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 |
|---|---|---|---|---|
| Boot mlti podous univ xlg HCPCS L4396 | $314.19 | $483.37 | $201.26 – $201.26 | 5 |
| Boot softgait shrt m HCPCS L4387 | not published | not published | $190.16 – $190.16 | 5 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | not published | not published | $330.09 – $330.09 | 5 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | not published | not published | $330.09 – $330.09 | 5 |
| Borrelia antibody CPT 86619 | $33.88 | $52.13 | $8.92 – $30.10 | 10 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $61.62 | $94.80 | $11.35 – $38.32 | 10 |
| Borrelia miyamotoi amp prb CPT 87478 | $82.65 | $127.16 | $21.26 – $48.69 | 10 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | not published | not published | $2.04 – $8.57 | 4 |
| (both sides) donor search management CPT 38204 | not published | not published | $117.72 – $117.72 | 1 |
| (both sides) smear without diff wbc count CPT 85008 | $12.43 | $19.12 | $2.28 – $4.12 | 8 |
| Botulism ig IV CPT 90288 | not published | not published | $58,905.00 – $58,905.00 | 1 |
| Bowel imaging CPT 78290 | $812.30 | $1,249.69 | $211.95 – $334.31 | 3 |
| Bpg axillary-pop/-tibial CPT 35623 | not published | not published | $967.46 – $1,443.80 | 2 |
| Bpg carotid-vertebral CPT 35642 | not published | not published | $732.28 – $1,085.74 | 2 |
| Bpg ilio-celiac CPT 35632 | not published | not published | $1,327.08 – $1,977.92 | 2 |
| Bpg ilio-mesenteric CPT 35633 | not published | not published | $1,458.29 – $2,204.68 | 2 |
| Bpg iliorenal CPT 35634 | not published | not published | $1,299.00 – $1,941.83 | 2 |
| Bpg pop-tibl/-prnl artery CPT 35671 | not published | not published | $832.96 – $1,234.05 | 2 |
| Bpg splenorenal CPT 35636 | not published | not published | $1,172.87 – $1,755.62 | 2 |
| Bpg subclavian-axillary CPT 35616 | not published | not published | $811.22 – $1,209.18 | 2 |
| Bpg subclavian-vertebral CPT 35645 | not published | not published | $699.40 – $1,041.70 | 2 |
| Brace adj motion lerman type HCPCS L2186 | not published | not published | $190.23 – $190.23 | 5 |
| Brace afo dbl upright cust HCPCS L1990 | $953.62 | $1,467.11 | $610.87 – $610.87 | 5 |
| Brace afo lg left 6607 HCPCS L1930 | $424.36 | $652.86 | $271.84 – $271.84 | 5 |
| Brace afopos solid ankle cust HCPCS L1960 | $1,325.79 | $2,039.68 | $849.26 – $849.26 | 5 |
| Brace afo spiral prefab HCPCS L1951 | not published | not published | $1,007.37 – $1,007.37 | 5 |
| Brace ank aftr bioskn med lg HCPCS L1906 | $247.73 | $381.12 | $139.58 – $139.58 | 5 |
| Brace ank air stirrup univ HCPCS L4350 | $160.37 | $246.73 | $102.72 – $102.72 | 5 |
| Brace ankle joint dflxn assist HCPCS L2210 | not published | not published | $84.42 – $84.42 | 5 |
| Brace ankle stablizing lg HCPCS L1902 | $187.40 | $288.30 | $120.04 – $120.04 | 5 |
| Brace back epic lo 627 HCPCS L0642 | not published | not published | $280.18 – $280.18 | 5 |
| Brace back epic lso 637 HCPCS L0650 | $2,011.64 | $3,094.83 | $809.61 – $809.61 | 5 |
| Brace back epic tslo 456 HCPCS L0457 | not published | not published | $677.75 – $677.75 | 5 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | not published | not published | $493.08 – $493.08 | 5 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $3,164.42 | $4,868.34 | $1,782.97 – $1,782.97 | 5 |
| Brace back t-lso custom HCPCS L0486 | $3,630.46 | $5,585.32 | $2,325.57 – $2,325.57 | 5 |
| Brace back vista 464 tlso HCPCS L0648 | not published | not published | $699.71 – $699.71 | 5 |
| Brace cust back lso HCPCS L0631 | not published | not published | $1,231.38 – $1,231.38 | 5 |
| Brace fx hum ovr shldr lg HCPCS L3981 | not published | not published | $1,098.83 – $1,098.83 | 5 |
| Brace fx hum ovr shldr sm HCPCS L3980 | $620.54 | $954.68 | $397.49 – $397.49 | 5 |
| Brace halo bremer l2830 HCPCS L2830 | not published | not published | $132.94 – $132.94 | 5 |
| Brace kafo dbl upright cust HCPCS L2036 | $4,437.69 | $6,827.21 | $2,842.66 – $2,842.66 | 5 |
| Brace knee 32in univ t-scope short lt/rt HCPCS L1852 | not published | not published | $634.46 – $634.46 | 5 |
| Brace knee extender plus 22-30in HCPCS L1832 | $1,454.17 | $2,237.19 | $931.51 – $931.51 | 5 |
| Brace knee hing pat open med HCPCS L1820 | not published | not published | $169.15 – $169.15 | 5 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | $1,454.17 | $2,237.19 | $503.87 – $503.87 | 5 |
| Brace knee postop tscope xl HCPCS L1845 | not published | not published | $1,180.50 – $1,180.50 | 5 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | not published | not published | $123.44 – $123.44 | 5 |
| Brace m arm board HCPCS L3809 | not published | not published | $272.97 – $272.97 | 5 |
