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, levothyroxine, freskabi HCPCS J0651 | not published | not published | $6.40 – $6.94 | 3 |
| Inj, levothyroxine, hikma HCPCS J0652 | not published | not published | $5.14 – $7.69 | 3 |
| Inj, lidocaine w epinephrine HCPCS J2004 | not published | not published | $0.01 – $0.01 | 1 |
| Inj, linezolid (hospira) HCPCS J2021 | not published | not published | $6.34 – $34.17 | 4 |
| Inj, lovotibeglogene autotem HCPCS J3394 | not published | not published | $3,286,000.00 – $3,286,000.00 | 1 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $318.85 – $359.68 | 4 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $21.18 – $26.48 | 3 |
| Inj luxturna 1 billion vec g HCPCS J3398 | not published | not published | $2,924.00 – $3,400.00 | 3 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $2,129.44 | $3,276.06 | $45.79 – $55.93 | 2 |
| Inj marstacim-hncq, 0.5 mg HCPCS J7172 | not published | not published | $50.47 – $51.19 | 2 |
| Inj. meloxicam 1 mg HCPCS J1738 | not published | not published | $3.01 – $3.76 | 3 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $86.94 – $354.00 | 4 |
| Inj, melphalan flufenami 1mg HCPCS J9247 | not published | not published | $570.00 – $570.00 | 1 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $773.80 – $801.48 | 3 |
| Inj menotropins 75 iu HCPCS S0122 | not published | not published | $123.22 – $269.32 | 3 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | not published | not published | $2.16 – $4.15 | 4 |
| Inj, meropenem (b. braun) HCPCS J2184 | not published | not published | $1.87 – $4.26 | 4 |
| Inj., meropenem, vaborbactam HCPCS J2186 | not published | not published | $2.14 – $2.47 | 3 |
| Inj meropenem (wg crit care) HCPCS J2183 | not published | not published | $1.41 – $1.60 | 3 |
| Inj metaraminol bitartrate HCPCS J0380 | not published | not published | $1.07 – $1.07 | 1 |
| Inj, micafungin (par pharm) HCPCS J2247 | not published | not published | $0.22 – $1.80 | 4 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | not published | not published | $32.66 – $47.57 | 3 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $243.63 – $258.54 | 4 |
| Inj, motixafortide, 0.25 mg HCPCS J2277 | not published | not published | $25.22 – $26.48 | 3 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | $53.81 | $82.78 | $8.57 – $13.79 | 4 |
| Inj moxifloxacin (fres kabi) HCPCS J2281 | not published | not published | $6.64 – $13.80 | 4 |
| Inj multihance HCPCS A9577 | $3.46 | $5.32 | $1.79 – $6.31 | 4 |
| Inj multihance multipack HCPCS A9578 | not published | not published | $1.70 – $6.63 | 4 |
| Inj. mycophenolate mofetil HCPCS J7519 | not published | not published | $0.31 – $0.40 | 3 |
| Inj naloxone hydrochloride HCPCS J2310 | $20.70 | $31.85 | $9.21 – $18.81 | 2 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | not published | not published | $641.83 – $686.08 | 4 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $1,496.23 | $2,301.89 | $48.99 – $74.96 | 2 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | not published | not published | $1.52 – $1.88 | 2 |
| Inj nivolumab 2 mg hyaluron HCPCS J9289 | not published | not published | $27.80 – $28.14 | 2 |
| Inj, nogapendekin pmln, 1mcg HCPCS J9028 | not published | not published | $94.31 – $94.73 | 3 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $108.90 – $168.76 | 2 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $2,203.21 | $3,389.55 | $86.11 – $132.63 | 2 |
| Inj, nyposi 1 mcg HCPCS Q5148 | not published | not published | $1.00 – $1.03 | 2 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | not published | not published | $47.05 – $48.06 | 2 |
| Inj, ocriplasmin, 0.125 mg HCPCS J7316 | not published | not published | $948.16 – $1,185.20 | 2 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | $98.86 | $152.10 | $40.21 – $56.16 | 4 |
| Inj ogivri 10 mg HCPCS Q5114 | not published | not published | $31.94 – $105.64 | 4 |
| Inj, olaratumab, 10 mg HCPCS J9285 | not published | not published | $47.15 – $58.94 | 2 |
| Inj, oliceridine 0.1 mg HCPCS C9101 | not published | not published | $1.24 – $1.55 | 2 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $381.24 – $404.95 | 3 |
| Inj, omacetaxine mep, 0.01mg HCPCS J9262 | not published | not published | $2.38 – $4.17 | 3 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $3.87 – $4.80 | 4 |
| Inj onase abepar-xioi treat HCPCS J3399 | not published | not published | $2,550,000.00 – $2,661,968.43 | 2 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $20.99 – $105.97 | 4 |
| Inj, pafolacianine, 0.1 mg HCPCS A9603 | not published | not published | $135.47 – $135.47 | 1 |
