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 |
|---|---|---|---|---|
| Above knee leather socket HCPCS L5642 | not published | not published | $905.20 – $905.20 | 5 |
| Above knee manual lock HCPCS L5925 | not published | not published | $411.36 – $411.36 | 5 |
| Above knee wood socket HCPCS L5644 | not published | not published | $723.09 – $723.09 | 5 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $12.05 – $19.92 | 2 |
| Abrasion lesion single CPT 15786 | not published | not published | $98.64 – $152.81 | 2 |
| Abscess drain retroperitoneal surg code CPT 49406 | $3,486.44 | $5,363.76 | $138.80 – $226.39 | 2 |
| Abscess imaging ltd area CPT 78805 | not published | not published | $139.80 – $139.80 | 1 |
| Abscess imaging whole body CPT 78806 | not published | not published | $279.42 – $279.42 | 1 |
| Absorpt drg >16<=48 in w/bdr HCPCS A6255 | not published | not published | $4.34 – $4.34 | 5 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | not published | not published | $4.64 – $4.64 | 5 |
| Absorpt drg <=16 sq in w/bdr HCPCS A6254 | not published | not published | $1.70 – $1.70 | 5 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | not published | not published | $2.84 – $2.84 | 5 |
| Absorpt drg > 48 sq in without b HCPCS A6253 | not published | not published | $9.03 – $9.03 | 5 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | not published | not published | $89.30 – $143.28 | 2 |
| Access thoracic lymph duct CPT 38794 | $765.02 | $1,176.96 | $213.92 – $338.16 | 2 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | not published | not published | $0.05 – $0.15 | 4 |
| Acetaminophen level CPT 80143 | $49.56 | $76.25 | $11.30 – $22.37 | 8 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | not published | not published | $19.06 – $47.82 | 4 |
| Acetone qualitative CPT 82009 | $16.35 | $25.16 | $0.51 – $5.42 | 10 |
| Acetylcholine receptor modulating antibody CPT 86043 | $26.72 | $41.10 | $7.23 – $16.27 | 10 |
| Acetylcholinesterase assay CPT 82013 | not published | not published | $8.19 – $27.65 | 10 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | not published | not published | $0.37 – $3.00 | 4 |
| Acetylcysteine non-comp unit HCPCS J7608 | not published | not published | $4.43 – $13.59 | 4 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $91.46 – $123.74 | 3 |
| Acne surgery 10040 CPT 10040 | not published | not published | $35.36 – $60.25 | 2 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $144.97 – $189.40 | 2 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $114.27 – $158.58 | 2 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | not published | not published | $36.69 – $52.61 | 2 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | not published | not published | $25.76 – $48.96 | 2 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | not published | not published | $36.69 – $50.07 | 2 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | not published | not published | $66.35 – $104.75 | 2 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $297.56 | $457.78 | $124.36 – $197.01 | 3 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | not published | not published | $6.73 – $10.58 | 2 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $37.62 | $57.87 | $10.39 – $21.42 | 2 |
| Acoustic immitance testing CPT 92570 | not published | not published | $20.09 – $33.87 | 2 |
| Acoustic refl threshold tst CPT 92568 | not published | not published | $10.72 – $17.47 | 2 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $482.34 – $680.68 | 2 |
| Acth stimulation panel CPT 80402 | not published | not published | $19.48 – $195.66 | 10 |
| Acth stimulation panel CPT 80406 | not published | not published | $52.15 – $176.08 | 10 |
| Actigraphy testing CPT 95803 | not published | not published | $75.52 – $163.13 | 3 |
| Actinotherapy uv light CPT 96900 | not published | not published | $19.31 – $21.51 | 2 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $27.99 – $45.09 | 2 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | not published | not published | $17.66 – $35.91 | 2 |
| Acup 1/> without estim ea add 15 CPT 97811 | not published | not published | $17.36 – $32.43 | 2 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $22.97 – $41.71 | 2 |
| Acute hepatitis panel CPT 80074 | $172.39 | $265.21 | $31.73 – $57.16 | 8 |
| Acute venous thrombus image CPT 78456 | not published | not published | $189.06 – $294.12 | 3 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | not published | not published | $0.04 – $0.14 | 4 |
