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 |
|---|---|---|---|---|
| Knee disc/dial lock/adj flex HCPCS L2425 | not published | not published | $171.93 – $171.93 | 5 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | not published | not published | $171.93 – $171.93 | 5 |
| Knee joint cam lock each joi HCPCS L2415 | not published | not published | $145.69 – $145.69 | 5 |
| Knee joint drop lock ea jnt HCPCS L2405 | not published | not published | $104.57 – $104.57 | 5 |
| Knee lift loop drop lock rin HCPCS L2492 | not published | not published | $133.49 – $133.49 | 5 |
| Knee MRI (with and without contrast) CPT 73723 | $2,278.18 | $3,504.89 | $230.38 – $421.66 | 3 |
| Knee MRI (with contrast) CPT 73722 | $2,278.18 | $3,504.89 | $195.72 – $348.86 | 3 |
| Knee MRI (without contrast) CPT 73721 | $956.04 | $1,470.83 | $115.56 – $235.15 | 3 |
| Knee orth pos locking joint HCPCS L1831 | not published | not published | $353.04 – $353.04 | 5 |
| Knee-shin exo fluid swing ph HCPCS L5724 | not published | not published | $2,301.49 – $2,301.49 | 5 |
| Knee-shin exo frct swg & sta HCPCS L5718 | not published | not published | $1,115.26 – $1,115.26 | 5 |
| Knee-shin exo frict swg & st HCPCS L5712 | not published | not published | $602.92 – $602.92 | 5 |
| Knee-shin exo mech stance ph HCPCS L5716 | not published | not published | $892.28 – $892.28 | 5 |
| Knee-shin exo mnl lock ultra HCPCS L5711 | not published | not published | $695.72 – $695.72 | 5 |
| Knee-shin exo variable frict HCPCS L5714 | not published | not published | $531.19 – $531.19 | 5 |
| Knee-shin ext jnts fld swg e HCPCS L5726 | not published | not published | $2,129.66 – $2,129.66 | 5 |
| Knee-shin fluid swg & stance HCPCS L5728 | not published | not published | $3,241.24 – $3,241.24 | 5 |
| Knee-shin pneum/hydra pneum HCPCS L5780 | not published | not published | $1,401.65 – $1,401.65 | 5 |
| Knee-shin pneum swg frct exo HCPCS L5722 | not published | not published | $1,105.34 – $1,105.34 | 5 |
| Knee-shin pro flex/ext cont HCPCS L5859 | not published | not published | $17,437.90 – $17,437.90 | 5 |
| Knee-shin sys hydraul stance HCPCS L5848 | not published | not published | $1,292.38 – $1,292.38 | 5 |
| Knee-shin sys stance flexion HCPCS L5845 | not published | not published | $2,154.15 – $2,154.15 | 5 |
| Knee X-ray CPT 73564 | $275.16 | $423.33 | $28.73 – $36.57 | 3 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $201.75 | $310.38 | $20.06 – $27.22 | 3 |
| Knee X-ray (3 views, both knees) CPT 73562 | $201.75 | $310.38 | $25.20 – $32.60 | 3 |
| Knee X-ray (standing, both knees) CPT 73565 | $201.75 | $310.38 | $22.95 – $33.69 | 3 |
| Kne-shin exo sng axi mnl loc HCPCS L5710 | not published | not published | $463.38 – $463.38 | 5 |
| Kne sing axis fric shin sach HCPCS L5200 | not published | not published | $4,046.07 – $4,046.07 | 5 |
| Ko dbl upright w/air pre cst HCPCS L1847 | not published | not published | $689.92 – $689.92 | 5 |
| Ko dbl upright w/air pre ots HCPCS L1848 | not published | not published | $689.92 – $689.92 | 5 |
| Ko derot ant cruciate custom HCPCS L1840 | not published | not published | $1,189.15 – $1,189.15 | 5 |
| Ko elastic w/joints pre ots HCPCS L1812 | not published | not published | $77.63 – $77.63 | 5 |
