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 |
|---|---|---|---|---|
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | not published | not published | $452.48 – $1,564.74 | 8 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | not published | not published | $364.87 – $364.87 | 1 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $389.75 – $701.88 | 8 |
| Hrdtry perph neurphy panel CPT 81448 | $1,555.11 | $2,392.48 | $389.75 – $701.88 | 8 |
| Hsv dna dir probe CPT 87528 | not published | not published | $13.36 – $24.06 | 8 |
| Htt gene charac alleles CPT 81274 | not published | not published | $166.55 – $374.74 | 10 |
| Htt gene detc abnor alleles CPT 81271 | $364.35 | $560.54 | $83.02 – $188.62 | 10 |
| Human epididymis protein 4 (he4) CPT 86305 | $75.34 | $115.91 | $13.87 – $46.82 | 10 |
| Human ig IV CPT 90283 | not published | not published | $63.53 – $74.37 | 2 |
| Human ig sc CPT 90284 | not published | not published | $15.77 – $16.01 | 2 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | not published | not published | $3.02 – $3.34 | 2 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $31.76 – $66.96 | 4 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $0.35 – $0.57 | 3 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $66.33 | $102.05 | $0.36 – $0.45 | 4 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | not published | not published | $3.40 – $18.00 | 4 |
| Hydrocolld drg >16<=48 w/bdr HCPCS A6238 | not published | not published | $11.25 – $32.50 | 6 |
| Hydrocolld drg >16<=48 without b HCPCS A6235 | not published | not published | $23.97 – $23.97 | 5 |
| Hydrocolld drg <=16 in w/bdr HCPCS A6237 | not published | not published | $6.01 – $11.27 | 6 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | not published | not published | $4.68 – $9.33 | 6 |
| Hydrocolld drg filler paste HCPCS A6240 | not published | not published | $17.45 – $17.45 | 5 |
| Hydrocortisone acetate inj HCPCS J1700 | not published | not published | $1.03 – $1.03 | 1 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $44.77 | $68.87 | $8.25 – $23.06 | 4 |
| Hydrocortisone sodium ph inj HCPCS J1710 | not published | not published | $4.69 – $4.69 | 1 |
| Hydrogel drg <= 16 in w/bdr HCPCS A6245 | not published | not published | $10.36 – $10.36 | 5 |
| Hydrogel drg >48 in without bdr HCPCS A6244 | not published | not published | $55.99 – $55.99 | 5 |
| Hydrogel drg > 48 sq in w/b HCPCS A6247 | not published | not published | $33.89 – $33.89 | 5 |
| Hydrogel drsg gel filler HCPCS A6248 | not published | not published | $14.06 – $23.15 | 6 |
| Hydrogel dsg>16<=48 sq in HCPCS A6232 | not published | not published | $9.78 – $9.78 | 5 |
| Hydrogel dsg<=16 sq in HCPCS A6231 | not published | not published | $1.97 – $6.66 | 6 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | not published | not published | $0.14 – $0.14 | 3 |
| Hydromorphone 250 mg HCPCS S0092 | not published | not published | $67.21 – $83.40 | 3 |
| Hydromorphone injection HCPCS J1170 | not published | not published | $2.26 – $3.80 | 2 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.01 – $0.01 | 2 |
| Hydroxyurea 500 mg HCPCS S0176 | not published | not published | $0.38 – $0.67 | 3 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | not published | not published | $2.41 – $27.86 | 4 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | not published | not published | $0.09 – $0.13 | 3 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $63.44 | $97.60 | $11.92 – $21.48 | 8 |
| Hymenotomy CPT 56442 | not published | not published | $35.84 – $49.04 | 2 |
| Hymovis injection 1 mg HCPCS J7322 | $151.61 | $233.25 | $17.50 – $35.85 | 4 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $710.21 – $1,100.67 | 2 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $26.82 – $35.60 | 3 |
| Hyperbaric oxygen therapy CPT 99183 | not published | not published | $90.62 – $129.06 | 2 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $6.79 – $18.25 | 10 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $760.31 – $965.46 | 3 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $329.91 – $441.41 | 3 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $406.05 – $597.65 | 3 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $493.70 – $773.08 | 3 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $788.19 – $1,066.64 | 3 |
