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 |
|---|---|---|---|---|
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $1,251.85 – $2,045.04 | 2 |
| Gstr rstcv px sm int rcnstj CPT 43847 | not published | not published | $1,365.51 – $2,265.08 | 2 |
| Gstr rstcv px v-banded gstp CPT 43842 | not published | not published | $1,535.61 – $1,535.61 | 1 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $548.50 – $884.14 | 2 |
| G-tube reposition CPT 43761 | $270.24 | $415.76 | $73.14 – $132.72 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $68.70 – $84.69 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,517.45 | $2,334.54 | $97.97 – $156.97 | 2 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $1,063.87 | $1,636.73 | $681.49 – $681.49 | 5 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $546.00 | $840.00 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $623.22 | $958.80 | not published | 0 |
| Guid loc target vol rad tx CPT 77387 | $80.76 | $124.25 | $30.50 – $55.24 | 3 |
| Gw stiffened micro access kit HCPCS C1894 | $934.38 | $1,437.50 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $346.79 – $460.91 | 2 |
| Hair analysis HCPCS P2031 | not published | not published | $3.00 – $5.94 | 8 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $182.78 – $267.41 | 2 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $248.56 – $366.83 | 2 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $51.86 – $51.86 | 5 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $2,482.19 – $2,482.19 | 5 |
| Halo cervical into jckt vest HCPCS L0810 | $4,699.01 | $7,229.25 | $3,010.05 – $3,010.05 | 5 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $3,603.40 – $3,603.40 | 5 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $38.84 | $59.76 | $3.94 – $26.68 | 4 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | not published | not published | $0.73 – $3.60 | 4 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $258.53 – $258.53 | 5 |
| Hand-held pefr meter a4614 HCPCS A4614 | not published | not published | $24.67 – $33.89 | 6 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $17.84 – $17.84 | 1 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $115.37 – $115.37 | 5 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $2,147.09 – $2,147.09 | 5 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $2,232.44 – $2,232.44 | 5 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $766.41 – $766.41 | 5 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $2,173.00 – $2,173.00 | 5 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $86.00 | $132.31 | $14.60 – $23.45 | 4 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $672.63 – $892.53 | 2 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $560.83 – $702.04 | 2 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $608.41 – $800.89 | 2 |
| Hand X-ray CPT 73130 | $201.75 | $310.38 | $22.31 – $29.02 | 3 |
| Hand X-ray (2 views, both hands) CPT 73120 | $275.16 | $423.33 | $18.46 – $24.00 | 3 |
| Haptoglobin quantitative CPT 83010 | $45.53 | $70.04 | $8.38 – $28.30 | 10 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $250.94 – $250.94 | 5 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $178.60 – $178.60 | 5 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $166.40 – $166.40 | 5 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $57.74 – $94.67 | 2 |
| Harvest auto stem cells CPT 38206 | not published | not published | $56.58 – $94.91 | 2 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $93.16 – $139.57 | 2 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $297.36 – $484.36 | 2 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $248.40 – $383.52 | 2 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $55.73 – $55.73 | 1 |
| Harvest vein for bypass 35500 CPT 35500 | not published | not published | $232.22 – $354.25 | 2 |
| Hast w/i&r phys/qhp CPT 94452 | not published | not published | $34.86 – $44.34 | 3 |
| Hast w/oxygen titrate CPT 94453 | not published | not published | $46.25 – $62.30 | 3 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,413.29 | $2,174.29 | $363.60 – $720.00 | 8 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $448.71 | $690.32 | $122.65 – $433.33 | 10 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $94.17 – $450.30 | 10 |
| Hbb full gene sequence CPT 81364 | $764.54 | $1,176.22 | $196.70 – $389.50 | 8 |
| Hbb gene com variants CPT 81361 | not published | not published | $105.93 – $336.33 | 10 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $122.65 – $433.33 | 10 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $94.17 – $450.30 | 10 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $6.46 – $11.65 | 8 |
| Hbot, full body chamber, 30m HCPCS G0277 | $312.32 | $480.49 | $157.99 – $171.18 | 2 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $336.54 | $517.76 | $133.85 – $236.79 | 3 |
| Hcg free betachain test CPT 84704 | not published | not published | $10.19 – $28.10 | 10 |
| Hcg qualitative CPT 84703 | $27.24 | $41.90 | $2.02 – $9.02 | 10 |
| Hcg quantitative CPT 84702 | $54.49 | $83.83 | $10.03 – $28.10 | 10 |
| Hc hearing aid chck binaurl CPT 92593 | not published | not published | $16.83 – $16.83 | 1 |
| Hc hearing aid chck monarl CPT 92592 | not published | not published | $86.64 – $86.64 | 1 |
| Hc hearing aid exam one ear CPT 92590 | not published | not published | $11.40 – $11.40 | 1 |
| Hc metata joint dislocation anes CPT 28635 | not published | not published | $101.60 – $150.06 | 2 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | not published | not published | $238.91 – $410.82 | 2 |
| Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 | not published | not published | $127.26 – $218.14 | 2 |
| Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 | not published | not published | $214.42 – $368.07 | 2 |
| Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 | not published | not published | $33.47 – $57.84 | 2 |
| Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 | not published | not published | $116.29 – $202.34 | 2 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $96.11 – $150.70 | 3 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $146.80 – $216.97 | 3 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $2,384.04 | $3,667.76 | $131.52 – $202.93 | 3 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $875.00 – $1,344.36 | 2 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $16,155.11 | $24,854.02 | $94.15 – $133.98 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $201.78 – $257.51 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $335.42 – $443.96 | 3 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $516.73 – $694.60 | 3 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $159.83 – $201.55 | 3 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $240.73 – $313.10 | 3 |
| Head CT scan (with and without contrast) CPT 70470 | $799.16 | $1,229.47 | $93.46 – $190.17 | 3 |
| Head CT scan (with contrast) CPT 70460 | $799.16 | $1,229.47 | $78.45 – $159.64 | 3 |
| Head CT scan (without contrast) CPT 70450 | $499.36 | $768.24 | $54.78 – $111.48 | 3 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $0.01 – $815.48 | 8 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $0.01 – $1,950.00 | 8 |
| Heart first pass add-on CPT 78496 | not published | not published | $15.76 – $32.06 | 3 |
| Heart first pass multiple CPT 78483 | not published | not published | $124.23 – $203.03 | 3 |
| Heart image spect CPT 78494 | not published | not published | $127.70 – $195.97 | 3 |
| Heart infarct image CPT 78466 | $812.30 | $1,249.69 | $103.96 – $182.23 | 3 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $119.24 – $184.71 | 3 |
| Heart revascularize (tmr) CPT 33140 | not published | not published | $1,196.48 – $1,728.71 | 2 |
| Heart tmr w/other procedure 33141 CPT 33141 | not published | not published | $96.85 – $145.36 | 2 |
| Heavy duty control cable HCPCS L6660 | not published | not published | $112.37 – $112.37 | 5 |
| Heavy metal qual any number CPT 83015 | not published | not published | $13.95 – $47.12 | 10 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $201.75 | $310.38 | $16.85 – $21.84 | 3 |
| Heel leather reinforced HCPCS L3440 | not published | not published | $91.55 – $91.55 | 5 |
| Heinz bodies direct CPT 85441 | not published | not published | $2.80 – $9.45 | 10 |
| Heinz bodies induced CPT 85445 | not published | not published | $4.32 – $11.81 | 10 |
| Helicobacter pylori antibody igm CPT 86677 | $52.51 | $80.78 | $8.11 – $20.22 | 10 |
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.