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 |
|---|---|---|---|---|
| Eye Socket, Pituitary or Ear CT Scan (with contrast) CPT 70481 | $799.16 | $1,229.47 | $104.10 – $211.84 | 3 |
| Eye Socket, Pituitary or Ear CT Scan (without contrast) CPT 70480 | $499.36 | $768.24 | $80.91 – $164.64 | 3 |
| Eye surgery follow-up add-on CPT 67331 | not published | not published | $84.07 – $360.25 | 2 |
| Eye suture during surgery CPT 67335 | not published | not published | $125.07 – $174.40 | 2 |
| Ezh2 gene common variants CPT 81237 | not published | not published | $106.29 – $239.15 | 10 |
| Ezh2 gene full gene sequence CPT 81236 | not published | not published | $171.43 – $385.72 | 10 |
| F-18 fdg pet diag HCPCS A9552 | $306.10 | $470.93 | $259.11 – $259.11 | 1 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | not published | not published | $3,028.84 – $3,428.88 | 2 |
| F-18 fluciclovine per mci HCPCS A9588 | not published | not published | $547.65 – $576.00 | 2 |
| F9 full gene sequence CPT 81238 | $1,248.98 | $1,921.50 | $363.60 – $720.00 | 8 |
| Fabrication & fitting HCPCS V2628 | not published | not published | $378.33 – $378.33 | 5 |
| Face bone graft CPT 21210 | not published | not published | $573.10 – $889.18 | 2 |
| Face, Eye Socket and Neck MRI (with and without contrast) CPT 70543 | $1,510.60 | $2,324.00 | $194.35 – $345.87 | 3 |
| Face, Eye Socket and Neck MRI (without contrast) CPT 70540 | $956.04 | $1,470.83 | $132.75 – $262.50 | 3 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | $201.75 | $310.38 | $17.94 – $23.27 | 3 |
| Facial Bones X-ray (complete) CPT 70150 | $275.16 | $423.33 | $28.04 – $36.19 | 3 |
| Facial nerve function test CPT 92516 | not published | not published | $15.67 – $26.78 | 2 |
| Factor ix CPT 85250 | $68.91 | $106.02 | $12.70 – $42.84 | 10 |
| Factor ix alprolix recomb HCPCS J7201 | not published | not published | $3.09 – $4.14 | 6 |
| Factor ix complex HCPCS J7194 | not published | not published | $1.34 – $1.70 | 6 |
| Factor ix idelvion inj HCPCS J7202 | not published | not published | $5.18 – $5.98 | 5 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $1.21 – $1.66 | 6 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $4.32 – $5.41 | 5 |
| Factor ix recombinan rixubis HCPCS J7200 | not published | not published | $1.36 – $2.04 | 6 |
| Factor ix recombinant nos HCPCS J7195 | not published | not published | $1.60 – $1.88 | 6 |
| Factor viia recomb sevenfact HCPCS J7212 | not published | not published | $2.19 – $2.82 | 5 |
| Factor viii CPT 85240 | $64.79 | $99.68 | $9.49 – $21.48 | 10 |
| Factor viii HCPCS J7190 | not published | not published | $1.05 – $1.73 | 6 |
| Factor viii fc fusion recomb HCPCS J7205 | not published | not published | $2.08 – $2.86 | 6 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $1.13 – $2.28 | 5 |
| Factor viii pegylated recomb HCPCS J7207 | not published | not published | $2.10 – $2.75 | 5 |
| Factor viii recombinant nos HCPCS J7192 | not published | not published | $1.29 – $2.15 | 6 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $1.40 – $2.40 | 6 |
| Factor viii recomb obizur HCPCS J7188 | not published | not published | $3.23 – $3.54 | 5 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $8.55 – $13.76 | 6 |
| Factor xiii recomb a-subunit HCPCS J7181 | not published | not published | $12.77 – $20.22 | 5 |
| Fallopian tube recnl CPT 58345 | not published | not published | $209.32 – $304.64 | 2 |
| Fam adapt bhv tx gdn phy/qhp CPT 97156 | not published | not published | $10.36 – $10.36 | 1 |
| Family therapy without pt 50min 90846 CPT 90846 | $294.41 | $452.94 | $65.75 – $109.27 | 4 |
| Family therapy with patient 50 min 90847 CPT 90847 | $321.46 | $494.55 | $65.75 – $113.17 | 4 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $0.01 | $0.02 | $0.01 – $0.01 | 2 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $28.90 – $32.87 | 4 |
| Fancc gene CPT 81242 | not published | not published | $22.19 – $43.94 | 8 |
| Fasciotomy hip/thigh any typ CPT 27025 | not published | not published | $717.49 – $1,019.44 | 2 |
| Fat/lipids feces qualitative CPT 82705 | $18.43 | $28.36 | $3.39 – $11.48 | 10 |
| Fatty acids nonesterified CPT 82725 | $44.21 | $68.02 | $12.50 – $22.52 | 8 |
| Fda ide #g240020 carry bag HCPCS Q0499 | not published | not published | $200.58 – $200.58 | 5 |