| Hypnotherapy CPT 90880 | not published | not published | $67.95 – $118.21 | 3 |
| Hypothermia ill neonate CPT 99184 | not published | not published | $154.53 – $262.99 | 2 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $11.91 – $26.65 | 4 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $775.80 – $1,158.75 | 2 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $718.63 – $1,048.26 | 2 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $765.36 – $1,121.51 | 2 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $664.12 – $970.89 | 2 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $197.18 – $270.13 | 2 |
| Hysterosalpingography s&i CPT 74740 | $579.34 | $891.29 | $57.30 – $83.26 | 3 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $178.11 – $259.68 | 2 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $167.74 – $243.26 | 2 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $110.48 – $159.85 | 2 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $204.54 – $299.98 | 2 |
| Hysteroscopy remove fb CPT 58562 | $6,519.73 | $10,030.36 | $160.14 – $233.79 | 2 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $257.60 – $377.50 | 2 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $225.54 – $330.67 | 2 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $618.62 – $830.11 | 2 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $394.60 | $607.08 | $205.88 – $207.79 | 2 |
| I-123 iobenguane diag HCPCS A9582 | not published | not published | $4,723.22 – $8,122.37 | 2 |
| I-123 ioflupane diag HCPCS A9584 | $3,908.12 | $6,012.50 | $2,747.52 – $2,961.60 | 2 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $194.42 | $299.10 | $94.69 – $100.49 | 2 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $37.10 – $42.00 | 2 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $259.11 – $259.11 | 1 |
| I131 iodide cap, rx HCPCS A9517 | $30.61 | $47.09 | $59.96 – $59.96 | 1 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $80.75 – $95.00 | 2 |
| Iaadi respiratory synctial virus CPT 87280 | $43.39 | $66.75 | $8.11 – $18.25 | 10 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $20.87 – $42.11 | 8 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $157.51 | $242.32 | $3.79 – $21.71 | 10 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $120.05 | $184.69 | $27.14 – $61.06 | 10 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $45.86 | $70.56 | $13.14 – $97.00 | 4 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $1,483.83 – $2,938.27 | 8 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $1.50 – $3.32 | 4 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $103.68 – $357.96 | 3 |
| Icatibant injection HCPCS J1744 | not published | not published | $49.47 – $162.66 | 3 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $159.25 – $182.66 | 3 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $10.03 – $13.96 | 2 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $0.77 – $1.05 | 2 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $3.77 – $4.99 | 2 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $745.17 – $1,043.70 | 2 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $275.26 – $439.05 | 2 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $38.13 – $62.08 | 4 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $72.47 – $193.62 | 2 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $503,400.00 – $567,977.78 | 3 |
| Identify sperm tissue CPT 89264 | not published | not published | $103.65 – $103.65 | 1 |
| Idet 1 or more levels CPT 22527 | not published | not published | $177.17 – $177.17 | 1 |
| Idet single level CPT 22526 | not published | not published | $378.08 – $378.08 | 1 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $562.10 – $701.32 | 2 |
| Idh1 common variants CPT 81120 | $566.48 | $871.51 | $117.11 – $231.90 | 8 |
| Idh2 common variants CPT 81121 | $867.05 | $1,333.93 | $179.25 – $354.95 | 8 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $365.01 – $551.75 | 2 |
| I&d lacrimal gland CPT 68400 | $1,964.82 | $3,022.80 | $93.68 – $155.19 | 2 |
| I&d lacrimal sac CPT 68420 | not published | not published | $117.17 – $197.37 | 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.