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 |
|---|---|---|---|---|
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $77.06 – $132.93 | 2 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $65.44 – $111.89 | 2 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $56.58 – $105.86 | 2 |
| Esophagoscopy flex remove fb CPT 43215 | $3,353.62 | $5,159.42 | $105.11 – $182.70 | 2 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $144.70 – $256.28 | 2 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $98.93 – $172.11 | 2 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $185.92 – $335.03 | 2 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $131.41 – $235.84 | 2 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $111.65 – $197.94 | 2 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $394.66 – $697.46 | 2 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $118.04 – $207.76 | 2 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $147.16 – $259.57 | 2 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $141.71 – $251.27 | 2 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $121.89 – $216.18 | 2 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $121.14 – $216.18 | 2 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $133.58 – $246.25 | 2 |
| Esophagotomy thrc rmvl fb CPT 43045 | not published | not published | $1,020.77 – $1,635.93 | 2 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $104.46 – $183.58 | 2 |
| Esophagus motility study CPT 91010 | not published | not published | $118.71 – $191.71 | 3 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $293.46 – $608.31 | 3 |
| Esoph egd dilation <30 mm CPT 43249 | $3,520.58 | $5,416.28 | $112.94 – $199.42 | 2 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $96.36 – $167.81 | 2 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $640.55 – $1,033.01 | 2 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $860.21 – $1,415.71 | 2 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $13.12 – $21.14 | 3 |
| Esoph imped function test CPT 91037 | not published | not published | $110.54 – $152.84 | 3 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $239.98 – $484.63 | 3 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $98.38 – $173.36 | 2 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $100.00 – $176.12 | 2 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $76.17 – $132.50 | 2 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $2,669.16 – $4,551.77 | 2 |
| Esphg thrsc moblj CPT 43288 | not published | not published | $2,806.12 – $4,756.38 | 2 |
| Esphg tot w/laps moblj CPT 43286 | not published | not published | $2,386.05 – $3,988.11 | 2 |
| Esphg tot w/thrcm CPT 43112 | not published | not published | $2,592.12 – $4,408.98 | 2 |
| Esrd home pt serv p mo 12-19 CPT 90965 | not published | not published | $431.43 – $513.22 | 2 |
| Esrd home pt serv p mo 20+ CPT 90966 | not published | not published | $258.89 – $300.19 | 2 |
| Esrd home pt serv p mo 2-11 CPT 90964 | not published | not published | $446.67 – $536.68 | 2 |
| Esrd home pt serv p mo <2yrs CPT 90963 | not published | not published | $523.71 – $621.33 | 2 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | not published | not published | $179.30 – $207.21 | 2 |
| Esrd serv 1 vst p mo 12-19 CPT 90959 | not published | not published | $283.10 – $334.36 | 2 |
| Esrd serv 4 visits p mo <2yr CPT 90951 | not published | not published | $991.10 – $1,201.75 | 2 |
| Esrd serv 4 vsts p mo 2-11 CPT 90954 | not published | not published | $865.79 – $872.63 | 2 |
| Esrd srv 1 visit p mo 2-11 CPT 90956 | not published | not published | $306.25 – $358.42 | 2 |
| Esrd srv 2-3 vsts p mo 12-19 CPT 90958 | not published | not published | $433.64 – $514.69 | 2 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | not published | not published | $259.16 – $300.54 | 2 |
| Esrd srv 2-3 vsts p mo 2-11 CPT 90955 | not published | not published | $450.18 – $535.60 | 2 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | not published | not published | $311.22 – $363.11 | 2 |
| Esrd srv 4 vsts p mo 12-19 CPT 90957 | not published | not published | $666.35 – $791.01 | 2 |
| Esrd svc pr day pt 12-19 CPT 90969 | not published | not published | $14.53 – $17.14 | 2 |
| Esrd svc pr day pt <2 CPT 90967 | not published | not published | $15.37 – $20.05 | 2 |
| Esrd svc pr day pt 20+ CPT 90970 | not published | not published | $8.38 – $9.79 | 2 |
| Esrd svc pr day pt 2-11 CPT 90968 | not published | not published | $14.81 – $17.89 | 2 |
| Essure 58565 CPT 58565 | not published | not published | $331.50 – $481.05 | 2 |
