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 |
|---|---|---|---|---|
| Lubricant per ounce HCPCS A4402 | not published | not published | $2.07 – $2.27 | 6 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $73.10 – $73.10 | 5 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $90.05 – $90.05 | 5 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $66.79 – $83.30 | 3 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $89.65 – $89.65 | 5 |
| Lumbar sling HCPCS L1090 | not published | not published | $115.60 – $115.60 | 5 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,185.04 – $1,752.54 | 2 |
| Lumizyme injection HCPCS J0221 | not published | not published | $168.96 – $214.02 | 4 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $662.54 | $1,019.29 | $26.94 – $46.32 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | $255.27 | $392.72 | $11.12 – $18.57 | 3 |
| Lung Function Test (Spirometry) CPT 94010 | $367.00 | $564.61 | $17.40 – $27.33 | 3 |
| Lung perfusion imaging CPT 78580 | $812.30 | $1,249.69 | $143.25 – $227.12 | 3 |
| Lung transplant double CPT 32853 | not published | not published | $3,435.33 – $5,086.62 | 2 |
| Lung transplant single CPT 32851 | not published | not published | $2,470.49 – $3,637.76 | 2 |
| Lung transplant with bypass CPT 32852 | not published | not published | $2,701.71 – $3,954.90 | 2 |
| Lung transplant with bypass CPT 32854 | not published | not published | $3,642.16 – $5,397.39 | 2 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,141.30 – $1,627.79 | 2 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $205.04 – $216.30 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $41.24 – $43.83 | 4 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $259.11 – $323.33 | 4 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $361.46 | $556.10 | $233.78 – $263.29 | 3 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $613.75 – $613.75 | 5 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $21.92 – $36.41 | 2 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $346.17 – $346.17 | 5 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $13.36 – $24.06 | 8 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $546.65 – $790.27 | 2 |
| Lymphatics/lymph node imaging CPT 78195 | $859.59 | $1,322.44 | $210.59 – $335.10 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $24.36 – $43.87 | 8 |
| Lymphocyte transformation mitogen CPT 86353 | $177.43 | $272.97 | $32.67 – $58.84 | 8 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $55.31 – $227.41 | 8 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $31.70 – $57.11 | 8 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $243.96 – $384.38 | 2 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $244.36 – $384.38 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | $5,491.15 | $8,447.92 | $273.29 – $384.38 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $262.32 – $384.38 | 2 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $114.56 – $154.11 | 2 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $115.30 – $160.15 | 2 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $152.31 – $226.50 | 2 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $4.80 – $15.33 | 3 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $5.81 – $7.87 | 3 |
| Macroscopic exam arthropod CPT 87168 | $15.44 | $23.76 | $2.85 – $5.12 | 8 |
| Macroscopic exam parasite CPT 87169 | $15.44 | $23.76 | $2.02 – $5.17 | 10 |
| Magnesium CPT 83735 | $24.24 | $37.29 | $4.47 – $11.43 | 10 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $3.42 | $5.26 | $0.25 – $0.57 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $195.99 – $272.20 | 3 |
| Makena, 10 mg HCPCS J1726 | $21.95 | $33.77 | $19.41 – $32.76 | 3 |
| Malaria antibody CPT 86750 | $47.72 | $73.41 | $8.79 – $29.68 | 10 |
| Male sling procedure CPT 53440 | not published | not published | $563.55 – $856.14 | 2 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,244.13 – $3,367.76 | 2 |
| Manipulate finger w/anesth CPT 26340 | $3,188.88 | $4,905.97 | $298.91 – $376.05 | 2 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $357.26 – $466.83 | 2 |
| Manipulation of hip joint CPT 27275 | not published | not published | $145.98 – $204.20 | 2 |
| Manipulation of spine CPT 22505 | not published | not published | $122.61 – $146.24 | 2 |
| Manipulat palm cord post inj CPT 26341 | $495.44 | $762.22 | $59.83 – $84.09 | 2 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $1.77 – $2.67 | 2 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $1.04 – $7.89 | 3 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $83.59 – $83.59 | 5 |
| Manual diff wbc count b-coat CPT 85009 | $14.87 | $22.87 | $3.38 – $6.08 | 8 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $63.53 – $103.01 | 3 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $99.74 – $152.67 | 2 |
| Map tachycard site(s) CPT 93609 | not published | not published | $110.60 – $153.75 | 2 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $48.53 – $56.44 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $238.31 | $366.63 | $336.84 – $336.84 | 1 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $869.92 – $1,256.00 | 2 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $111.88 – $111.88 | 5 |
| Mastectomy form HCPCS L8020 | not published | not published | $293.60 – $293.60 | 5 |
| Mastectomy partial CPT 19301 | not published | not published | $513.02 – $722.11 | 2 |
| Mast mod rad CPT 19307 | not published | not published | $913.49 – $1,325.08 | 2 |
| Mastoidectomy CPT 69501 | not published | not published | $522.91 – $804.52 | 2 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $691.41 – $1,067.47 | 2 |
| Mastoids complete CPT 70130 | not published | not published | $36.76 – $48.42 | 3 |
| Mastoid surgery revision CPT 69603 | not published | not published | $965.84 – $1,401.72 | 2 |
| Mastopexy CPT 19316 | not published | not published | $596.13 – $858.96 | 2 |
| Mast radical CPT 19305 | not published | not published | $889.18 – $1,252.73 | 2 |
| Mast rad urban type CPT 19306 | not published | not published | $953.48 – $1,327.45 | 2 |
| Mast simple complete CPT 19303 | not published | not published | $742.66 – $1,059.71 | 2 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $76.09 – $335.50 | 2 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $2,200.00 – $2,332.00 | 2 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $19.70 – $19.97 | 2 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $20.87 – $78.95 | 10 |
| M.avium-intra dna dir prob CPT 87560 | $80.00 | $123.07 | $18.19 – $32.75 | 8 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $20.87 – $51.41 | 8 |
| Maxillofacial fixation CPT 21100 | not published | not published | $274.52 – $412.64 | 2 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $52.34 | $80.53 | $9.64 – $31.18 | 10 |
| Mayo aathr protein s free CPT 85306 | $55.47 | $85.34 | $10.21 – $34.47 | 10 |
| Mayo activated protein c resistance assay CPT 85307 | $55.47 | $85.34 | $10.21 – $33.48 | 10 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $43.07 | $66.26 | $10.61 – $46.28 | 10 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $95.81 | $147.40 | $10.62 – $10.62 | 1 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $141.13 | $217.12 | $5.05 – $11.36 | 3 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $53.50 | $82.30 | $9.85 – $22.52 | 10 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $190.95 | $293.77 | $5.05 – $13.71 | 3 |
| Mayo alpha 1 antitrypsin CPT 82103 | $48.63 | $74.81 | $8.96 – $28.42 | 10 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $54.55 | $83.93 | $10.05 – $23.87 | 10 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $65.23 | $100.35 | $5.05 – $11.36 | 3 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $5.05 – $11.36 | 3 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $440.16 | $677.17 | $100.40 – $145.96 | 8 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $331.74 | $510.37 | $34.53 – $109.99 | 8 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $401.59 | $617.83 | $83.02 – $188.62 | 10 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $3,400.29 | $5,231.22 | $183.60 – $1,392.00 | 8 |
| Mayo androstenedione CPT 82157 | $105.94 | $162.98 | $19.51 – $65.88 | 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.