| #acylcarnitineprfl CPT 82017 | $61.05 | $93.92 | $11.24 – $37.96 | 10 |
| Acylcarnitines qual CPT 82016 | not published | not published | $10.99 – $37.10 | 10 |
| Adalimumab injection HCPCS J0135 | not published | not published | $828.58 – $828.58 | 1 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $25.91 – $25.91 | 1 |
| Adaptive behavior tx by tech CPT 97153 | not published | not published | $12.96 – $12.96 | 1 |
| Adding walker to prev cast CPT 29440 | not published | not published | $21.47 – $32.59 | 2 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $494.85 – $494.85 | 5 |
| Add le poly knee custom kafo HCPCS L2387 | not published | not published | $190.18 – $190.18 | 5 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $668.02 – $668.02 | 5 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $412.39 – $412.39 | 5 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $442.58 – $442.58 | 5 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $368.35 – $368.35 | 5 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $873.65 – $873.65 | 5 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $445.33 – $445.33 | 5 |
| Add up-ex prosthes lock mech HCPCS L6698 | not published | not published | $608.96 – $608.96 | 5 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | not published | not published | $0.39 – $1.92 | 4 |
| Adenovirus ag ia CPT 87301 | $28.22 | $43.42 | $7.99 – $18.25 | 10 |
| Adenovirus antibody,serum - quest CPT 86603 | $46.58 | $71.66 | $8.11 – $18.25 | 10 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $14.49 – $32.96 | 10 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $674.18 – $949.69 | 2 |
| Adhesive, liquid or equal HCPCS A4364 | not published | not published | $4.19 – $7.56 | 6 |
| Adh-sendout CPT 84588 | $122.82 | $188.96 | $22.61 – $76.36 | 10 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $352.24 – $495.67 | 2 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $539.31 – $869.15 | 2 |
| Adjustment gastric band HCPCS S2083 | not published | not published | $77.45 – $77.45 | 1 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $0.51 | $0.78 | $0.22 – $0.59 | 3 |
| Admin ecg contrast agent CPT 93352 | not published | not published | $29.33 – $59.68 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $61.08 | $93.97 | $23.32 – $33.67 | 3 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $61.08 | $93.97 | $54.40 – $74.78 | 3 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $728.29 | $1,120.44 | $108.79 – $154.36 | 3 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $71.31 | $109.71 | $85.33 – $118.53 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $61.08 | $93.97 | $31.79 – $35.16 | 3 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $61.08 | $93.97 | $58.69 – $87.13 | 3 |
| Administration immunization each additional component CPT 90461 | not published | not published | $7.28 – $17.26 | 2 |
| Administration immunization each additional vaccine CPT 90472 | $77.25 | $118.85 | $13.24 – $17.26 | 2 |
| Administration immunization first component each vaccine CPT 90460 | $67.74 | $104.21 | $19.29 – $22.51 | 2 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $14.36 – $22.51 | 2 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $10.24 – $17.26 | 2 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $67.74 | $104.21 | $21.91 – $24.82 | 2 |
| Administration vaccine hepatitis b HCPCS G0010 | $67.74 | $104.21 | $31.18 – $31.18 | 1 |
| Administration vaccine influenza virus HCPCS G0008 | $67.74 | $104.21 | $31.18 – $31.18 | 1 |
| Administration vaccine pneumococcal HCPCS G0009 | $67.74 | $104.21 | $31.18 – $31.18 | 1 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $67.74 | $104.21 | $18.95 – $20.09 | 2 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $32.13 – $43.63 | 4 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $288.21 – $465.31 | 3 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $954.15 – $1,363.43 | 2 |
| Adrenalin epinephrine inject HCPCS J0171 | not published | not published | $0.14 – $0.76 | 2 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $53.22 – $95.50 | 2 |
| Adv prim care mgmt lvl 1 HCPCS G0556 | not published | not published | $9.22 – $19.29 | 2 |
| Adv prim care mgmt lvl 2 HCPCS G0557 | not published | not published | $28.31 – $58.67 | 2 |
| Adv prim care mgmt lvl 3 HCPCS G0558 | not published | not published | $61.03 – $128.93 | 2 |
| Aep hearing status deter i&r CPT 92651 | $366.43 | $563.74 | $66.62 – $99.08 | 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.