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 |
|---|---|---|---|---|
| Als1-emergency HCPCS A0427 | not published | not published | $497.39 – $497.39 | 1 |
| Als 2 HCPCS A0433 | not published | not published | $654.46 – $654.46 | 1 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $182.29 | $280.44 | $82.16 – $98.59 | 4 |
| Alt/sgpt CPT 84460 | $19.18 | $29.50 | $3.52 – $11.43 | 10 |
| Altuviiio per factor viii iu HCPCS J7214 | not published | not published | $4.60 – $4.67 | 4 |
| Aluminum - quest CPT 82108 | $92.22 | $141.87 | $16.98 – $57.33 | 10 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $185.75 – $286.01 | 2 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $29.31 – $44.80 | 2 |
| Amantadine (symmetrel)-sendout CPT 80375 | $732.82 | $1,127.42 | $14.50 – $14.50 | 1 |
| Ambl bp mntr w/software CPT 93784 | not published | not published | $39.34 – $60.66 | 2 |
| Ambl bp mntr w/sw a/r CPT 93788 | $335.52 | $516.18 | $4.84 – $11.76 | 3 |
| Ambl bp mntr w/sw i&r CPT 93790 | not published | not published | $15.20 – $24.30 | 2 |
| Amifostine HCPCS J0207 | not published | not published | $415.67 – $1,285.69 | 3 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $1.57 | $2.42 | $0.60 – $1.92 | 4 |
| Amines vaginal fluid qual CPT 82120 | not published | not published | $2.02 – $7.19 | 10 |
| Amino acid screen, urine CPT 82128 | not published | not published | $7.76 – $20.90 | 10 |
| Amino acid single qual CPT 82127 | not published | not published | $6.21 – $20.90 | 10 |
| Amino acids quant 2-5 CPT 82136 | $61.05 | $93.92 | $13.07 – $31.82 | 10 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | not published | not published | $1.59 – $1.87 | 2 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $1.78 – $1.97 | 4 |
| Aminolevulinic acid delta CPT 82135 | $59.54 | $91.60 | $10.96 – $19.74 | 8 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $321.82 – $462.61 | 4 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | not published | not published | $9.76 – $11.16 | 4 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | not published | not published | $2.36 – $4.61 | 4 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | not published | not published | $0.33 – $0.51 | 4 |
| Amitriptyline (elavil) -sendout CPT 80335 | $85.33 | $131.28 | $4.98 – $11.36 | 3 |
| Amitriptyline injection HCPCS J1320 | not published | not published | $2.11 – $2.11 | 1 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | not published | not published | $21.51 – $23.22 | 4 |
| Ammonia CPT 82140 | $52.74 | $81.14 | $9.71 – $32.78 | 10 |
| Amnioarmor 1 sq cm HCPCS Q4188 | not published | not published | $103.97 – $576.00 | 2 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $58.40 – $76.89 | 2 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $128.05 – $171.98 | 2 |
| Amniocore per sq cm HCPCS Q4227 | not published | not published | $103.97 – $540.00 | 2 |
| Amnio-maxx or lite per sq cm HCPCS Q4239 | not published | not published | $103.97 – $399.74 | 2 |
| Amniotic fluid scan CPT 82143 | not published | not published | $6.23 – $20.43 | 10 |
| Amniowrap2 per sq cm HCPCS Q4221 | not published | not published | $103.97 – $103.97 | 1 |
| Amobarbital 125 mg inj HCPCS J0300 | not published | not published | $175.94 – $219.92 | 3 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $545.85 – $723.07 | 2 |
| Amphetamine confirm urine -sendout CPT 80324 | $195.00 | $300.00 | $5.05 – $11.36 | 3 |
| Amphetamines 5 or more CPT 80326 | $197.35 | $303.62 | $5.05 – $11.36 | 3 |
| Ampho b cholesteryl sulfate HCPCS J0288 | not published | not published | $12.80 – $12.80 | 1 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | not published | not published | $21.48 – $52.44 | 4 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $10.30 – $12.60 | 3 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $19.84 – $61.14 | 4 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $1.52 | $2.34 | $0.59 – $3.12 | 4 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | not published | not published | $1.33 – $6.16 | 4 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $170.94 – $315.59 | 8 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $6,661.44 | $10,248.37 | $326.67 – $480.48 | 2 |
| Amp thigh through femur re-amp 27596 CPT 27596 | $10,645.06 | $16,377.01 | $536.30 – $795.58 | 2 |
| Amputate hand at wrist CPT 25922 | not published | not published | $509.18 – $685.40 | 2 |
