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 |
|---|---|---|---|---|
| Thyroid met imaging CPT 78015 | not published | not published | $141.07 – $215.03 | 3 |
| Thyroid met imaging/studies CPT 78016 | not published | not published | $178.86 – $278.50 | 3 |
| Thyroid mets imag whole body CPT 78018 | $859.59 | $1,322.44 | $193.66 – $306.21 | 3 |
| Thyroid met uptake CPT 78020 | not published | not published | $43.25 – $62.94 | 3 |
| Thyroid (TSH) Test CPT 84443 | $60.82 | $93.57 | $9.09 – $20.45 | 10 |
| Thyroid Ultrasound CPT 76536 | $323.71 | $498.02 | $67.06 – $95.49 | 3 |
| Thyroid uptake measurement CPT 78012 | not published | not published | $58.19 – $80.52 | 3 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $4,112.43 | $6,326.81 | $1,575.16 – $2,204.59 | 4 |
| Thyrotropin releasing hormone CPT 80438 | not published | not published | $18.18 – $60.49 | 10 |
| Thyroxine binding globulin (tbg) CPT 84442 | $53.50 | $82.30 | $9.09 – $20.45 | 10 |
| Tibial arthroscopy/surgery CPT 29855 | not published | not published | $596.00 – $871.91 | 2 |
| Tibial arthroscopy/surgery CPT 29856 | not published | not published | $748.81 – $1,104.69 | 2 |
| Tibial length sock fx or equ HCPCS L2840 | not published | not published | $59.38 – $59.38 | 5 |
| Tibial tubercle hgt with toe f HCPCS L5020 | not published | not published | $2,426.15 – $2,426.15 | 5 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $20,150.88 | $31,001.35 | $850.04 – $850.04 | 1 |
| Tib/per revasc stnt & ather CPT 37235 | not published | not published | $448.16 – $448.16 | 1 |
| Tib/per revasc w/ather add-on 37233 CPT 37233 | not published | not published | $365.94 – $365.94 | 1 |
| Tic-brn enceph vac 0.25ml im CPT 90626 | not published | not published | $303.90 – $337.20 | 2 |
| Tic-brn enceph vac 0.5ml im CPT 90627 | not published | not published | $303.90 – $337.20 | 2 |
| Tigecycline injection HCPCS J3243 | not published | not published | $0.30 – $2.52 | 4 |
| Tilt table locking hip sing HCPCS L5270 | not published | not published | $6,296.42 – $6,296.42 | 5 |
| Tilt table study CPT 93660 | $1,106.90 | $1,702.92 | $63.92 – $81.55 | 3 |
| Tinzaparin sodium injection HCPCS J1655 | not published | not published | $2.91 – $2.91 | 1 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | not published | not published | $2.92 – $4.48 | 4 |
| Tisagenlecleucel car-pos t HCPCS Q2042 | not published | not published | $523,130.87 – $611,693.17 | 2 |
| Tis cgen car anomal 1st shnt CPT 33745 | not published | not published | $753.97 – $1,145.88 | 2 |
| Tis cgen car anomal ea addl CPT 33746 | not published | not published | $301.18 – $453.91 | 2 |
| Tis clt agrft f/s/n/h/f/g ad CPT 15156 | not published | not published | $109.06 – $167.00 | 2 |
| Tis clt agrft f/s/n/h/f/g ea CPT 15157 | not published | not published | $119.49 – $182.23 | 2 |
| Tis cltr skn agrft t/a/l add CPT 15151 | not published | not published | $78.94 – $121.62 | 2 |
| Tis cltr skn agrft t/a/l ea CPT 15152 | not published | not published | $99.12 – $151.74 | 2 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | not published | not published | $183.42 – $196.12 | 4 |
| Tiss ex molecul study add-on CPT 88388 | not published | not published | $2.85 – $2.85 | 1 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | not published | not published | $19.48 – $25.04 | 2 |
| Tissue culture placenta CPT 88235 | $532.94 | $819.91 | $100.16 – $299.77 | 10 |
| Tissue culture skin/biopsy CPT 88233 | $509.28 | $783.50 | $93.77 – $299.77 | 10 |
| Tissue culture tumor CPT 88239 | not published | not published | $98.30 – $299.77 | 10 |
| Tissue exam koh skin/hair/nails CPT 87220 | $15.44 | $23.76 | $2.85 – $5.12 | 8 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | not published | not published | $103.97 – $121.00 | 2 |
| Tissue matrix xcm thk 20x30cm -cost per sq cm HCPCS Q4142 | not published | not published | $103.97 – $103.97 | 1 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | not published | not published | $19.81 – $19.81 | 1 |
| Tissue transglutaminase iga CPT 86364 | $29.19 | $44.91 | $6.98 – $15.70 | 10 |
| Tixagev and cilgav inj HCPCS M0220 | $381.09 | $586.29 | not published | 0 |
| Tl-201 thallium diag per mci HCPCS A9505 | $44.04 | $67.76 | $71.80 – $162.57 | 2 |
| Tlh uterus 250 g or less CPT 58570 | not published | not published | $595.19 – $846.59 | 2 |
| Tlh uterus over 250 g CPT 58572 | not published | not published | $772.72 – $1,093.77 | 2 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $676.97 – $953.54 | 2 |
| Tlh w/t/o uterus over 250 g CPT 58573 | not published | not published | $903.34 – $1,282.14 | 2 |
| Tlso 2mod symphis-xipho pre HCPCS L0458 | not published | not published | $1,069.75 – $1,069.75 | 5 |
| Tlso 2 piece rigid shell HCPCS L0491 | not published | not published | $921.22 – $921.22 | 5 |
