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 |
|---|---|---|---|---|
| X-ray ribs 2 views left CPT 71100 | $201.75 | $310.38 | $20.39 – $26.86 | 3 |
| X-ray sella turcica CPT 70240 | not published | not published | $18.76 – $25.07 | 3 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,211.40 | $1,863.69 | $28.31 – $36.91 | 3 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $48.23 – $71.42 | 3 |
| X-ray small intestine follow-through study CPT 74248 | $648.60 | $997.85 | $38.68 – $78.72 | 3 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $201.75 | $310.38 | $25.20 – $32.26 | 3 |
| X-ray surgical specimen CPT 76098 | $1,211.40 | $1,863.69 | $10.44 – $27.93 | 3 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $201.75 | $310.38 | $23.48 – $30.82 | 3 |
| X-ray upper gi delay w/kub CPT 74241 | not published | not published | $80.41 – $80.41 | 1 |
| X-ray upper gi&small intest CPT 74245 | not published | not published | $125.03 – $125.03 | 1 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $52.32 – $74.29 | 3 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $193.87 – $465.08 | 3 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $57.91 – $117.84 | 3 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $103.97 – $540.00 | 2 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $8.61 – $29.05 | 10 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.35 – $1.91 | 6 |
| Yersinia antibody CPT 86793 | not published | not published | $8.11 – $18.25 | 10 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $71,875.11 – $74,124.43 | 2 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $75.79 – $1,140.00 | 2 |
| Ziconotide injection HCPCS J2278 | $25.88 | $39.82 | $7.90 – $11.31 | 4 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.51 – $1.75 | 4 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.31 – $1.51 | 3 |
| Zika virus dna/rna amp probe CPT 87662 | $129.92 | $199.88 | $34.19 – $115.45 | 10 |
| Zika virus igm antibody CPT 86794 | $42.67 | $65.64 | $11.22 – $36.16 | 10 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.79 – $1.79 | 5 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $5.18 – $19.67 | 4 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.22 – $19.20 | 4 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $33.67 – $33.92 | 2 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $12.17 | $18.72 | $3.36 – $24.30 | 4 |
| Zoster vaccine-live inj CPT 90736 | $449.25 | $691.16 | $255.20 – $255.20 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $117.11 – $263.50 | 10 |
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.