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 |
|---|---|---|---|---|
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $235.20 – $259.70 | 2 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $1.25 – $2.78 | 4 |
| Inj cefazolin sodium, hikma HCPCS J0688 | not published | not published | $0.85 – $0.98 | 3 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $0.63 – $0.97 | 3 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $5.80 – $14.48 | 4 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $4.48 – $8.75 | 4 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | not published | not published | $2.28 – $2.55 | 4 |
| Inj ceftolozane tazobactam HCPCS J0695 | not published | not published | $3.98 – $10.04 | 4 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $111.22 – $124.27 | 3 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $15.62 – $18.00 | 4 |
| Inj, cimerli, 0.1 mg HCPCS Q5128 | not published | not published | $82.53 – $83.34 | 2 |
| Inj, cipaglucosidase, 5 mg HCPCS J1203 | not published | not published | $89.85 – $96.30 | 3 |
| Inj, clevidipine butyrate HCPCS C9248 | not published | not published | $3.87 – $3.87 | 1 |
| Inj, clindamycin (baxter) HCPCS J0737 | not published | not published | $2.19 – $2.53 | 3 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $277.15 | $426.39 | $28.35 – $45.93 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | not published | not published | $84.06 – $99.01 | 3 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $1,043.55 – $4,925.16 | 3 |
| Inj, crovalimab-akkz, 10 mg HCPCS J1307 | not published | not published | $499.48 – $551.51 | 3 |
| Inj cutaquig 100 mg HCPCS J1551 | not published | not published | $14.03 – $23.67 | 4 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $16.68 – $24.20 | 4 |
| Inj, cyclophos (baxter) 5mg HCPCS J9076 | not published | not published | $4.39 – $4.92 | 3 |
| Inj cyclophos dr.reddy's 5mg HCPCS J9072 | not published | not published | $8.92 – $9.05 | 3 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $0.49 – $4.38 | 4 |
| Inj cyclophosphamd (ingenus) HCPCS J9073 | not published | not published | $0.50 – $1.76 | 3 |
| Inj, cyclophosphamd, sandoz HCPCS J9074 | not published | not published | $3.44 – $4.34 | 3 |
| Inj, daptomycin (baxter) HCPCS J0874 | not published | not published | $0.06 – $0.07 | 3 |
| Inj, daptomycin (hospira) HCPCS J0877 | not published | not published | $0.06 – $0.18 | 4 |
| Inj daptomycin (xellia) HCPCS J0873 | not published | not published | $0.03 – $0.04 | 3 |
| Inj daxibotulinumtoxina-lanm HCPCS J0589 | not published | not published | $2.99 – $3.11 | 3 |
| Inj, decitabine (sun pharma) HCPCS J0893 | not published | not published | $0.78 – $6.00 | 3 |
| Inj delandistrogene mox rokl HCPCS J1413 | not published | not published | $3,392,000.00 – $3,392,000.00 | 1 |
| Inj. denosumab-bbdz, 1 mg HCPCS Q5136 | $51.45 | $79.15 | $27.66 – $28.23 | 2 |
| Inj diclofenac sodium 0.5mg HCPCS J1130 | not published | not published | $0.20 – $0.20 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $111.53 – $181.59 | 2 |
| Inj, docetaxel (beizray) 1mg HCPCS J9174 | not published | not published | $46.81 – $47.44 | 2 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | not published | not published | $4.16 – $4.18 | 3 |
| Inj dupuytren cord w/enzyme CPT 20527 | $332.02 | $510.80 | $47.82 – $73.59 | 2 |
| Inj, durolane 1 mg HCPCS J7318 | $39.26 | $60.40 | $6.24 – $20.09 | 4 |
| Inj dx for sinogram CPT 20501 | $638.70 | $982.62 | $25.95 – $43.05 | 2 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $60.97 – $93.45 | 2 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $449.46 | $691.47 | $47.97 – $79.08 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | not published | not published | $35.75 – $54.45 | 4 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $469.74 – $513.37 | 4 |
| Injection, cangrelor HCPCS C9460 | not published | not published | $19.22 – $20.01 | 2 |
| Injection, caplacizumab-yhdp HCPCS C9047 | not published | not published | $748.07 – $828.22 | 2 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $40.51 – $64.39 | 2 |
| Injection, casimersen, 10 mg HCPCS J1426 | not published | not published | $153.60 – $192.00 | 3 |
| Injection, cimetidine hydroc HCPCS S0023 | not published | not published | $1.98 – $1.98 | 1 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $67.63 – $76.82 | 4 |
| Injection, delafloxacin HCPCS C9462 | not published | not published | $0.57 – $0.57 | 1 |
