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 |
|---|---|---|---|---|
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $169.48 – $269.56 | 2 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $149.92 – $237.23 | 2 |
| Laryngoscopy w/fb removal CPT 31530 | not published | not published | $142.48 – $222.67 | 2 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $85.66 – $132.41 | 2 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $86.80 – $135.06 | 2 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | not published | not published | $83.64 – $122.13 | 2 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $237.58 – $383.21 | 2 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $184.35 – $294.49 | 2 |
| Laser surgery eye strands CPT 67031 | not published | not published | $253.47 – $418.35 | 2 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $107.28 – $152.46 | 2 |
| Laser surgery of prostate CPT 52647 | not published | not published | $736.45 – $736.45 | 1 |
| Laser surgery of prostate CPT 52648 | not published | not published | $436.77 – $784.91 | 2 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $75.17 – $108.20 | 2 |
| Laser treatment of retina CPT 67039 | not published | not published | $672.30 – $1,133.05 | 2 |
| Laser treatment of retina CPT 67040 | not published | not published | $722.88 – $1,224.63 | 2 |
| Lateral canthopexy CPT 21282 | not published | not published | $304.16 – $431.23 | 2 |
| Lateral thoracic extension HCPCS L1210 | not published | not published | $400.90 – $400.90 | 5 |
| Lateral trochanteric pad HCPCS L1290 | not published | not published | $90.32 – $90.32 | 5 |
| Latex suspension sleeve each HCPCS L6632 | not published | not published | $79.54 – $79.54 | 5 |
| Lat retinacular release open CPT 27425 | not published | not published | $361.53 – $499.72 | 2 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $84.05 – $117.86 | 2 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $809.04 – $1,187.75 | 2 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $558.24 – $820.13 | 2 |
| Lead capillary CPT 83655 | $43.81 | $67.40 | $8.07 – $27.25 | 10 |
| Leads any type vad, rep only HCPCS Q0487 | not published | not published | $410.25 – $410.25 | 5 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $995.12 – $1,531.72 | 2 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $1,019.62 – $1,574.37 | 2 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $1,256.73 – $1,973.02 | 2 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $1,048.84 – $1,642.91 | 2 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $1,166.38 – $1,860.01 | 2 |
| Left compres band >=3" <5"/yd HCPCS A6449 | not published | not published | $2.50 – $2.50 | 5 |
| Left compres band <3"/yd HCPCS A6448 | not published | not published | $1.64 – $1.64 | 5 |
| Left compres band >=5"/yd HCPCS A6450 | not published | not published | $2.50 – $2.50 | 5 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $666.26 | $1,025.01 | $153.29 – $277.54 | 3 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $799.16 | $1,229.47 | $91.82 – $186.85 | 3 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $499.36 | $768.24 | $68.42 – $139.23 | 3 |
| Legg perthes orth newington HCPCS L1710 | not published | not published | $2,054.23 – $2,054.23 | 5 |
| Legg perthes orthosis trilat HCPCS L1720 | not published | not published | $1,514.21 – $1,514.21 | 5 |
| Legg perthes orth scottish r HCPCS L1730 | not published | not published | $1,335.40 – $1,335.40 | 5 |
| Legg perthes patten bottom t HCPCS L1755 | not published | not published | $1,872.63 – $1,872.63 | 5 |
| Legion pneumo dna dir prob CPT 87540 | $47.22 | $72.65 | $13.36 – $24.06 | 8 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $20.87 – $50.11 | 8 |
| Leg perthes orth toronto typ HCPCS L1700 | not published | not published | $1,754.84 – $1,754.84 | 5 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $696.69 – $1,006.03 | 2 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $666.26 | $1,025.02 | $123.95 – $207.50 | 3 |
| Leishmania antibody CPT 86717 | $44.32 | $68.19 | $8.11 – $18.25 | 10 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $532.19 – $702.90 | 2 |
| Lengthening of palate CPT 42227 | not published | not published | $637.02 – $930.71 | 2 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $686.00 – $990.03 | 2 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $1,117.12 – $1,315.16 | 2 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $389.91 – $567.29 | 2 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $505.33 – $718.86 | 2 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $670.95 – $976.11 | 2 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $1,111.13 – $1,191.68 | 2 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $743.79 – $994.12 | 2 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $749.90 – $1,108.21 | 2 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $842.83 – $1,249.81 | 2 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | not published | not published | $145.73 – $145.73 | 5 |
| Lens iol ant chamb 10.5 HCPCS V2630 | not published | not published | $145.73 – $145.73 | 5 |
| Lepirudin HCPCS J1945 | not published | not published | $118.71 – $118.71 | 1 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | not published | not published | $2.93 – $12.00 | 4 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $6.92 – $12.47 | 8 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $362.47 | $557.64 | $160.34 – $542.03 | 4 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $3,686.90 | $5,672.16 | $1,021.84 – $1,867.04 | 4 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $3,855.86 – $3,855.86 | 1 |
| Leuprolide acetate injeciton HCPCS J9218 | $34.18 | $52.59 | $17.78 – $60.86 | 3 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $220.74 – $706.67 | 3 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $42.06 – $111.43 | 4 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $1.35 – $1.35 | 1 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.28 – $2.57 | 4 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.08 – $1.52 | 4 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | not published | not published | $0.03 – $0.10 | 4 |
| Levetiracetam therapeutic drug level CPT 80177 | $47.96 | $73.79 | $8.83 – $23.87 | 10 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $1.03 – $9.84 | 4 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $406.00 – $406.00 | 1 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | not published | not published | $5.10 – $7.26 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | $6,095.95 | $9,378.39 | $276.62 – $276.62 | 1 |
| Lidocaine injection HCPCS J2001 | not published | not published | $0.02 – $0.05 | 2 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | not published | not published | $0.01 – $0.01 | 1 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | not published | $0.00 – $0.01 | 2 |
| Lidocaine therapeutic drug level CPT 80176 | $53.18 | $81.81 | $9.79 – $17.63 | 8 |
| Lift assist for elbow HCPCS L6635 | not published | not published | $247.39 – $247.39 | 5 |
| Lift heel adj small gl60404sm HCPCS L3332 | not published | not published | $88.45 – $88.45 | 5 |
| Lift heel adjustable med HCPCS L3334 | not published | not published | $45.78 – $45.78 | 5 |
| Lifts elevation metal extens HCPCS L3330 | not published | not published | $678.86 – $678.86 | 5 |
| Ligate esophagus veins CPT 43400 | not published | not published | $1,148.83 – $1,918.94 | 2 |
| Ligate leg veins open CPT 37761 | not published | not published | $395.45 – $600.01 | 2 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $428.61 – $691.98 | 2 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $53.54 – $80.37 | 2 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $1,137.14 – $1,826.07 | 2 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $343.53 – $524.58 | 2 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $293.84 – $476.69 | 2 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $272.56 – $391.96 | 2 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $153.29 – $229.22 | 2 |
| Ligation common iliac vein CPT 37660 | not published | not published | $987.37 – $1,454.60 | 2 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $184.71 – $271.12 | 2 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $543.41 – $816.43 | 2 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $546.50 – $810.64 | 2 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $531.40 – $801.29 | 2 |
| Ligation major artery chest CPT 37616 | not published | not published | $869.09 – $1,226.51 | 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.