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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $127.02 | $195.41 | $21.64 – $48.69 | 10 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $127.02 | $195.41 | $24.84 – $44.72 | 8 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,508.29 | $2,320.44 | $277.72 – $500.14 | 8 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $82.65 | $127.16 | $23.38 – $73.06 | 10 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $77.79 | $119.68 | $21.64 – $48.69 | 10 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $127.02 | $195.41 | $20.87 – $93.78 | 10 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $127.02 | $195.41 | $21.64 – $48.69 | 10 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $143.24 | $220.37 | $30.79 – $69.28 | 10 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $335.96 | $516.86 | $82.59 – $192.58 | 10 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $316.20 | $486.46 | $82.59 – $192.58 | 10 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $127.02 | $195.41 | $20.87 – $42.11 | 8 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $68.43 | $105.27 | $21.64 – $48.69 | 10 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $136.85 | $210.54 | $60.35 – $84.22 | 7 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $41.68 – $93.78 | 10 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $584.60 – $815.72 | 7 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $981.72 | $1,510.34 | $277.72 – $500.14 | 8 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $446.81 | $687.40 | $85.49 – $153.95 | 8 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $734.19 | $1,129.53 | $157.79 – $355.03 | 10 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $155.01 | $238.47 | $20.87 – $51.41 | 8 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $155.01 | $238.47 | $28.55 – $51.41 | 8 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $155.01 | $238.47 | $28.55 – $96.39 | 10 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $307.96 | $473.78 | $56.70 – $191.48 | 10 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $464.26 | $714.25 | $95.04 – $218.86 | 10 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $238.93 | $367.59 | $30.52 – $57.00 | 4 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $30.52 – $60.00 | 4 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $119.34 | $183.60 | $27.71 – $113.55 | 5 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $15.80 – $48.69 | 10 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | $169.88 | $261.36 | $98.16 – $98.16 | 1 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | $51.68 | $79.50 | $29.71 – $29.71 | 1 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | not published | not published | $56.95 – $69.62 | 2 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $2,256.70 – $3,421.80 | 2 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $2,178.71 – $3,399.24 | 2 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $62.48 – $75.77 | 2 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $59.43 – $72.22 | 2 |
| Infuse radioactive materials CPT 77750 | not published | not published | $101.35 – $131.79 | 3 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $48.56 – $74.80 | 2 |
| Ingest challenge ini 120 min CPT 95076 | $1,062.35 | $1,634.39 | $52.76 – $81.30 | 2 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $92.42 – $92.42 | 1 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $2,129.35 – $2,129.35 | 5 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,572.33 – $1,572.33 | 5 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $33.84 – $72.65 | 2 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,580.90 – $1,580.90 | 5 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $29.33 – $57.39 | 2 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $248.23 – $432.45 | 2 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $50.40 – $160.80 | 4 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $84.00 – $207.27 | 4 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $25.20 – $112.09 | 4 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $44.70 – $113.40 | 2 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $406.48 | $625.36 | $206.41 – $206.41 | 1 |
| Init/sub psych care m 1st 30 HCPCS G2214 | $62.44 | $96.06 | $28.24 – $44.20 | 2 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | $11.37 | $17.49 | $5.87 – $6.18 | 3 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $14.37 | $22.11 | $4.68 – $7.66 | 4 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.09 – $0.22 | 3 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.05 – $0.15 | 4 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.05 – $0.25 | 4 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.03 – $0.05 | 3 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,893.43 – $4,172.53 | 3 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $91.72 – $91.72 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $13.75 – $13.75 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $63,235.61 – $64,331.61 | 3 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.98 – $6.77 | 2 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $34.52 – $36.21 | 3 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $803.26 – $866.20 | 2 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | $625.98 | $963.04 | $298.68 – $321.18 | 3 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.51 – $2.15 | 5 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $2.05 – $2.05 | 1 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $4.07 – $4.45 | 3 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $121.54 – $138.11 | 3 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $33.01 – $86.23 | 3 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $9.16 – $10.11 | 2 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $120.00 – $150.00 | 3 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $38.31 | $58.94 | $17.78 – $18.68 | 4 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $3,445.58 – $3,674.68 | 3 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $3.14 – $3.96 | 4 |
| Inj, artesunate, 1mg HCPCS J0391 | not published | not published | $46.94 – $51.83 | 2 |
| Inj. asceniv HCPCS J1554 | not published | not published | $490.46 – $556.31 | 4 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $54.38 – $58.70 | 4 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $32.10 – $32.55 | 2 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $102.92 – $107.44 | 3 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $77.82 – $83.94 | 4 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $52.96 – $52.96 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $364.38 | $560.59 | $163.30 – $214.04 | 4 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $39.96 – $44.12 | 3 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $2,968,000.00 – $2,968,000.00 | 1 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $39.83 – $45.60 | 3 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $209.91 – $234.00 | 4 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.16 – $0.18 | 3 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $24.75 – $25.63 | 2 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $43.97 – $54.96 | 3 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $43.97 – $54.96 | 3 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $1.43 – $9.74 | 4 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $71.52 – $89.40 | 3 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $420.05 – $430.58 | 3 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $1,680.21 – $1,722.30 | 3 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $339.99 – $370.00 | 4 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $860.80 – $1,760.93 | 6 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $1.42 – $1.45 | 3 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.58 – $0.58 | 1 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $60.22 – $271.20 | 4 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $0.39 – $1.05 | 3 |
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.