| Tlso 2 shl symphys-stern cst HCPCS L0460 | $2,136.99 | $3,287.68 | $1,204.08 – $1,204.08 | 5 |
| Tlso 3mod sacro-scap pre HCPCS L0462 | $2,338.05 | $3,597.00 | $1,497.69 – $1,497.69 | 5 |
| Tlso 3 piece rigid shell HCPCS L0492 | not published | not published | $605.18 – $605.18 | 5 |
| Tlso corset front HCPCS L0970 | not published | not published | $135.93 – $135.93 | 5 |
| Tlso flex trnk sj-t9 pre ots HCPCS L0455 | not published | not published | $236.34 – $236.34 | 5 |
| Tlso full corset HCPCS L0974 | not published | not published | $205.73 – $205.73 | 5 |
| Tlso r fram soft ant pre cst HCPCS L0466 | not published | not published | $429.32 – $429.32 | 5 |
| Tlso r fram soft pre ots HCPCS L0467 | not published | not published | $265.06 – $265.06 | 5 |
| Tlso rig fram pelvic pre cst HCPCS L0468 | not published | not published | $526.74 – $526.74 | 5 |
| Tlso rig fram pelvic pre ots HCPCS L0469 | not published | not published | $337.73 – $337.73 | 5 |
| Tlso rigid frame pre subclav HCPCS L0470 | not published | not published | $854.19 – $854.19 | 5 |
| Tlso rigid lined custom fab HCPCS L0482 | $3,437.06 | $5,287.78 | $2,201.69 – $2,201.69 | 5 |
| Tlso rigid lined pre one pie HCPCS L0488 | not published | not published | $1,204.08 – $1,204.08 | 5 |
| Tlso rigid plastic cust fab HCPCS L0484 | $3,414.61 | $5,253.24 | $2,187.31 – $2,187.31 | 5 |
| Tlso rigid plastic custom fa HCPCS L0480 | $3,084.14 | $4,744.83 | $1,975.61 – $1,975.61 | 5 |
| Tlso rigid plastic pre one HCPCS L0490 | not published | not published | $339.33 – $339.33 | 5 |
| Tlso trnk sj-t9 pre cst HCPCS L0454 | not published | not published | $416.01 – $416.01 | 5 |
| Tmvr w/prosthetic ring 33426 CPT 33426 | not published | not published | $1,810.02 – $2,638.35 | 2 |
| Tmvr w/rad reconst w or without ring 33427 CPT 33427 | not published | not published | $1,845.47 – $2,707.86 | 2 |
| Tnot opn elbw to sho ea tdn CPT 24310 | not published | not published | $361.72 – $521.47 | 2 |
| Tobramycin comp unit HCPCS J7685 | not published | not published | $45.33 – $45.33 | 1 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $2.75 | $4.23 | $1.60 – $2.38 | 4 |
| Tobramycin non-comp unit HCPCS J7682 | not published | not published | $12.30 – $106.04 | 4 |
| Tobramycin peak therapeutic drug level CPT 80200 | $58.37 | $89.80 | $10.61 – $23.87 | 10 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $26.02 | $40.03 | $4.40 – $7.37 | 4 |
| Tocilizumab for covid-19 HCPCS Q0249 | not published | not published | $6.81 – $7.57 | 4 |
| Toe joint transfer CPT 26556 | not published | not published | $2,512.37 – $3,765.66 | 2 |
| Toe X-ray (both feet) CPT 73660 | $201.75 | $310.38 | $18.21 – $24.06 | 3 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $80.17 | $123.34 | $10.37 – $27.49 | 3 |
| Tomosynthesis breast screen bilateral CPT 77063 | $80.17 | $123.34 | $19.10 – $28.87 | 4 |
| Tone decay hearing test CPT 92563 | not published | not published | $29.13 – $33.86 | 2 |
| Tongue and neck surgery CPT 41135 | not published | not published | $1,577.37 – $2,451.35 | 2 |
| Tongue base vol reduction CPT 41530 | not published | not published | $297.03 – $418.48 | 2 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | not published | not published | $82.78 – $124.18 | 2 |
| Tongue jaw & neck surgery CPT 41155 | not published | not published | $2,151.39 – $3,398.55 | 2 |
| Tongue mouth jaw surgery CPT 41150 | not published | not published | $1,598.06 – $2,476.96 | 2 |
| Tongue mouth neck surgery CPT 41153 | not published | not published | $1,729.69 – $2,685.37 | 2 |
| Tongue removal neck surgery CPT 41145 | not published | not published | $1,988.85 – $3,114.02 | 2 |
| Tongue suspension CPT 41512 | not published | not published | $508.24 – $740.05 | 2 |
| Tongue to lip surgery CPT 41510 | not published | not published | $353.53 – $507.73 | 2 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $190.53 – $281.37 | 2 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $200.44 – $293.06 | 2 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | not published | not published | $1.25 – $4.20 | 4 |
| Topotecan oral HCPCS J8705 | not published | not published | $111.28 – $125.33 | 4 |
| Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution HCPCS J3263 | not published | not published | $39.10 – $40.89 | 3 |
| Torsion ank & half solid sti HCPCS L2375 | not published | not published | $129.84 – $129.84 | 5 |
| Torsion straight knee joint HCPCS L2380 | not published | not published | $141.47 – $141.47 | 5 |
| Tot abd hyst/par vag/pelv node sam 58200 CPT 58200 | not published | not published | $1,024.03 – $1,424.42 | 2 |
| Total hip arthroplasty CPT 27132 | not published | not published | $1,227.11 – $1,875.29 | 2 |
| Total Hip Replacement CPT 27130 | not published | not published | $948.08 – $1,509.57 | 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.