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 |
|---|---|---|---|---|
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $300.18 – $426.79 | 2 |
| Ligation major artery neck CPT 37615 | not published | not published | $378.73 – $580.93 | 2 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $444.62 – $644.90 | 2 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $978.40 – $1,488.17 | 2 |
| Ligation of femoral vein CPT 37650 | not published | not published | $342.94 – $505.02 | 2 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,279.59 – $1,910.35 | 2 |
| Ligation of neck artery CPT 37606 | not published | not published | $607.26 – $773.56 | 2 |
| Ligation of salivary duct CPT 42665 | not published | not published | $162.26 – $232.49 | 2 |
| Ligation of shunt CPT 49428 | not published | not published | $333.19 – $478.19 | 2 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $638.30 – $937.50 | 2 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $189.98 – $285.89 | 2 |
| Lig/band angioaccess av fistula CPT 37607 | $5,765.71 | $8,870.33 | $280.95 – $414.84 | 2 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $432.93 – $639.43 | 2 |
| Liletta, 52 mg HCPCS J7297 | $1,968.28 | $3,028.12 | $625.00 – $1,014.12 | 3 |
| Limb exercise test CPT 95875 | not published | not published | $49.23 – $80.39 | 3 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $151.12 – $243.62 | 2 |
| Limited ankle motion ea jnt HCPCS L2200 | $88.37 | $135.95 | $56.60 – $56.60 | 5 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $142.35 – $142.35 | 5 |
| Limited visual field xm CPT 92081 | not published | not published | $14.66 – $31.85 | 3 |
| Lincomycin injection HCPCS J2010 | not published | not published | $4.23 – $13.79 | 4 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | not published | not published | $2.27 – $16.00 | 4 |
| Lipase CPT 83690 | $24.96 | $38.40 | $4.60 – $13.07 | 10 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $261.10 – $396.55 | 2 |
| Lipoprotein blood high res frac & quant CPT 83701 | $99.26 | $152.70 | $22.56 – $40.63 | 8 |
| Lipoprotein blood quant CPT 83704 | $114.17 | $175.64 | $22.78 – $41.03 | 8 |
| Lipoprotein direct measurement hdl CPT 83718 | $29.67 | $45.64 | $5.08 – $11.43 | 10 |
| Lipoprotein direct measurement ldl CPT 83721 | $34.54 | $53.14 | $7.00 – $12.60 | 8 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $21.25 – $41.03 | 8 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $492,360.00 – $579,570.61 | 3 |
| Listeria monocytogenes CPT 86723 | $47.72 | $73.41 | $8.11 – $18.25 | 10 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $193.82 – $193.82 | 5 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $77.75 – $77.75 | 5 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $606.56 – $606.56 | 5 |
| Lithium therapeutic drug level CPT 80178 | $23.92 | $36.80 | $4.40 – $14.87 | 10 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $8,313.00 | $12,789.23 | $102.56 – $139.05 | 2 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $903.71 – $930.19 | 2 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,068.55 – $1,107.12 | 2 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $926.50 – $1,346.85 | 2 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $610.08 | $938.58 | $105.72 – $237.87 | 10 |
| Liver elastography 91200 CPT 91200 | not published | not published | $18.48 – $27.74 | 3 |
| Liver Function Test CPT 80076 | $29.58 | $45.50 | $5.00 – $16.47 | 10 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,086.62 – $1,609.28 | 2 |
| Liver image (3d) with flow CPT 78206 | not published | not published | $250.22 – $250.22 | 1 |
| Liver imaging CPT 78201 | not published | not published | $123.88 – $190.44 | 3 |
| Liver imaging (3d) CPT 78205 | not published | not published | $181.53 – $181.53 | 1 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $137.80 – $200.57 | 3 |
| Liver/spleen imag static only CPT 78215 | $812.30 | $1,249.69 | $126.88 – $191.60 | 3 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $85.95 – $112.75 | 3 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $49.44 – $85.71 | 2 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $365.22 – $521.75 | 2 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $3,412.03 – $3,412.03 | 5 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.20 | $0.30 | $0.66 – $1.04 | 4 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $16.45 – $109.16 | 3 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $212.00 – $226.61 | 4 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $135.33 – $135.33 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $1.44 | $2.21 | $0.83 – $2.30 | 4 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $53.13 – $53.13 | 5 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $145.94 | $224.53 | $93.48 – $93.48 | 5 |
| Loudness balance test CPT 92562 | not published | not published | $40.04 – $50.28 | 2 |
| Low back disk surgery CPT 63030 | not published | not published | $723.35 – $1,068.00 | 2 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $93.96 – $93.96 | 1 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $225.11 – $225.11 | 1 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $107.38 – $107.38 | 1 |
| Low cost skin substitute app HCPCS C5277 | $1,256.37 | $1,932.88 | $254.38 – $254.38 | 1 |
| Low cost skin substitute app HCPCS C5272 | not published | not published | $19.64 – $19.64 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $50.60 – $50.60 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $28.35 – $28.35 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $63.71 – $63.71 | 1 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $215.09 | $330.91 | $70.81 – $144.10 | 3 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,623.89 | $2,498.29 | $112.83 – $229.60 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,623.89 | $2,498.29 | $91.82 – $186.85 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $499.36 | $768.24 | $68.15 – $138.67 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,510.60 | $2,324.00 | $173.62 – $308.39 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,510.60 | $2,324.00 | $152.87 – $270.92 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $956.04 | $1,470.83 | $100.55 – $204.61 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $275.16 | $423.33 | $24.22 – $30.10 | 3 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $275.16 | $423.33 | $33.22 – $39.80 | 3 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $275.16 | $423.33 | $38.68 – $52.80 | 3 |
| Lower jaw bone graft CPT 21215 | not published | not published | $595.73 – $922.53 | 2 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $201.75 | $310.38 | $18.14 – $24.71 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $13.05 – $82.91 | 2 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $14.40 – $18.00 | 3 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $533.24 – $772.21 | 2 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $609.25 – $891.94 | 2 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $602.34 – $878.99 | 2 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $658.38 – $960.49 | 2 |
| Lso corset front HCPCS L0972 | not published | not published | $131.03 – $131.03 | 5 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $57.18 – $57.18 | 5 |
| Lso full corset HCPCS L0976 | not published | not published | $183.75 – $183.75 | 5 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $194.26 – $194.26 | 5 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,582.02 – $1,582.02 | 5 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $809.61 – $809.61 | 5 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $110.38 – $110.38 | 5 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $1,169.32 – $1,169.32 | 5 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,734.18 – $1,734.18 | 5 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $536.98 | $826.12 | $343.97 – $343.97 | 5 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $195.46 – $195.46 | 5 |
| Lso s/c shell/panel custom HCPCS L0640 | $1,959.48 | $3,014.58 | $1,255.19 – $1,255.19 | 5 |
| Lso s/c shell/panel prefab HCPCS L0639 | $2,011.64 | $3,094.83 | $1,288.60 – $1,288.60 | 5 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $14.65 – $49.48 | 10 |
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.