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 |
|---|---|---|---|---|
| Fusion of hand joint CPT 26843 | not published | not published | $628.14 – $829.75 | 2 |
| Fusion of knee CPT 27580 | not published | not published | $1,105.44 – $1,605.94 | 2 |
| Fusion of knuckle CPT 26850 | not published | not published | $577.78 – $778.07 | 2 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $586.69 – $788.64 | 2 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $690.05 – $918.25 | 2 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $697.95 – $929.74 | 2 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $650.51 – $882.96 | 2 |
| Fusion of skull arteries CPT 61711 | not published | not published | $1,981.88 – $2,817.84 | 2 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $599.50 – $910.67 | 2 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $786.89 – $1,202.47 | 2 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $535.57 – $759.65 | 2 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $490.03 – $716.47 | 2 |
| Fusion of thumb CPT 26841 | not published | not published | $614.01 – $817.14 | 2 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $528.81 – $767.06 | 2 |
| Fusion of toes CPT 28280 | not published | not published | $266.69 – $394.09 | 2 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $1,076.22 – $1,550.07 | 2 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $933.62 – $1,355.22 | 2 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $852.77 – $1,312.61 | 2 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $166.55 – $374.74 | 10 |
| Fxn gene detc abnor alleles CPT 81284 | $303.73 | $467.27 | $83.02 – $188.62 | 10 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $166.55 – $329.80 | 8 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $94.17 – $222.24 | 10 |
| G0180 home health certification HCPCS G0180 | not published | not published | $46.97 – $70.83 | 2 |
| G6pc gene CPT 81250 | not published | not published | $35.44 – $70.19 | 8 |
| G6pd full gene sequence CPT 81249 | $1,248.98 | $1,921.50 | $363.60 – $720.00 | 8 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $105.93 – $209.77 | 8 |
| G6pd known familial variant CPT 81248 | not published | not published | $94.17 – $450.30 | 10 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $121.73 | $187.27 | $143.08 – $162.02 | 2 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $61.24 – $66.67 | 2 |
| Gabapentin non-blood CPT 80355 | $65.23 | $100.35 | $11.96 – $11.96 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $0.69 | $1.06 | $0.26 – $1.00 | 4 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $2.80 | $4.31 | $1.44 – $6.18 | 4 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $0.44 | $0.68 | $0.09 – $0.24 | 3 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $28.03 | $43.12 | $14.75 – $17.25 | 4 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $14.05 – $47.41 | 10 |
| Galactokinase - sendout CPT 82759 | not published | not published | $14.31 – $48.33 | 10 |
| Galactose transferase test CPT 82776 | not published | not published | $7.82 – $14.09 | 8 |
| Galectin-3 CPT 82777 | $129.72 | $199.57 | $10.79 – $53.10 | 8 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $812.30 | $1,249.69 | $204.85 – $330.42 | 3 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $859.59 | $1,322.44 | $278.67 – $452.05 | 3 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $512.02 – $729.98 | 2 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $9.09 – $9.09 | 1 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $1,095.19 – $1,128.00 | 2 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $648.84 – $960.00 | 2 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $1.06 – $1.06 | 1 |
| Galsulfase injection HCPCS J1458 | not published | not published | $400.83 – $525.97 | 4 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $104.52 – $503.60 | 4 |
| Gamma globulin 1 cc inj HCPCS J1460 | $82.69 | $127.22 | $36.80 – $55.39 | 4 |
| Gammaglobulin iga CPT 82784 | $33.65 | $51.77 | $6.20 – $20.92 | 10 |
| Gammaglobulin ige CPT 82785 | $59.56 | $91.63 | $10.97 – $28.42 | 10 |
| Gamma glutamyltransferase CPT 82977 | $26.05 | $40.08 | $4.80 – $11.43 | 10 |
| Gammagraft HCPCS Q4111 | not published | not published | $7.85 – $7.87 | 2 |
| Gammaplex injection HCPCS J1557 | not published | not published | $41.04 – $118.52 | 4 |
