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 |
|---|---|---|---|---|
| Aep neurodiagnostic i&r CPT 92653 | $689.09 | $1,060.14 | $66.60 – $95.08 | 2 |
| Aep thrshld est mlt freq i&r CPT 92652 | $689.09 | $1,060.14 | $89.74 – $129.86 | 2 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $3,024.55 – $3,524.94 | 3 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $726,970.92 – $813,967.38 | 2 |
| _afb id by dna probe rflx ast CPT 87149 | $72.57 | $111.65 | $13.36 – $24.06 | 8 |
| #afb mycobacteria suscep. #1 CPT 87190 | $21.44 | $32.98 | $4.87 – $16.45 | 10 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $417.47 | $642.26 | $76.86 – $138.43 | 8 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $83.02 – $164.40 | 8 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $166.55 – $329.80 | 8 |
| Aflibercept injection HCPCS J0178 | $1,542.79 | $2,373.52 | $743.60 – $1,110.00 | 4 |
| Afo molded ankle gauntlet HCPCS L1904 | $872.39 | $1,342.14 | $558.83 – $558.83 | 5 |
| Afo molded plas rig ant tib HCPCS L1945 | not published | not published | $1,063.73 – $1,063.73 | 5 |
| Afo molded to patient plasti HCPCS L1940 | $1,126.12 | $1,732.49 | $721.37 – $721.37 | 5 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $1,899.72 | $2,922.64 | $1,070.39 – $1,070.39 | 5 |
| Afo sing bar clasp attach sh HCPCS L1910 | not published | not published | $382.27 – $382.27 | 5 |
| Afo sing solid stirrup calf HCPCS L1980 | not published | not published | $473.39 – $473.39 | 5 |
| Afo sing upright with adjust s HCPCS L1920 | not published | not published | $429.77 – $429.77 | 5 |
| Afo spiral molded to pt plas HCPCS L1950 | not published | not published | $1,141.23 – $1,141.23 | 5 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | not published | not published | $310.01 – $310.01 | 5 |
| Afo supramalleolar custom HCPCS L1907 | not published | not published | $674.95 – $674.95 | 5 |
| Afo tib fx cast molded to pt HCPCS L2108 | $2,326.17 | $3,578.72 | $1,490.08 – $1,490.08 | 5 |
| Afo tib fx cast plaster mold HCPCS L2106 | not published | not published | $1,002.44 – $1,002.44 | 5 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | $1,387.25 | $2,134.23 | $888.63 – $888.63 | 5 |
| Afo tibial fracture rigid HCPCS L2116 | not published | not published | $977.63 – $977.63 | 5 |
| Afo tibial fracture soft HCPCS L2112 | not published | not published | $680.97 – $680.97 | 5 |
| Afo, walk boot type, cus fab HCPCS L4631 | not published | not published | $2,160.48 – $2,160.48 | 5 |
| Afo w/ankle joint, prefab HCPCS L1971 | not published | not published | $562.23 – $562.23 | 5 |
| After cataract laser surgery CPT 66821 | not published | not published | $227.87 – $364.67 | 2 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $174.32 – $236.29 | 4 |
| Air conduction bilat CPT 92552 | not published | not published | $25.50 – $34.98 | 3 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $65.27 – $105.42 | 2 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $29.12 – $33.75 | 3 |
| Ak 4 bar ling w/hydraul swig HCPCS L5613 | not published | not published | $3,000.26 – $3,000.26 | 5 |
| Ak 4 bar link w/fric swing HCPCS L5611 | not published | not published | $1,972.47 – $1,972.47 | 5 |
| Ak/bk self-aligning unit ea HCPCS L5617 | not published | not published | $685.94 – $685.94 | 5 |
| Ak flex inner socket ext fra HCPCS L5651 | not published | not published | $1,470.22 – $1,470.22 | 5 |
| Ak/knee disartic acrylic soc HCPCS L5631 | not published | not published | $717.21 – $717.21 | 5 |
| Ak/knee disartic pelvic band HCPCS L5697 | not published | not published | $98.28 – $98.28 | 5 |
| Ak/knee disartic pelvic join HCPCS L5696 | not published | not published | $246.04 – $246.04 | 5 |
| Ak/knee disartic silesian ba HCPCS L5698 | not published | not published | $160.34 – $160.34 | 5 |
| Ak open end sach HCPCS L5321 | not published | not published | $4,023.73 – $4,023.73 | 5 |
| Ak pelvic control belt light HCPCS L5692 | not published | not published | $162.67 – $162.67 | 5 |
| Ak pelvic control belt pad/l HCPCS L5694 | not published | not published | $222.10 – $222.10 | 5 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | not published | not published | $232.21 – $232.21 | 5 |
| Ak univ multiplex sys frict HCPCS L5616 | not published | not published | $1,662.72 – $1,662.72 | 5 |
| Albumin body fluid quantitative each specimen CPT 82042 | $22.82 | $35.11 | $5.07 – $11.43 | 10 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $284.79 | $438.14 | $53.08 – $54.00 | 4 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $21.23 – $33.00 | 4 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $77.11 | $118.63 | $53.08 – $55.55 | 4 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $10.62 – $39.12 | 4 |
