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 |
|---|---|---|---|---|
| Injection, siltuximab HCPCS J2860 | not published | not published | $82.37 – $174.07 | 4 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $252.04 | $387.76 | $27.70 – $44.33 | 2 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $318.37 | $489.80 | $29.62 – $42.88 | 2 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $318.37 | $489.80 | $33.77 – $48.78 | 2 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $168.98 | $259.97 | $11.32 – $11.32 | 1 |
| Injection, ticarcillin disod HCPCS S0040 | not published | not published | $10.58 – $10.58 | 1 |
| Injection torsemide 10 mg/ml HCPCS J3265 | not published | not published | $2.86 – $2.86 | 1 |
| Injection treatment of eye CPT 66020 | not published | not published | $94.43 – $154.31 | 2 |
| Injection treatment of eye CPT 66030 | not published | not published | $80.87 – $130.22 | 2 |
| Injection treatment of nerve CPT 64605 | not published | not published | $337.67 – $390.28 | 2 |
| Injection treatment of nerve CPT 64610 | not published | not published | $361.50 – $536.19 | 2 |
| Injection treatment of nerve CPT 64681 | $2,188.39 | $3,366.76 | $160.90 – $263.07 | 2 |
| Injection treatment of nose CPT 30200 | not published | not published | $44.52 – $64.78 | 2 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $61.39 – $94.18 | 2 |
| Inject/treat eye socket CPT 67500 | not published | not published | $46.11 – $71.90 | 2 |
| Inject/treat eye socket CPT 67505 | not published | not published | $48.56 – $84.00 | 2 |
| Inject/treat eye socket CPT 67515 | not published | not published | $32.00 – $59.30 | 2 |
| Inj, eculizumab-aagh, 2 mg HCPCS Q5151 | not published | not published | $31.67 – $31.77 | 2 |
| Inj, eculizumab-aeeb, 2 mg HCPCS Q5152 | not published | not published | $41.16 – $42.35 | 2 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $33.37 – $34.26 | 3 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $22.61 – $38.56 | 3 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $381.50 – $405.24 | 4 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $51.98 – $63.16 | 5 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,276.42 | $1,963.73 | $72.81 – $112.61 | 2 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $61.69 – $94.76 | 2 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $2.25 – $2.25 | 1 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.18 – $1.38 | 4 |
| Inj, erzofri, 1 mg HCPCS J2428 | not published | not published | $15.30 – $15.87 | 2 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | $8.03 | $12.35 | $3.96 – $4.38 | 3 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $153.60 – $192.00 | 3 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $186.31 – $197.63 | 4 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $18.04 – $38.38 | 4 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $2,199,912.00 – $2,199,912.00 | 1 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $9.53 – $12.32 | 5 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | $82.63 | $127.12 | $32.38 – $43.80 | 4 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $25.78 – $25.78 | 1 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $20.83 – $31.37 | 4 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $134.26 – $158.80 | 4 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.02 – $0.04 | 2 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $1.10 – $1.32 | 5 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $7.15 – $7.39 | 3 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $2.46 – $3.02 | 3 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $142.90 – $270.22 | 3 |
| Inj follitropin beta 75 iu HCPCS S0128 | not published | not published | $143.34 – $261.00 | 3 |
| Inj for ext venography CPT 36005 | $142.07 | $218.57 | $34.31 – $54.40 | 2 |
| Inj for mammo ductogram CPT 19030 | not published | not published | $53.47 – $87.99 | 2 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.04 – $2.41 | 4 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $503.85 – $819.82 | 4 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $3.22 – $3.56 | 3 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $3.32 – $60.00 | 4 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $19.20 – $24.00 | 3 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | $7.27 | $11.18 | $3.15 – $3.30 | 2 |
| Inj, ganciclovir (exela) HCPCS J1574 | not published | not published | $48.00 – $60.00 | 3 |
| Inj ganirelix acetat 250 mcg HCPCS S0132 | not published | not published | $141.00 – $220.82 | 3 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $5.29 – $8.65 | 2 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $116.47 – $127.52 | 4 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $2,772.80 – $2,864.68 | 3 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | not published | not published | $1.34 – $1.66 | 3 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | not published | not published | $1.28 – $1.54 | 3 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $153.60 – $192.00 | 3 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $3.22 – $8.39 | 4 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $66.92 – $151.00 | 4 |
| Inj., haegarda 10 units HCPCS J0599 | not published | not published | $11.62 – $12.83 | 3 |
| Inj, hemgenix, per tx dose HCPCS J1411 | not published | not published | $3,710,000.00 – $3,710,000.00 | 1 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | not published | not published | $0.40 – $2.94 | 4 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $58.34 – $93.50 | 4 |
| Inj, hercessi, 10 mg HCPCS Q5146 | not published | not published | $32.46 – $37.15 | 2 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $54.94 – $112.20 | 4 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $32.98 – $60.31 | 2 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $36.57 – $74.47 | 2 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $38.55 – $77.82 | 2 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $18.95 – $57.82 | 2 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $18.42 – $58.93 | 2 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $1.06 – $1.64 | 5 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | not published | not published | $4.79 – $5.55 | 2 |
| Inj hydroxyprogst capoat nos HCPCS J1729 | $5.85 | $9.00 | $13.10 – $16.37 | 3 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $76.95 – $80.28 | 4 |
| Inj, idacio, 1 mg HCPCS Q5144 | not published | not published | $11.91 – $11.91 | 1 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | not published | not published | $2.50 – $2.72 | 4 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $42.74 – $82.60 | 4 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | not published | not published | $0.12 – $0.14 | 3 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $484.40 – $524.00 | 4 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $107.65 – $163.80 | 2 |
| Inj. infugem, 100 mg HCPCS J9198 | not published | not published | $36.48 – $45.60 | 3 |
| Inj. insulin (fiasp) HCPCS J1812 | not published | not published | $1.39 – $1.53 | 2 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $20.03 – $34.50 | 2 |
| Inj intralesional > 7 lsns CPT 11901 | $497.06 | $764.71 | $30.37 – $53.40 | 2 |
| Inj, invega hafyera/trinza HCPCS J2427 | not published | not published | $12.67 – $13.26 | 3 |
| Inj ivig privigen 500 mg HCPCS J1459 | not published | not published | $42.08 – $97.55 | 4 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $1.91 – $2.07 | 4 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $2.45 – $2.88 | 5 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $1.49 – $2.29 | 5 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | not published | not published | $0.91 – $1.38 | 3 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $84.80 – $96.47 | 4 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $20.33 – $88.93 | 4 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $1.33 – $1.34 | 3 |
| Inj lefamulin 1 mg HCPCS J0691 | not published | not published | $0.66 – $0.82 | 3 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $22.03 – $22.94 | 3 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $29.58 | $45.50 | $19.18 – $44.13 | 4 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.02 – $0.42 | 4 |
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.