| Inj, palonosetron (posfrea) HCPCS J2468 | not published | not published | $55.23 – $59.91 | 3 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | not published | not published | $3.71 – $6.24 | 2 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $70.43 – $71.35 | 3 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $258.46 – $616.71 | 4 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $99.04 – $117.42 | 4 |
| Inj, pedmark, 100 mg HCPCS J0208 | not published | not published | $87.68 – $96.82 | 2 |
| Inj, pegcetacoplan, 1mg HCPCS J2781 | $317.74 | $488.83 | $138.05 – $148.94 | 3 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $34.68 | $53.36 | $24.71 – $392.55 | 4 |
| Inj, pegulicianine, 1 mg HCPCS A9615 | not published | not published | $33.97 – $37.51 | 2 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $7.99 – $97.88 | 4 |
| Inj pemetrexed (accord) 10mg HCPCS J9296 | not published | not published | $9.74 – $9.74 | 2 |
| Inj, pemetrexed (avyxa) 10mg HCPCS J9292 | not published | not published | $73.67 – $81.23 | 3 |
| Inj pemetrexed (bluepoint) HCPCS J9322 | not published | not published | $9.22 – $9.22 | 1 |
| Inj pemetrexed ditromethamin HCPCS J9323 | not published | not published | $0.13 – $10.34 | 2 |
| Inj pemetrexed, hospira 10mg HCPCS J9294 | not published | not published | $2.94 – $4.19 | 3 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | not published | not published | $1.49 – $4.88 | 3 |
| Inj pemetrexed (teva) 10mg HCPCS J9314 | not published | not published | $8.37 – $15.33 | 3 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | not published | not published | $6,731.00 – $7,239.00 | 2 |
| Inj, pemrydi rtu, 10 mg HCPCS J9324 | not published | not published | $67.94 – $81.06 | 3 |
| Inj perflexane lip micros,ml HCPCS Q9955 | not published | not published | $12.96 – $12.96 | 1 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $29.39 – $44.99 | 2 |
| Inj., perseris, 0.5 mg HCPCS J2798 | not published | not published | $12.14 – $13.20 | 4 |
| Inj plasminogen tvmh 1mg HCPCS J2998 | not published | not published | $31.67 – $42.30 | 3 |
| Inj., plazomicin, 5 mg HCPCS J0291 | not published | not published | $3.51 – $3.97 | 4 |
| Inj pozelimab-bbfg, 1 mg HCPCS J9376 | not published | not published | $83.08 – $91.73 | 2 |
| Inj proc ankle arthr CPT 27648 | not published | not published | $36.10 – $59.41 | 2 |
| Inj proc elbow arthro CPT 24220 | $199.53 | $306.97 | $46.76 – $77.06 | 2 |
| Inj proc for lymphang CPT 38790 | not published | not published | $62.33 – $92.87 | 2 |
| Inj proc lumbr disk ea lvl CPT 62290 | not published | not published | $118.89 – $190.12 | 2 |
| Inj proc myelogram lumbar CPT 62284 | $504.22 | $775.73 | $59.69 – $99.07 | 2 |
| Inj proc sialogram CPT 42550 | not published | not published | $43.47 – $71.87 | 2 |
| Inj progesterone per 50 mg HCPCS J2675 | not published | not published | $0.56 – $3.75 | 4 |
| Inj prohance multipack HCPCS A9576 | $2.78 | $4.28 | $1.37 – $3.86 | 4 |
| Inj protirelin per 250 mcg HCPCS J2725 | not published | not published | $20.54 – $20.54 | 1 |
| Inj recombin esperoct per iu HCPCS J7204 | not published | not published | $2.14 – $2.84 | 5 |
| Inj, releuko 1 mcg HCPCS Q5125 | not published | not published | $0.31 – $0.64 | 4 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | $1.92 | $2.96 | $0.71 – $1.32 | 5 |
| Inj retro urethrocysto CPT 51610 | $130.94 | $201.44 | $47.82 – $72.91 | 2 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | $24.55 | $37.77 | $12.77 – $14.58 | 4 |
| Inj roctavian ml 2x10^13vc g HCPCS J1412 | not published | not published | $11,201.40 – $12,553.71 | 2 |
| Inj., rolapitant, 0.5 mg HCPCS J2797 | not published | not published | $0.85 – $0.85 | 1 |
| Inj romidepsin non-lyo 0.1mg HCPCS J9318 | not published | not published | $28.52 – $38.38 | 3 |
| Inj, rykindo, 0.5 mg HCPCS J2801 | not published | not published | $11.80 – $13.03 | 2 |
| Inj scleros sol mult veins CPT 36471 | $886.07 | $1,363.19 | $54.62 – $85.55 | 2 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $27.55 – $42.83 | 2 |
| Inj, sculptra, 0.5mg HCPCS Q2028 | not published | not published | $0.62 – $0.62 | 1 |
| Inj sebelipase alfa 1 mg HCPCS J2840 | not published | not published | $490.08 – $612.60 | 3 |
| Inj secretin synthetic human HCPCS J2850 | not published | not published | $31.50 – $43.79 | 3 |
| Inj secukinumab intrav 1mg HCPCS J3247 | not published | not published | $17.73 – $18.23 | 3 |
| Inj, sezaby, 1 mg HCPCS J2561 | not published | not published | $1.28 – $1.41 | 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.