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 |
|---|---|---|---|---|
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $146.22 | $224.95 | $21.27 – $29.84 | 3 |
| Irrigation sphenoid sinus CPT 31002 | not published | not published | $138.11 – $211.35 | 2 |
| Irrigation syringe HCPCS A4322 | not published | not published | $4.35 – $4.35 | 5 |
| Irrigation tray HCPCS A4320 | not published | not published | $6.96 – $6.96 | 5 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $18.49 – $27.89 | 2 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $78.86 – $88.16 | 4 |
| Island pedicle flap graft CPT 15740 | not published | not published | $617.20 – $945.16 | 2 |
| IV cipaglucosidase alfa-atga HCPCS G0138 | not published | not published | $160.41 – $270.98 | 2 |
| Ivc venogram s&i CPT 75825 | $5,491.15 | $8,447.92 | $50.14 – $102.02 | 3 |
| IV Fluids (each additional hour) CPT 96361 | $133.11 | $204.79 | $10.70 – $14.87 | 2 |
| IV Fluids (first hour) CPT 96360 | $348.36 | $535.94 | $27.46 – $40.37 | 2 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $119.30 – $157.94 | 3 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $168.98 | $259.97 | $17.09 – $23.24 | 2 |
| IV inj ra drug dx study CPT 78808 | $773.62 | $1,190.18 | $33.61 – $68.39 | 3 |
| IV Medicine Infusion (additional drug) CPT 96367 | $80.28 | $123.50 | $24.49 – $34.45 | 2 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $133.11 | $204.79 | $17.66 – $24.04 | 2 |
| IV Medicine Infusion (first hour) CPT 96365 | $348.36 | $535.94 | $54.87 – $78.70 | 2 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $76.24 – $120.06 | 2 |
| IV Push Injection (each additional drug) CPT 96375 | $133.11 | $204.79 | $12.90 – $18.40 | 2 |
| IV Push Injection (first drug) CPT 96374 | $348.36 | $535.94 | $30.95 – $43.01 | 2 |
| Ivp w/nephrotomography CPT 74415 | not published | not published | $105.20 – $143.24 | 3 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $336.54 | $517.76 | $82.98 – $118.45 | 3 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $80.82 – $141.31 | 4 |
| Jak2 targeted sequence analysis CPT 81279 | $492.40 | $757.54 | $112.23 – $252.52 | 10 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $415.11 – $587.46 | 2 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $446.96 – $704.34 | 2 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $201.75 | $310.38 | $34.19 – $43.74 | 3 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $275.16 | $423.33 | $25.58 – $32.97 | 3 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $175.40 – $311.47 | 2 |
| John cunningham antibody CPT 86711 | $52.10 | $80.15 | $11.25 – $20.27 | 8 |
| J-tube placement CPT 44015 | not published | not published | $102.68 – $179.03 | 2 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,457.75 – $1,457.75 | 5 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,494.65 – $1,494.65 | 5 |
| Kafo fem fx cast molded to p HCPCS L2128 | not published | not published | $2,373.90 – $2,373.90 | 5 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $1,481.88 – $1,481.88 | 5 |
| Kafo fem fx cast thermoplas HCPCS L2126 | not published | not published | $1,834.71 – $1,834.71 | 5 |
| Kafo femoral fx cast rigid HCPCS L2136 | not published | not published | $1,811.94 – $1,811.94 | 5 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $1,235.97 – $1,235.97 | 5 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $2,500.46 – $2,500.46 | 5 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $2,515.30 – $2,515.30 | 5 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $211.34 – $211.34 | 5 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,314.30 – $1,314.30 | 5 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $4,915.21 – $4,915.21 | 5 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $1,416.67 – $1,416.67 | 5 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $2,158.33 – $2,158.33 | 5 |
| Keratoprosthesis CPT 65770 | not published | not published | $982.81 – $1,638.53 | 2 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $103.97 – $103.97 | 1 |
| Ketamine and metabolite screen - quest CPT 80357 | $335.41 | $516.02 | $11.96 – $11.96 | 1 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $10.31 – $18.56 | 8 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $29.58 | $45.50 | $5.44 – $9.80 | 8 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $2.27 | $3.49 | $0.29 – $1.97 | 4 |
| Kidney endoscopy CPT 50551 | not published | not published | $214.90 – $335.64 | 2 |
| Kidney endoscopy CPT 50553 | not published | not published | $229.00 – $357.47 | 2 |
| Kidney endoscopy CPT 50570 | not published | not published | $356.24 – $559.69 | 2 |
| Kidney endoscopy CPT 50575 | not published | not published | $515.24 – $813.42 | 2 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $248.37 – $388.54 | 2 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $408.74 – $644.16 | 2 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $251.41 – $393.66 | 2 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $286.78 – $448.97 | 2 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $407.41 – $642.53 | 2 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $438.87 – $691.94 | 2 |
| Kidney function study CPT 78725 | not published | not published | $67.12 – $100.67 | 3 |
| Kidney imaging (3d) CPT 78710 | not published | not published | $180.24 – $180.24 | 1 |
| Kidney imaging morphology CPT 78700 | not published | not published | $108.60 – $167.40 | 3 |
| Kidney imag w/bld flow multi CPT 78709 | $859.59 | $1,322.44 | $214.60 – $337.43 | 3 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $859.59 | $1,322.44 | $135.34 – $209.18 | 3 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $323.71 | $498.02 | $58.88 – $90.68 | 3 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $323.71 | $498.02 | $27.49 – $55.95 | 3 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $56.56 | $87.02 | $48.75 – $52.48 | 6 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | not published | not published | $5.44 – $9.97 | 6 |
| Kit gene analys d816 variant CPT 81273 | $366.03 | $563.13 | $75.67 – $149.84 | 8 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $19.70 – $32.81 | 6 |
| Kit monitr cath camino icp w/integratd licox bolt fitting HCPCS A9279 | not published | not published | $129.56 – $129.56 | 1 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $23.50 – $57.82 | 3 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | not published | not published | $2,069.73 – $2,069.73 | 5 |
| Kit trach suct cls 30.5cm HCPCS A4605 | not published | not published | $23.38 – $23.38 | 5 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $479.30 – $691.71 | 2 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $401.20 – $572.67 | 2 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $326.60 – $455.20 | 2 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $421.24 – $602.34 | 2 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $484.36 – $693.07 | 2 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $703.10 – $1,034.76 | 2 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $425.49 – $585.53 | 2 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $413.41 – $597.16 | 2 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $387.24 – $551.34 | 2 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $502.25 – $730.23 | 2 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $508.89 – $736.92 | 2 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $435.45 – $625.23 | 2 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $524.73 – $776.12 | 2 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $641.49 – $940.85 | 2 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $478.73 – $684.93 | 2 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $493.60 – $709.09 | 2 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $579.69 – $832.46 | 2 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $727.28 – $1,095.40 | 2 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $923.84 – $1,361.44 | 2 |
| Knee cap medial or lateral p HCPCS L2800 | not published | not published | $122.57 – $122.57 | 5 |
| Knee control condylar pad HCPCS L2810 | not published | not published | $89.75 – $89.75 | 5 |
| Knee control full kneecap HCPCS L2795 | not published | not published | $109.70 – $109.70 | 5 |
| Knee disart expand wall sock HCPCS L5653 | not published | not published | $712.51 – $712.51 | 5 |
| Knee disarticulat leather so HCPCS L5640 | not published | not published | $1,043.77 – $1,043.77 | 5 |
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.