| Amputate hand at wrist CPT 25920 | not published | not published | $569.16 – $780.03 | 2 |
| Amputate leg at thigh CPT 27591 | not published | not published | $725.29 – $1,073.87 | 2 |
| Amputate leg at thigh CPT 27592 | not published | not published | $510.16 – $753.95 | 2 |
| Amputate lower leg at knee CPT 27598 | not published | not published | $523.98 – $787.88 | 2 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $605.33 – $806.32 | 2 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $584.82 – $879.13 | 2 |
| Amputate upper arm & implant CPT 24931 | not published | not published | $700.13 – $1,038.74 | 2 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $445.20 – $629.89 | 2 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $477.78 – $677.96 | 2 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $527.11 – $759.96 | 2 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $466.56 – $663.71 | 2 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $638.51 – $845.80 | 2 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $388.87 – $562.17 | 2 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $445.26 – $630.77 | 2 |
| Amputation follow-up surgery CPT 24930 | not published | not published | $589.18 – $859.51 | 2 |
| Amputation follow-up surgery CPT 25924 | not published | not published | $556.31 – $754.58 | 2 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $667.61 – $1,008.25 | 2 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $489.03 – $725.53 | 2 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $487.09 – $715.02 | 2 |
| Amputation of foot at ankle CPT 27888 | not published | not published | $431.74 – $736.52 | 2 |
| Amputation of forearm CPT 25900 | not published | not published | $547.53 – $791.41 | 2 |
| Amputation of forearm CPT 25905 | not published | not published | $538.53 – $777.18 | 2 |
| Amputation of forearm CPT 25915 | not published | not published | $864.37 – $1,303.96 | 2 |
| Amputation of hand CPT 25927 | not published | not published | $685.55 – $913.91 | 2 |
| Amputation of leg at hip CPT 27290 | not published | not published | $1,196.51 – $1,809.41 | 2 |
| Amputation of leg at hip CPT 27295 | not published | not published | $934.54 – $1,400.83 | 2 |
| Amputation of lower leg CPT 27882 | not published | not published | $448.18 – $659.38 | 2 |
| Amputation of lower leg CPT 27881 | not published | not published | $616.29 – $957.13 | 2 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $406.49 – $602.87 | 2 |
| Amputation of upper arm CPT 24900 | not published | not published | $587.63 – $819.03 | 2 |
| Amputation of upper arm CPT 24920 | not published | not published | $560.62 – $816.25 | 2 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $537.22 – $818.26 | 2 |
| Amputation toe interphalangeal joint CPT 28825 | $6,787.76 | $10,442.70 | $129.71 – $203.00 | 2 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $134.01 – $209.26 | 2 |
| Amylase CPT 82150 | $425.41 | $654.48 | $4.31 – $11.43 | 10 |
| Anabolic steroid 1 or 2 CPT 80327 | $61.55 | $94.69 | $14.95 – $14.95 | 1 |
| Anabolic steroid 3 or more CPT 80328 | not published | not published | $16.75 – $16.75 | 1 |
| Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 | not published | not published | $54.98 – $60.71 | 2 |
| Ana ds-dna CPT 86226 | $43.81 | $67.40 | $8.07 – $14.53 | 8 |
| Analgesics non-opioid 3-5 CPT 80330 | not published | not published | $6.40 – $6.40 | 1 |
| Analgesics non-opioid 6/more CPT 80331 | not published | not published | $6.40 – $6.40 | 1 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $108.84 | $167.45 | $7.72 – $7.72 | 1 |
| Anal pressure record CPT 91122 | not published | not published | $139.15 – $224.86 | 2 |
| Anal/urinary muscle study CPT 51784 | $366.43 | $563.74 | $23.94 – $127.23 | 3 |
| Anal/urinary muscle study CPT 51785 | not published | not published | $147.33 – $363.70 | 3 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | not published | not published | $35.45 – $57.28 | 2 |
| Analysis gene f2 20210g>a variant CPT 81240 | $192.56 | $296.24 | $30.35 – $147.80 | 10 |
| Analysis gene f5 leiden variant CPT 81241 | $221.14 | $340.21 | $27.19 – $165.08 | 10 |
| Analysis nerve CPT 88356 | not published | not published | $25.62 – $112.30 | 5 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | not published | not published | $26.52 – $42.93 | 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.