| Gamunex-c/gammaked HCPCS J1561 | $122.30 | $188.16 | $45.94 – $80.04 | 4 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | not published | not published | $31.46 – $86.40 | 4 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $3,355.13 – $3,355.13 | 1 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $20.87 – $42.11 | 8 |
| Gardner vag dna quant CPT 87512 | not published | not published | $20.87 – $50.11 | 8 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $4.15 – $8.05 | 8 |
| Gastric emptying imag study CPT 78265 | not published | not published | $247.08 – $382.18 | 3 |
| Gastric emptying imag study CPT 78266 | not published | not published | $283.30 – $447.94 | 3 |
| Gastric motility studies CPT 91020 | not published | not published | $160.27 – $254.29 | 3 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $127.98 – $203.03 | 3 |
| Gastrin test CPT 82938 | not published | not published | $11.79 – $39.80 | 10 |
| Gastroduodenostomy CPT 43810 | not published | not published | $773.42 – $1,278.58 | 2 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $151.71 – $234.15 | 3 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $124.02 – $182.68 | 3 |
| Gastrointestinal repair CPT 43360 | not published | not published | $1,719.51 – $2,831.31 | 2 |
| Gastrointestinal repair CPT 43361 | not published | not published | $2,028.08 – $3,395.91 | 2 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $1,018.84 – $1,692.95 | 2 |
| Gastrojejunostomy w/vagotomy CPT 43825 | not published | not published | $995.48 – $1,646.11 | 2 |
| Gastroplasty duodenal switch CPT 43845 | not published | not published | $1,478.51 – $2,459.01 | 2 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $485.56 – $755.08 | 2 |
| Gated heart multiple CPT 78473 | not published | not published | $162.28 – $245.46 | 3 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | not published | not published | $3.46 – $3.46 | 5 |
| Gauze >16 <=48 sq in w/bordr HCPCS A6220 | not published | not published | $1.70 – $3.69 | 6 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | not published | not published | $3.04 – $3.04 | 5 |
| Gauze <= 16 sq in w/border HCPCS A6219 | not published | not published | $1.11 – $1.36 | 6 |
| Gauze > 48 in no w/sal without b HCPCS A6224 | not published | not published | $5.13 – $5.13 | 5 |
| Gba gene CPT 81251 | not published | not published | $28.63 – $56.70 | 8 |
| Gc stocking full lngth 18-30 HCPCS A6536 | not published | not published | $73.95 – $73.95 | 5 |
| Gc stocking full lngth 30-40 HCPCS A6537 | not published | not published | $87.67 – $87.67 | 5 |
| Gc stocking full lngth 40+ HCPCS A6538 | not published | not published | $102.65 – $102.65 | 5 |
| Gc stocking thighlngth 18-30 HCPCS A6533 | not published | not published | $54.86 – $54.86 | 5 |
| Gc stocking thighlngth 30-40 HCPCS A6534 | not published | not published | $62.65 – $62.65 | 5 |
| Gc stocking thighlngth 40+ HCPCS A6535 | not published | not published | $72.13 – $72.13 | 5 |
| Gc stocking waistlngth 18-30 HCPCS A6539 | not published | not published | $97.86 – $97.86 | 5 |
| Gc stocking waistlngth 30-40 HCPCS A6540 | not published | not published | $116.68 – $116.68 | 5 |
| Gc stocking waistlngth 40+ HCPCS A6541 | not published | not published | $138.21 – $138.21 | 5 |
| Gefitinib oral HCPCS J8565 | not published | not published | $54.46 – $311.56 | 3 |
| Gel cap app device for trach HCPCS L8515 | not published | not published | $75.84 – $75.84 | 5 |
| Gel cap for trach voice pros HCPCS L8512 | not published | not published | $2.59 – $2.59 | 5 |
| Gel-one HCPCS J7326 | $1,045.69 | $1,608.75 | $528.05 – $1,380.00 | 4 |
| Gel-syn injection 0.1 mg HCPCS J7328 | $4.88 | $7.51 | $0.58 – $2.54 | 4 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | not published | not published | $2.88 – $12.49 | 4 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | not published | not published | $233.12 – $247.37 | 4 |
| General health panel CPT 80050 | $56.84 | $87.44 | $24.18 – $35.21 | 2 |
| Genetic tstg severe inh cond CPT 81443 | $6,510.12 | $10,015.57 | $1,483.83 – $2,938.27 | 8 |
| Genioplasty augmentation CPT 21120 | not published | not published | $399.84 – $592.56 | 2 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $640.01 – $1,012.49 | 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.