| Ko rigid without joints pre ots HCPCS L1836 | $249.87 | $384.42 | $98.90 – $98.90 | 5 |
| Ko single upright pre cst HCPCS L1843 | $1,680.18 | $2,584.89 | $1,076.26 – $1,076.26 | 5 |
| Ko single upright prefab ots HCPCS L1851 | not published | not published | $665.06 – $665.06 | 5 |
| Ko supracondylar socket mold HCPCS L1860 | not published | not published | $1,501.91 – $1,501.91 | 5 |
| Ko swedish type pre ots HCPCS L1850 | not published | not published | $227.80 – $227.80 | 5 |
| Ko w/0 joint rigid molded to HCPCS L1834 | not published | not published | $1,009.91 – $1,009.91 | 5 |
| Ko w adj flex/ext rotat mold HCPCS L1846 | $2,418.09 | $3,720.14 | $1,548.97 – $1,548.97 | 5 |
| Ko w/adj jt rot cntrl molded HCPCS L1844 | not published | not published | $1,878.84 – $1,878.84 | 5 |
| Kras gene addl variants CPT 81276 | $566.48 | $871.51 | $119.49 – $268.85 | 10 |
| Kras gene variants exon 2 CPT 81275 | $566.48 | $871.51 | $90.31 – $434.81 | 10 |
| Kyleena, 19.5 mg HCPCS J7296 | $2,565.91 | $3,947.55 | $1,214.63 – $1,287.51 | 3 |
| Kyphectomy 1-2 segments CPT 22818 | not published | not published | $1,559.41 – $2,412.25 | 2 |
| Kyphectomy 3 or more CPT 22819 | not published | not published | $1,795.97 – $2,765.12 | 2 |
| Kyphosis pad HCPCS L1020 | not published | not published | $99.33 – $99.33 | 5 |
| Kyphosis pad floating HCPCS L1025 | not published | not published | $191.06 – $191.06 | 5 |
| Lab draw < 3 yrs fem/jugular 36400 CPT 36400 | $25.68 | $39.50 | $13.22 – $21.18 | 2 |
| Lab draw <3 yrs scalp vein 36405 CPT 36405 | not published | not published | $10.66 – $17.52 | 2 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | not published | not published | $0.22 – $0.42 | 3 |
| Labioplasty 56800 CPT 56800 | not published | not published | $186.38 – $264.85 | 2 |
| Lab pathology consultation CPT 80500 | not published | not published | $13.88 – $13.88 | 1 |
| Lab pathology consultation CPT 80502 | not published | not published | $43.18 – $43.18 | 1 |
| Lacer molded to patient mode HCPCS L2330 | not published | not published | $601.62 – $601.62 | 5 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | not published | not published | $0.19 – $0.39 | 2 |
| Lactate dehydrogenase (ldh) CPT 83615 | $21.83 | $33.59 | $4.03 – $11.43 | 10 |
| Lactated ringers intravenous solution HCPCS J7120 | $11.54 | $17.75 | $2.01 – $11.07 | 4 |
| Lactation class HCPCS S9443 | not published | not published | $10.36 – $10.36 | 1 |
| Lactic acid CPT 83605 | $38.67 | $59.49 | $7.71 – $21.13 | 10 |
| Lactoferrin fecal qualitative CPT 83630 | $71.06 | $109.32 | $5.25 – $23.64 | 10 |
| Lactoferrin fecal quant CPT 83631 | $71.06 | $109.32 | $11.39 – $25.63 | 10 |
| Lam facetc/frmt arthrd lum 1 CPT 63052 | not published | not published | $184.11 – $258.47 | 2 |
| Lam facetec & foramot crv CPT 63045 | not published | not published | $1,001.08 – $1,406.76 | 2 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $857.41 – $1,211.33 | 2 |
| Lam facetec & foramot thrc CPT 63046 | not published | not published | $951.08 – $1,346.35 | 2 |
| Lam factc/frmt arthrd lum ea CPT 63053 | not published | not published | $163.99 – $193.46 | 2 |
| Lamie bx/exc idrl spine lesn lmbr 63282 CPT 63282 | not published | not published | $1,541.75 – $2,150.31 | 2 |