| Fecal bilirubin test CPT 82252 | not published | not published | $3.03 – $5.47 | 8 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $63.93 – $351.12 | 4 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $51.10 – $79.56 | 2 |
| #fecal-sodium CPT 84302 | $17.59 | $27.06 | $3.24 – $10.94 | 10 |
| Feeding tube reposition CPT 74355 | not published | not published | $98.27 – $119.17 | 2 |
| Fees w/laryngeal sense i&r CPT 92617 | not published | not published | $28.31 – $48.69 | 2 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $67.36 – $117.32 | 2 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $49.56 | $76.25 | $10.61 – $23.87 | 10 |
| Fem focal defic constant fri HCPCS L5230 | not published | not published | $4,657.24 – $4,657.24 | 5 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $171.13 – $261.17 | 2 |
| Femoral lgth sock fx or equa HCPCS L2850 | not published | not published | $76.37 – $76.37 | 5 |
| Fem/popl revasc w/stent CPT 37226 | not published | not published | $581.47 – $581.47 | 1 |
| Fem urinary collect pouch HCPCS A4328 | not published | not published | $14.87 – $14.87 | 5 |
| Feno poc CPT 95012 | not published | not published | $16.03 – $21.36 | 2 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $1.25 | $1.93 | $0.54 – $1.38 | 4 |
| Fern test HCPCS Q0114 | $28.55 | $43.92 | $6.48 – $11.69 | 8 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $3.00 | $4.62 | $1.12 – $2.05 | 4 |
| Ferritin CPT 82728 | $49.33 | $75.89 | $9.08 – $30.67 | 10 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.36 – $2.13 | 3 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.36 – $2.13 | 3 |
| Fetal aneuploidy trisom risk CPT 81507 | $2,330.37 | $3,585.18 | $481.77 – $954.00 | 8 |
| Fetal biophys profile w/nst 76818 CPT 76818 | not published | not published | $58.53 – $73.86 | 3 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $486.21 – $910.86 | 8 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $2,113.85 | $3,252.07 | $486.21 – $910.86 | 8 |
| Fetal contract stress test 59020 - 26 CPT 59020 | not published | not published | $29.40 – $32.75 | 3 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $143.96 – $194.57 | 2 |
| Fetal fibronectin CPT 82731 | $233.08 | $358.59 | $15.89 – $144.92 | 10 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $220.91 – $297.95 | 2 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $27.99 | $43.06 | $5.15 – $17.39 | 10 |
| Fetal hemoglobin rosette CPT 85461 | $27.43 | $42.20 | $6.23 – $21.06 | 10 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $68.44 | $105.30 | $4.15 – $23.18 | 10 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $29.21 – $40.46 | 2 |
| Fetal monitor w/report CPT 59050 | not published | not published | $35.63 – $48.69 | 2 |
| Fetal non stress test CPT 59025 | not published | not published | $17.12 – $18.81 | 3 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $79.23 – $108.38 | 2 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $370.88 – $503.57 | 2 |
| #_fet/norfentcnfrmur CPT 80354 | $53.22 | $81.88 | $5.05 – $11.36 | 3 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $1.73 – $7.90 | 3 |
| Fibrin degradation d dimer quantitative CPT 85379 | $74.42 | $114.50 | $6.79 – $22.90 | 10 |
| Fibrin degradation products CPT 85362 | $24.96 | $38.40 | $4.60 – $15.50 | 10 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $6.47 – $21.87 | 10 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $6.79 – $22.90 | 10 |
| Fibrinogen activity CPT 85384 | $30.74 | $47.29 | $6.25 – $15.68 | 10 |
| Fibrinogen test CPT 85370 | $41.09 | $63.22 | $8.28 – $20.45 | 10 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $45.37 | $69.80 | $7.16 – $18.58 | 8 |
| Fibrinolytic antiplasmin CPT 85410 | $27.88 | $42.89 | $5.14 – $9.25 | 8 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $5.14 – $9.25 | 8 |
| Fibrinolytic plasminogen CPT 85415 | $62.20 | $95.69 | $11.45 – $20.63 | 8 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $6.79 – $12.22 | 8 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $23.63 | $36.35 | $4.34 – $7.84 | 8 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $1,857.47 – $2,786.00 | 2 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.28 – $0.88 | 5 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $2.14 | $3.30 | $0.98 – $1.25 | 4 |
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.