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 |
|---|---|---|---|---|
| Morphine 500 mg HCPCS S0093 | not published | not published | $4.98 – $10.88 | 3 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | not published | not published | $9.42 – $21.88 | 4 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $2,476.44 | $3,809.90 | $104.78 – $403.60 | 5 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $1,380.63 | $2,124.05 | $25.62 – $79.36 | 5 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $850.25 | $1,308.07 | $25.62 – $81.77 | 5 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $640.96 – $674.50 | 3 |
| Motion analysis video/3d CPT 96000 | not published | not published | $59.75 – $100.42 | 3 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $73.32 – $125.73 | 3 |
| Motor &/ sens nrve cndj test CPT 95905 | $724.57 | $1,114.73 | $25.03 – $81.24 | 3 |
| Mouth piece HCPCS A4617 | not published | not published | $0.25 – $4.42 | 6 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $217.93 – $335.04 | 2 |
| M/phmtrc alys ishquant/semiq CPT 88373 | not published | not published | $25.81 – $403.60 | 5 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $335.30 | $515.85 | $97.49 – $403.60 | 5 |
| M/phmtrc alysishquant/semiq CPT 88369 | not published | not published | $31.92 – $403.60 | 5 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $50.34 – $87.15 | 3 |
| Mpl gene analysis common variants CPT 81338 | not published | not published | $91.10 – $204.98 | 10 |
| M.pneumon dna dir probe CPT 87580 | not published | not published | $13.36 – $24.06 | 8 |
| M.pneumon dna quant CPT 87582 | not published | not published | $20.87 – $363.14 | 8 |
| Mpsv4 vaccine subq CPT 90733 | $208.63 | $320.97 | not published | 0 |
| MRA abdomen post contrast CPT 74185 | not published | not published | $206.56 – $365.46 | 3 |
| MRA aorta thoracic w/wo contrast CPT 71555 | not published | not published | $205.47 – $361.20 | 3 |
| MRA chest w IV cont HCPCS C8909 | not published | not published | $262.50 – $482.74 | 2 |
| MRA chest wo IV cont HCPCS C8910 | not published | not published | $262.50 – $262.50 | 1 |
| MRA chest wwo IV cont HCPCS C8911 | not published | not published | $262.50 – $262.50 | 1 |
| MRA ext low(run-off)pst cntrst CPT 73725 | not published | not published | $207.38 – $363.74 | 3 |
| MRA pelvis CPT 72198 | not published | not published | $207.38 – $364.17 | 3 |
| MRA pelvis w IV cont HCPCS C8918 | not published | not published | $262.50 – $483.84 | 2 |
| MRA pelvis wo IV cont HCPCS C8919 | not published | not published | $262.50 – $262.50 | 1 |
| MRA spinal canal CPT 72159 | not published | not published | $207.93 – $377.39 | 3 |
| MRA upper extremity post contrast-bil CPT 73225 | not published | not published | $200.29 – $363.33 | 3 |
| MRA w/cont, abd HCPCS C8900 | not published | not published | $262.50 – $486.82 | 2 |
| MRA w/cont, lwr ext HCPCS C8912 | not published | not published | $262.50 – $484.30 | 2 |
| Mra, w/dye, spinal canal HCPCS C8931 | $729.05 | $1,121.62 | $262.50 – $408.13 | 2 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $262.50 – $403.34 | 2 |
| MRA without cont, abd HCPCS C8901 | not published | not published | $262.50 – $262.50 | 1 |
| MRA without cont, lwr ext HCPCS C8913 | not published | not published | $262.50 – $262.50 | 1 |
| Mra, without dye, spinal canal HCPCS C8932 | $539.88 | $830.59 | $262.50 – $262.50 | 1 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $262.50 – $262.50 | 1 |
| MRA without fol w/cont, abd HCPCS C8902 | not published | not published | $262.50 – $262.50 | 1 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | not published | not published | $262.50 – $262.50 | 1 |