| Injection, doxercalciferol HCPCS J1270 | $3.43 | $5.27 | $0.31 – $1.20 | 4 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $26.31 – $66.71 | 2 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $6.46 – $24.46 | 4 |
| Injection epidural blood patch or clot CPT 62273 | $1,231.28 | $1,894.28 | $85.03 – $128.90 | 2 |
| Injection estrone per 1 mg HCPCS J1435 | not published | not published | $0.16 – $0.16 | 1 |
| Injection eye drug CPT 67028 | not published | not published | $62.90 – $115.82 | 2 |
| Injection, famotidine, 20 mg HCPCS S0028 | not published | not published | $1.07 – $1.07 | 1 |
| Injection for arthrography wrist (both sides) CPT 25246 | $94.60 | $145.54 | $51.24 – $85.24 | 2 |
| Injection for bladder x-ray CPT 51600 | $100.80 | $155.08 | $31.16 – $50.85 | 2 |
| Injection for hip x-ray CPT 27095 | not published | not published | $57.57 – $94.08 | 2 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $256.86 | $395.17 | $35.16 – $58.07 | 2 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $91.22 – $151.96 | 2 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $38.01 – $65.53 | 2 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $38.70 – $56.99 | 2 |
| Injection for ureter x-ray CPT 50690 | $632.78 | $973.51 | $51.53 – $79.62 | 2 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $24.31 – $86.40 | 3 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $5.28 – $42.00 | 4 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $57.50 – $69.00 | 3 |
| Injection, glucarpidase HCPCS C9293 | not published | not published | $395.27 – $439.78 | 2 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $25.22 | $38.80 | $12.27 – $13.73 | 4 |
| Injection into brain canal CPT 61026 | not published | not published | $84.65 – $117.85 | 2 |
| Injection into brain canal CPT 61055 | not published | not published | $81.60 – $138.85 | 2 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $159.35 – $232.22 | 2 |
| Injection into spinal artery CPT 62294 | not published | not published | $760.95 – $1,035.75 | 2 |
| Injection into vocal cord CPT 31513 | not published | not published | $93.67 – $146.56 | 2 |
| Injection intraop add-on CPT 48400 | not published | not published | $77.02 – $117.71 | 2 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $0.62 – $1.12 | 3 |
| Injection jaw joint x-ray CPT 21116 | not published | not published | $31.94 – $53.05 | 2 |
| Injection jugular CPT 36299 | $1,623.58 | $2,497.81 | not published | 0 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.18 – $2.42 | 4 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $5.73 – $6.49 | 3 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $12.73 – $22.73 | 2 |
| Injection of sinus tract CPT 20500 | not published | not published | $68.95 – $96.35 | 2 |
| Injection,onabotulinumtoxina HCPCS J0585 | $13.75 | $21.16 | $6.29 – $7.61 | 4 |
| Injection, pentamidine iseth HCPCS S0080 | not published | not published | $93.79 – $117.24 | 2 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.52 – $1.90 | 3 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $1.32 – $1.32 | 1 |
| Injection px peyronie ds CPT 54200 | not published | not published | $68.78 – $94.98 | 2 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | not published | not published | $22.78 – $37.64 | 2 |
| Injection, renflexis HCPCS Q5104 | $88.84 | $136.68 | $26.62 – $90.41 | 5 |
| Injection, ruconest HCPCS J0596 | not published | not published | $24.97 – $39.20 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,276.42 | $1,963.73 | $50.70 – $61.93 | 2 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,041.62 | $1,602.49 | $31.93 – $49.46 | 2 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,784.85 | $2,745.92 | $82.78 – $126.23 | 2 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | not published | not published | $42.32 – $68.07 | 2 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | not published | not published | $78.29 – $119.67 | 2 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | not published | not published | $36.58 – $58.90 | 2 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | not published | not published | $67.72 – $101.94 | 2 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $648.41 | $997.55 | $79.50 – $121.50 | 2 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $648.41 | $997.55 | $74.18 – $112.21 | 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.