| Albumin ischemia modified CPT 82045 | not published | not published | $12.06 – $40.73 | 10 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $20.93 | $32.20 | $3.86 – $11.43 | 10 |
| Albumin serum plasma or whole blood CPT 82040 | $17.91 | $27.56 | $3.30 – $11.14 | 10 |
| Albuterol comp con HCPCS J7610 | not published | not published | $1.16 – $1.16 | 1 |
| Albuterol comp unit HCPCS J7609 | not published | not published | $0.16 – $0.22 | 3 |
| Albuterol ipratrop non-comp HCPCS J7620 | not published | not published | $0.17 – $0.48 | 4 |
| Albuterol non-comp con HCPCS J7611 | not published | not published | $0.13 – $0.38 | 4 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.05 – $0.10 | 4 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $10.47 – $20.72 | 8 |
| Alcohols biomarkers 3/more CPT 80322 | not published | not published | $11.96 – $11.96 | 1 |
| Alcohol/sub misuse assess HCPCS G2011 | not published | not published | $12.27 – $21.28 | 3 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | not published | not published | $24.25 – $42.60 | 3 |
| Alcohol/subs interv >30 min HCPCS G0397 | not published | not published | $34.38 – $82.90 | 3 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $2,349.42 – $6,168.30 | 3 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $55.62 – $150.60 | 8 |
| Alefacept HCPCS J0215 | not published | not published | $20.62 – $20.62 | 1 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $1,918.20 – $2,707.21 | 4 |
| Alginate dressing <=16 sq in HCPCS A6196 | not published | not published | $5.23 – $10.49 | 6 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | not published | not published | $23.44 – $23.44 | 5 |
| Alginate drsg wound filler HCPCS A6199 | not published | not published | $2.64 – $7.52 | 6 |
| Alglucerase injection HCPCS J0205 | not published | not published | $24.59 – $24.59 | 1 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $187.20 – $187.20 | 1 |
| Alkaline phosphatase CPT 84075 | $18.74 | $28.83 | $3.45 – $11.43 | 10 |
| Allergen alpha lactalbumin ige CPT 86008 | $64.90 | $99.85 | $3.69 – $21.52 | 10 |
| Allergen egg white ige CPT 86003 | $18.88 | $29.05 | $3.47 – $8.30 | 10 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $28.85 | $44.39 | $5.31 – $9.56 | 8 |
| Allergy injections; 2 or more 95117 CPT 95117 | $101.01 | $155.40 | $10.03 – $11.67 | 2 |
| Allergy injection; single 95115 CPT 95115 | $101.01 | $155.40 | $8.38 – $9.91 | 2 |
| Allergy Skin Testing CPT 95004 | not published | not published | $2.94 – $4.37 | 2 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $4.02 – $5.83 | 2 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $961.59 – $1,419.92 | 2 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $78.17 – $78.17 | 1 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $101.72 – $199.80 | 2 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | not published | not published | $103.97 – $103.97 | 1 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $29.91 – $29.91 | 1 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $2,082.92 | $3,204.50 | $103.97 – $400.80 | 3 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $85.96 – $107.71 | 3 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $103.97 – $270.00 | 2 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | not published | not published | $103.97 – $489.50 | 2 |
| Alloskin HCPCS Q4115 | not published | not published | $10.41 – $12.86 | 2 |
| Alloskin ac, 1 cm HCPCS Q4141 | not published | not published | $103.97 – $112.05 | 2 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $5.04 – $7.93 | 2 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $2.49 – $4.10 | 2 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $5.05 – $6.20 | 4 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $233.08 | $358.59 | $23.99 – $144.92 | 10 |
| Alpha-fetoprotein amniotic CPT 82106 | $60.71 | $93.40 | $10.10 – $22.72 | 10 |
| Alpha-fetoprotein tumor marker CPT 82105 | $60.71 | $93.40 | $6.57 – $20.12 | 10 |
| Alprostadil for injection HCPCS J0270 | not published | not published | $5.89 – $11.38 | 3 |
| Alprostadil urethral suppos HCPCS J0275 | not published | not published | $39.37 – $39.37 | 1 |
| Als 1 HCPCS A0426 | not published | not published | $285.58 – $285.58 | 1 |
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.