| Lamie bx/exc idrl spine lesn thrc 63281 CPT 63281 | not published | not published | $1,627.40 – $2,279.19 | 2 |
| Lamie excise intrspinl lesion thrc 63266 CPT 63266 | not published | not published | $1,323.53 – $1,879.85 | 2 |
| Lamination collar with couplin HCPCS L6629 | not published | not published | $214.53 – $214.53 | 5 |
| Laminotomy single cervical CPT 63040 | not published | not published | $1,037.05 – $1,529.88 | 2 |
| Laminotomy single lumbar CPT 63042 | not published | not published | $983.82 – $1,429.02 | 2 |
| Lamiotoiotiotinotomy addl cervical 63043 CPT 63043 | not published | not published | $293.13 – $293.13 | 1 |
| Lam w/cordotomy 1stg thrc CPT 63197 | not published | not published | $1,338.95 – $1,786.01 | 2 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | not published | not published | $35.39 – $108.11 | 4 |
| Lanthanum carbonate oral 5mg HCPCS J0607 | $0.03 | $0.05 | $0.04 – $0.04 | 2 |
| Laparo ablate liver tumor rf CPT 47370 | not published | not published | $950.34 – $1,386.88 | 2 |
| Laparo ablate renal cyst CPT 50541 | not published | not published | $679.11 – $1,044.95 | 2 |
| Laparo ablate renal mass CPT 50542 | not published | not published | $864.21 – $1,326.91 | 2 |
| Laparo-asst vag hysterectomy CPT 58550 | not published | not published | $645.20 – $932.64 | 2 |
| Laparo cholecystectomy/explr CPT 47564 | not published | not published | $859.80 – $1,234.57 | 2 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $554.34 – $793.68 | 2 |
| Laparo cholecystoenterostomy CPT 47570 | not published | not published | $595.83 – $859.69 | 2 |
| Laparo drng lymphocele 49323 CPT 49323 | not published | not published | $491.44 – $706.43 | 2 |
| Laparo ligate spermatic vein CPT 55550 | not published | not published | $327.81 – $487.03 | 2 |
| Laparo-myomectomy complex CPT 58546 | not published | not published | $804.17 – $1,180.38 | 2 |
| Laparo new ureter/bladder CPT 50947 | not published | not published | $1,020.59 – $1,578.27 | 2 |
| Laparo new ureter/bladder CPT 50948 | not published | not published | $936.19 – $1,449.61 | 2 |
| Laparo partial colectomy 44204 CPT 44204 | not published | not published | $1,150.78 – $1,947.55 | 2 |
| Laparo partial nephrectomy CPT 50543 | not published | not published | $1,100.18 – $1,693.10 | 2 |
| Laparo radical nephrectomy CPT 50545 | not published | not published | $981.81 – $1,523.36 | 2 |
| Laparo removal donor kidney CPT 50547 | not published | not published | $1,250.39 – $1,788.67 | 2 |
| Laparo remove w/ureter CPT 50548 | not published | not published | $985.78 – $1,532.27 | 2 |
| Laparoscopic myomectomy CPT 58545 | not published | not published | $661.59 – $952.11 | 2 |
| Laparoscopic nephrectomy CPT 50546 | not published | not published | $891.31 – $1,366.42 | 2 |
| Laparoscopic proc CPT 45400 | not published | not published | $856.69 – $1,451.82 | 2 |
| Laparoscopic salpingostomy 58673 CPT 58673 | not published | not published | $574.33 – $841.64 | 2 |
| Laparoscopy adrenalectomy CPT 60650 | not published | not published | $898.28 – $1,330.24 | 2 |
| Laparoscopy aspiration CPT 49322 | not published | not published | $288.69 – $412.49 | 2 |
| Laparoscopy biopsy CPT 49321 | not published | not published | $267.74 – $383.55 | 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.