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 |
|---|---|---|---|---|
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $104.92 – $161.89 | 2 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $36.51 – $58.93 | 2 |
| Cystourethro w/implant CPT 52441 | not published | not published | $152.56 – $240.83 | 2 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $250.60 – $393.84 | 2 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $225.41 – $354.02 | 2 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $207.48 – $325.41 | 2 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | not published | not published | $0.81 – $1.22 | 4 |
| Cytarabine liposome inj HCPCS J9098 | not published | not published | $569.09 – $569.09 | 1 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $702.96 – $1,437.53 | 8 |
| Cytogenetics 25-99 CPT 88274 | $126.00 | $193.84 | $28.24 – $95.36 | 10 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $22.79 – $84.08 | 10 |
| Cytogenomic neo microra alys CPT 81277 | $3,084.16 | $4,744.86 | $702.96 – $1,392.00 | 8 |
| Cytogenom microarray copy nmbr var CPT 81228 | $2,638.16 | $4,058.70 | $183.60 – $1,080.00 | 8 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $821.29 – $2,235.86 | 8 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $7.99 – $26.96 | 10 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $52.10 | $80.15 | $9.58 – $32.38 | 10 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $60.97 | $93.80 | $8.11 – $20.22 | 10 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $8.94 – $30.20 | 10 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,171.25 – $2,108.22 | 4 |
| Cytomeg dna dir probe CPT 87495 | $88.02 | $135.42 | $16.07 – $36.16 | 10 |
| Cyto/molecular report CPT 88291 | $95.50 | $146.93 | $4.23 – $45.45 | 5 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $16.91 – $57.08 | 10 |
| Cytopath c/v automated CPT 88147 | not published | not published | $13.94 – $60.67 | 10 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $13.94 – $33.17 | 8 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $10.67 – $35.03 | 10 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $9.76 – $17.58 | 8 |
| Cytopath c/v manual CPT 88150 | not published | not published | $10.10 – $33.30 | 10 |
| Cytopath c/v redo CPT 88153 | not published | not published | $13.94 – $35.03 | 10 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $15.35 – $51.84 | 10 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $19.31 – $43.45 | 5 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $533.29 | $820.45 | $24.39 – $65.50 | 5 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | not published | not published | $17.74 – $59.87 | 10 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $73.31 | $112.79 | $13.50 – $45.58 | 10 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $564.24 | $868.06 | $19.31 – $43.45 | 5 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $434.95 | $669.15 | $19.31 – $43.45 | 5 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $88.49 | $136.14 | $4.22 – $7.10 | 3 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $214.40 | $329.85 | $12.74 – $17.12 | 3 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $581.62 | $894.80 | $19.31 – $54.91 | 5 |
| Cytopath smear other source CPT 88160 | not published | not published | $10.98 – $43.45 | 5 |
| Cytopath smear other source CPT 88162 | not published | not published | $19.31 – $74.01 | 5 |
| Cytopath smear oth prep screen & interp CPT 88161 | $497.61 | $765.56 | $10.98 – $43.45 | 5 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $10.10 – $22.25 | 8 |
| Cytopath tbs c/v manual CPT 88164 | $42.95 | $66.08 | $10.10 – $33.30 | 10 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $13.94 – $50.66 | 10 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $10.10 – $22.25 | 8 |
| Cytotoxic antibody screening CPT 86807 | $199.15 | $306.39 | $41.86 – $94.38 | 8 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $19.78 – $35.62 | 8 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $179.38 – $403.60 | 5 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $3.46 – $9.85 | 4 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $288.80 – $1,822.59 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | not published | not published | $11.29 – $20.12 | 4 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $14.90 – $48.41 | 4 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $0.05 | $0.07 | $0.03 – $0.14 | 4 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.04 – $0.06 | 3 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $52.99 – $58.17 | 4 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $7.37 | $11.34 | $2.92 – $9.29 | 4 |
| Darbepoetin alfa, esrd use HCPCS J0882 | $7.37 | $11.34 | $2.92 – $9.29 | 4 |
| Dark field exam spec collj CPT 87164 | not published | not published | $7.15 – $18.18 | 10 |
| Dark field exam without collj CPT 87166 | not published | not published | $7.53 – $18.18 | 10 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $249.02 – $272.89 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $26.33 – $80.49 | 4 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $42.30 – $42.30 | 1 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $219.16 – $355.71 | 2 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $134.68 – $181.46 | 2 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $171.78 – $244.23 | 2 |
| Dch glucoscan CPT 82948 | not published | not published | $2.02 – $6.05 | 10 |
| Dch pulmonary stress test CPT 94621 | not published | not published | $79.74 – $106.01 | 3 |
| Dch validity tests CPT 81002 | $10.20 | $15.70 | $2.02 – $4.54 | 10 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $442.44 – $654.36 | 2 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $1,402.26 – $1,945.87 | 2 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $213.86 – $307.98 | 2 |
| D&c of cervical stump CPT 57558 | not published | not published | $93.41 – $130.60 | 2 |
| Deamidated gliadin antibody iga CPT 86258 | $29.19 | $44.91 | $6.98 – $15.70 | 10 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $508.08 – $787.10 | 2 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $1,256.37 | $1,932.88 | $20.42 – $32.31 | 2 |
| Debridement (>20 cm) charge pt CPT 97598 | $299.50 | $460.77 | $18.02 – $28.35 | 2 |
| Debridement bone <= 20 sq cm CPT 11044 | $3,486.44 | $5,363.76 | $165.48 – $256.08 | 2 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $702.28 | $1,080.43 | $39.11 – $62.33 | 2 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,672.01 | $2,572.32 | $69.63 – $109.99 | 2 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $1,107.21 | $1,703.40 | $46.05 – $69.02 | 2 |
| Debride nail1-5 11720 CPT 11720 | $146.22 | $224.95 | $10.60 – $16.75 | 2 |
| Debride nail6 or more 11721 CPT 11721 | $146.22 | $224.95 | $17.87 – $27.98 | 2 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $1,517.45 | $2,334.54 | $216.58 – $334.81 | 2 |
| Debride skin bone at fx site CPT 11012 | not published | not published | $296.34 – $470.52 | 2 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $412.41 – $644.76 | 2 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $561.43 – $866.13 | 2 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $537.82 | $827.42 | $18.21 – $29.53 | 2 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $36.60 – $57.33 | 2 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | not published | not published | $204.40 – $310.61 | 2 |
| Debr inf skin add-on 11001 CPT 11001 | not published | not published | $10.57 – $16.18 | 2 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,256.37 | $1,932.88 | $113.77 – $173.55 | 2 |
| Decalcification CPT 88311 | $63.34 | $97.44 | $4.40 – $8.55 | 3 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $0.65 – $9.00 | 4 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $574.40 | $883.69 | $30.97 – $34.99 | 2 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $360.27 – $535.73 | 2 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $590.11 – $754.22 | 2 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $917.26 – $1,345.26 | 2 |
| Decompress fasciotomyhand 26037 CPT 26037 | not published | not published | $431.00 – $630.78 | 2 |
| Decompress fingers/hand CPT 26035 | not published | not published | $665.30 – $954.66 | 2 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $1,032.52 – $1,359.31 | 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.