| Establish access to aorta CPT 36160 | not published | not published | $88.30 – $140.79 | 2 |
| Establish access to artery CPT 36100 | not published | not published | $108.69 – $173.20 | 2 |
| Establish brain cavity shunt CPT 62223 | not published | not published | $819.83 – $1,137.62 | 2 |
| Establish brain cavity shunt CPT 62180 | not published | not published | $1,250.80 – $1,746.70 | 2 |
| Establish brain cavity shunt CPT 62190 | not published | not published | $755.82 – $1,010.29 | 2 |
| Establish brain cavity shunt CPT 62192 | not published | not published | $809.66 – $1,068.54 | 2 |
| Establish brain cavity shunt CPT 62200 | not published | not published | $1,081.40 – $1,498.05 | 2 |
| Establish brain cavity shunt CPT 62220 | not published | not published | $774.19 – $1,094.68 | 2 |
| Established Patient Office Visit (level 1) CPT 99211 | $210.10 | $323.23 | $6.47 – $25.45 | 4 |
| Established Patient Office Visit (level 2) CPT 99212 | $256.59 | $394.76 | $25.95 – $52.09 | 4 |
| Established Patient Office Visit (level 3) CPT 99213 | $297.19 | $457.22 | $36.25 – $52.09 | 4 |
| Established Patient Office Visit (level 4) CPT 99214 | $369.35 | $568.23 | $51.86 – $132.71 | 4 |
| Established Patient Office Visit (level 5) CPT 99215 | $487.32 | $749.72 | $73.75 – $178.40 | 4 |
| Estim aid bone healg invasiv CPT 20975 | not published | not published | $136.14 – $197.61 | 2 |
| Estradiol total CPT 82670 | $101.09 | $155.52 | $18.61 – $62.86 | 10 |
| Estradiol valerate 10 mg inj HCPCS J1380 | not published | not published | $7.30 – $31.86 | 4 |
| Estrogens total-sendout CPT 82672 | $78.51 | $120.79 | $14.46 – $48.82 | 10 |
| Etanercept injection HCPCS J1438 | not published | not published | $387.33 – $1,019.70 | 3 |
| Ethanolamine oleate 100 mg HCPCS J1430 | not published | not published | $444.50 – $547.27 | 4 |
| Eth estr and eton monthly HCPCS J7295 | not published | not published | $110.05 – $168.62 | 3 |
| Ethmoidectomy extranasal total 31205 CPT 31205 | not published | not published | $695.42 – $1,027.60 | 2 |
| Ethylene glycol -sendout CPT 82693 | $53.93 | $82.97 | $9.94 – $17.88 | 8 |
| Etonogestrel implant system HCPCS J7307 | $2,565.91 | $3,947.55 | $771.52 – $1,310.98 | 3 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | not published | not published | $0.69 – $1.04 | 4 |
| Etoposide 50 mg cap HCPCS J8560 | not published | not published | $75.48 – $90.40 | 4 |
| Euflexxa inj per dose HCPCS J7323 | $262.02 | $403.11 | $98.14 – $420.15 | 4 |
| Euglobulin lysis CPT 85360 | $62.65 | $96.38 | $5.61 – $15.01 | 10 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $388.98 – $513.92 | 2 |
| Eval aud funcj ea addl 15 CPT 92627 | not published | not published | $11.94 – $21.21 | 2 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $50.78 – $89.69 | 2 |
| Eval/fit voice prosthesis iii, st CPT 92607 | not published | not published | $102.46 – $152.19 | 3 |
| Evaluation cervical mucus CPT 89330 | not published | not published | $6.92 – $12.46 | 8 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $210.54 | $323.90 | $22.08 – $161.80 | 10 |
| Evaluation heart device CPT 93640 | not published | not published | $299.75 – $369.84 | 2 |
| Evaluation of speech fluency 92521 CPT 92521 | $422.25 | $649.62 | $93.14 – $149.44 | 4 |
| Evaluation psychiatric diagnostic CPT 90791 | $390.67 | $601.03 | $74.50 – $179.80 | 4 |
| Evasc prlng admn rx agnt 1st CPT 61650 | not published | not published | $418.98 – $612.66 | 2 |
| Evasc prlng admn rx agnt add CPT 61651 | not published | not published | $179.06 – $265.43 | 2 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | not published | not published | $900.80 – $1,392.20 | 2 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | not published | not published | $903.90 – $1,371.31 | 2 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | not published | not published | $1,316.40 – $2,050.86 | 2 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | not published | not published | $1,659.93 – $2,556.37 | 2 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | not published | not published | $321.12 – $499.05 | 2 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | not published | not published | $1,002.41 – $1,537.95 | 2 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | not published | not published | $1,633.07 – $2,565.81 | 2 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | not published | not published | $851.17 – $1,280.87 | 2 |
| Evasc rpr ilio-iliac rpt CPT 34708 | not published | not published | $1,333.92 – $2,059.56 | 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.