46 | 1 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $103.87 – $207.29 | 2 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $66.16 – $155.46 | 2 |
| Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 | not published | not published | $341.20 – $465.84 | 2 |
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $153.92 – $153.92 | 5 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $12.95 – $12.95 | 5 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $4.70 – $4.70 | 5 |
| Strapping of ankle and/or ft 29540 CPT 29540 | not published | not published | $12.88 – $20.65 | 3 |
| Strapping of chest CPT 29200 | not published | not published | $13.03 – $21.57 | 3 |
| Strapping of elbow or wrist 29260 CPT 29260 | not published | not published | $13.23 – $22.22 | 3 |
| Strapping of hand or finger CPT 29280 | not published | not published | $14.18 – $22.63 | 3 |
| Strapping of hip CPT 29520 | not published | not published | $13.03 – $21.63 | 2 |
| Strapping of knee CPT 29530 | not published | not published | $13.03 – $21.24 | 3 |
| Strapping of toes 29550 CPT 29550 | not published | not published | $8.12 – $13.10 | 2 |
| Strep a ag ia CPT 87430 | $49.27 | $75.80 | $5.25 – $20.17 | 10 |
| Strep a dna dir probe CPT 87650 | not published | not published | $6.65 – $24.06 | 10 |
| Strep a dna quant CPT 87652 | not published | not published | $20.87 – $50.11 | 8 |
| Strep b assay w/optic CPT 87802 | not published | not published | $8.47 – $15.28 | 8 |
| Strep b dna amp probe CPT 87653 | not published | not published | $21.64 – $48.69 | 10 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $75.00 – $75.00 | 1 |
| Streptokinase antibody CPT 86590 | not published | not published | $7.62 – $15.19 | 8 |
| Streptomycin injection HCPCS J3000 | $33.53 | $51.58 | $13.04 – $93.75 | 4 |
| Streptozocin injection HCPCS J9320 | not published | not published | $335.26 – $419.08 | 3 |
| Stress test pulmonary CPT 94618 | $255.27 | $392.72 | $11.66 – $12.96 | 2 |
| Stress tte complete CPT 93351 | $1,151.46 | $1,771.47 | $124.15 – $191.35 | 3 |
| Str markers spec anal addl CPT 81266 | not published | not published | $62.24 – $365.77 | 8 |
| Str markers specimen anal CPT 81265 | not published | not published | $200.44 – $279.68 | 8 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $88.55 – $120.32 | 2 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | not published | not published | $283.14 – $493.10 | 2 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | $36.40 – $54.71 | 2 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $71.74 – $109.12 | 2 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | not published | not published | $88.49 – $154.28 | 2 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | not published | not published | $85.07 – $148.17 | 2 |
| Subsequent repair of nerve CPT 64872 | not published | not published | $81.12 – $130.43 | 2 |
| Subtalar arthro w/deb CPT 29906 | not published | not published | $513.62 – $758.06 | 2 |
| Subtalar arthro w/exc CPT 29905 | not published | not published | $397.54 – $592.18 | 2 |
| Subtalar arthro w/fb rmvl CPT 29904 | not published | not published | $491.49 – $704.92 | 2 |
| Subtalar arthro w/fusion CPT 29907 | not published | not published | $669.05 – $974.18 | 2 |
| Subtemporal cranial dcmprn CPT 61340 | not published | not published | $1,136.00 – $1,551.14 | 2 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | not published | not published | $0.30 – $1.04 | 3 |
| Suction lipectomy upr extrem CPT 15878 | not published | not published | $424.93 – $424.93 | 1 |
| Suction socket HCPCS L6686 | not published | not published | $733.33 – $733.33 | 5 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $533.75 – $533.75 | 5 |
| Sugars multiple quant CPT 84379 | not published | not published | $7.68 – $25.94 | 10 |
| Sugars single quant CPT 84378 | $237.30 | $365.07 | $7.68 – $25.94 | 10 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | not published | not published | $0.04 – $0.04 | 2 |
| Sulfonylurea screen qn-sendout CPT 80377 | $140.35 | $215.93 | $11.96 – $14.15 | 2 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | not published | not published | $30.00 – $37.00 | 3 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $3.47 – $3.47 | 5 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $2.20 – $3.35 | 2 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $25.87 – $25.87 | 5 |
| Support clav 29.6-40.5in med HCPCS L3650 | $119.57 | $183.96 | $76.59 – $76.59 | 5 |
| Supprelin la implant HCPCS J9226 | not published | not published | $26,167.23 – $54,215.03 | 4 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $95.78 – $95.78 | 1 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $83.35 – $83.35 | 1 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $81.36 – $135.79 | 2 |
| Surg ect salp-oophorectomy 59120 CPT 59120 | not published | not published | $590.06 – $791.37 | 2 |
| Surg ect without salp-oophorectomy 59121 CPT 59121 | not published | not published | $590.22 – $792.01 | 2 |
| Surgery for urethra pouch CPT 53240 | not published | not published | $323.96 – $482.49 | 2 |
| Surgery of pancreatic cyst CPT 48500 | not published | not published | $883.86 – $1,277.46 | 2 |
| Surgery to stop leg growth CPT 27475 | not published | not published | $511.86 – $736.80 | 2 |
| Surgery to stop leg growth CPT 27477 | not published | not published | $560.90 – $816.67 | 2 |
| Surgery to stop leg growth CPT 27479 | not published | not published | $693.01 – $1,024.60 | 2 |
| Surgery to stop leg growth CPT 27485 | not published | not published | $516.70 – $746.77 | 2 |
| Surgical exposure prostate 55860 CPT 55860 | not published | not published | $650.23 – $995.71 | 2 |
| Surgical opening esophagus CPT 43351 | not published | not published | $1,034.64 – $1,643.23 | 2 |
| Surgical opening esophagus CPT 43352 | not published | not published | $838.85 – $1,341.33 | 2 |
| Surgical opening of stomach CPT 43510 | not published | not published | $731.74 – $1,192.51 | 2 |
| Surgical opening of stomach 43500 CPT 43500 | not published | not published | $609.11 – $990.10 | 2 |
| Surgical opening of throat CPT 42955 | not published | not published | $572.36 – $860.75 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $274.25 | $421.92 | $9.75 – $14.93 | 3 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $568.17 | $874.11 | $15.91 – $43.88 | 5 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $662.15 | $1,018.69 | $17.75 – $57.56 | 5 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $591.66 | $910.24 | $28.58 – $98.14 | 6 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $1,085.40 | $1,669.85 | $79.05 – $396.34 | 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.