| Brace or Splint Fitting and Training (each 15 minutes) CPT 97760 | $153.80 | $236.62 | $38.30 – $40.80 | 3 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $2,287.01 | $3,518.47 | $1,288.60 – $1,288.60 | 5 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | not published | not published | $1,192.99 – $1,192.99 | 5 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $426.13 | $655.59 | $272.97 – $272.97 | 5 |
| Brace tlso flex cust HCPCS L0450 | not published | not published | $127.31 – $127.31 | 5 |
| Brace wrist classic lft sm HCPCS L3908 | $140.23 | $215.74 | $89.82 – $89.82 | 5 |
| Brachioplasty 15836 CPT 15836 | not published | not published | $596.67 – $869.26 | 2 |
| Brach/thor cath 1st CPT 36215 | $714.33 | $1,098.97 | $155.08 – $240.41 | 2 |
| Brach/thor cath 2nd CPT 36216 | not published | not published | $198.30 – $306.07 | 2 |
| Brach/thor cath 3rd CPT 36217 | not published | not published | $244.36 – $366.47 | 2 |
| Brach/thor cath addl CPT 36218 | not published | not published | $37.85 – $58.40 | 2 |
| Brachy source yttrium-90 HCPCS C2616 | $38,753.81 | $59,621.25 | not published | 0 |
| Brachytx isodose complex CPT 77318 | not published | not published | $198.55 – $296.95 | 3 |
| Brachytx isodose intermed CPT 77317 | not published | not published | $146.26 – $219.80 | 3 |
| Brachytx isodose plan simple CPT 77316 | not published | not published | $112.24 – $167.08 | 3 |
| Braf gene CPT 81210 | $514.16 | $791.02 | $45.00 – $394.65 | 10 |
| Brain aneurysm repr complx CPT 61697 | not published | not published | $3,175.80 – $4,631.53 | 2 |
| Brain aneurysm repr complx CPT 61698 | not published | not published | $3,465.96 – $5,136.74 | 2 |
| Brain aneurysm repr simple CPT 61700 | not published | not published | $2,551.80 – $3,730.67 | 2 |
| Brain biopsy w/ct/mr guide CPT 61751 | not published | not published | $1,104.43 – $1,505.60 | 2 |
| Brain cavity shunt w/scope CPT 62201 | not published | not published | $978.03 – $1,317.46 | 2 |
| Brain flow imaging only CPT 78610 | not published | not published | $116.51 – $179.50 | 3 |
| Brain image < 4 views CPT 78600 | not published | not published | $119.51 – $182.63 | 3 |
| Brain image 4+ views CPT 78605 | not published | not published | $126.06 – $193.95 | 3 |
| Brain image w/flow < 4 views CPT 78601 | not published | not published | $138.07 – $215.41 | 3 |
| Brain image w/flow 4 + views CPT 78606 | not published | not published | $211.41 – $335.50 | 3 |
| Brain imaging (3d) CPT 78607 | not published | not published | $286.17 – $286.17 | 1 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $1,510.60 | $2,324.00 | $212.02 – $382.76 | 3 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $1,510.60 | $2,324.00 | $139.78 – $262.50 | 3 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $956.04 | $1,470.83 | $130.23 – $262.50 | 3 |
| Brain MRI (with and without contrast) CPT 70553 | $1,510.60 | $2,324.00 | $172.80 – $306.26 | 3 |
| Brain MRI (with contrast) CPT 70552 | $1,510.60 | $2,324.00 | $152.61 – $268.78 | 3 |
| Brain MRI (without contrast) CPT 70551 | $956.04 | $1,470.83 | $104.10 – $211.84 | 3 |
| Bra surgical elizabeth pink sm HCPCS L8000 | not published | not published | $45.10 – $45.10 | 5 |
| Brca1&2 gene full seq alys CPT 81163 | not published | not published | $283.61 – $561.60 | 8 |
| Brca1&2 gen ful dup/del alys CPT 81164 | not published | not published | $354.04 – $701.08 | 8 |
| Brca1 dna gene analy known fam var CPT 81215 | not published | not published | $38.91 – $450.30 | 10 |
| Brca1 gene full dup/del alys CPT 81166 | not published | not published | $182.62 – $361.62 | 8 |
| Brca1 gene full seq alys CPT 81165 | not published | not published | $171.43 – $339.46 | 8 |
| Brca2 dna gene analy full seq analy CPT 81216 | not published | not published | $112.18 – $222.14 | 8 |
| Brca2 dna gene analy known fam var CPT 81217 | not published | not published | $38.91 – $450.30 | 10 |
| Brca2 gene full dup/del alys CPT 81167 | not published | not published | $171.43 – $339.46 | 8 |
| Brcassure ashkenazi panel-sendout CPT 81212 | not published | not published | $73.75 – $528.00 | 10 |
| Brcassure comprehensive panel-sendout CPT 81162 | not published | not published | $1,506.43 – $2,189.86 | 8 |
| Breast augmentation 19325 CPT 19325 | not published | not published | $463.41 – $706.16 | 2 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $3,486.44 | $5,363.76 | $108.63 – $179.79 | 2 |
| Breastbone (Sternum) X-ray CPT 71120 | $201.75 | $310.38 | $19.31 – $25.07 | 3 |
| Breast prosthesis bra & form HCPCS L8001 | not published | not published | $150.77 – $150.77 | 5 |
| Breast prosthesis w adhesive HCPCS L8031 | not published | not published | $395.95 – $395.95 | 5 |
| Breast prosthes without adhesive HCPCS L8030 | not published | not published | $395.95 – $395.95 | 5 |
| Breast punct aspir cyst, bil CPT 19000 | $1,537.43 | $2,365.27 | $30.14 – $49.31 | 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.