| MRA without fol w/cont, pelvis HCPCS C8920 | not published | not published | $262.50 – $262.50 | 1 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $729.05 | $1,121.62 | $262.50 – $262.50 | 1 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | not published | not published | $262.50 – $262.50 | 1 |
| Mr elastography CPT 76391 | not published | not published | $120.20 – $244.60 | 3 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $1,109.93 – $1,109.93 | 1 |
| MRI brain w/dye CPT 70558 | not published | not published | $228.01 – $262.50 | 2 |
| MRI brain without dye CPT 70557 | not published | not published | $262.50 – $568.72 | 2 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $228.01 – $262.50 | 2 |
| MRI breast c- unilateral CPT 77046 | $539.88 | $830.59 | $119.93 – $244.04 | 3 |
| MRI breast c-+ w/cad uni CPT 77048 | not published | not published | $193.53 – $393.82 | 3 |
| MRI breast without cont bi CPT 77047 | $539.88 | $830.59 | $116.93 – $237.93 | 3 |
| MRI breast w IV cont bi CPT 77049 | not published | not published | $190.81 – $388.27 | 3 |
| MRI cardiac morph & func wo IV cont CPT 75557 | not published | not published | $140.40 – $262.50 | 3 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | not published | not published | $200.09 – $357.37 | 3 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | not published | not published | $238.29 – $429.76 | 3 |
| MRI chest without contrast CPT 71550 | $956.04 | $1,470.83 | $217.55 – $271.94 | 3 |
| MRI chest without & w/contrast CPT 71552 | $2,278.18 | $3,504.89 | $262.50 – $455.57 | 3 |
| MRI chest w IV cont CPT 71551 | $2,278.18 | $3,504.89 | $238.29 – $432.74 | 3 |
| MRI compatible system HCPCS L0859 | not published | not published | $1,399.89 – $1,399.89 | 5 |
| MRI fetal ea addl gestation CPT 74713 | not published | not published | $91.07 – $185.32 | 3 |
| MRI fetal sngl/1st gestation CPT 74712 | not published | not published | $218.10 – $270.99 | 3 |
| MRI guid ndl plc s&i CPT 77021 | not published | not published | $262.50 – $483.41 | 3 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $262.50 – $334.35 | 2 |
| MRI loex nonjt w IV cont CPT 73719 | $1,510.60 | $2,324.00 | $152.61 – $273.49 | 3 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $956.04 | $1,470.83 | $130.84 – $262.50 | 3 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $1,510.60 | $2,324.00 | $192.44 – $347.14 | 3 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,510.60 | $2,324.00 | $156.69 – $279.85 | 3 |
| MRI tmj CPT 70336 | $538.92 | $829.10 | $157.04 – $272.20 | 3 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $956.04 | $1,470.83 | $196.26 – $272.20 | 3 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $1,510.60 | $2,324.00 | $250.77 – $455.30 | 3 |
| MRI upper extremity w/dye CPT 73219 | not published | not published | $208.00 – $374.40 | 3 |
| MRI w/cont, breast, bi HCPCS C8906 | not published | not published | $262.50 – $262.50 | 1 |
| MRI w/cont, breast, uni HCPCS C8903 | not published | not published | $262.50 – $262.50 | 1 |
| MRI without fol w/cont, breast HCPCS C8908 | not published | not published | $262.50 – $262.50 | 1 |
| MRI without fol w/cont, brst, un HCPCS C8905 | not published | not published | $262.50 – $262.50 | 1 |
| Mr safety determination physician/other qhp CPT 76016 | $181.62 | $279.42 | $35.88 – $73.01 | 3 |
| Mr safety implant elec prepj CPT 76018 | $190.38 | $292.90 | $65.70 – $133.68 | 3 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $38.03 | $58.51 | $42.97 – $87.43 | 3 |
| Mr safety implt pos&/immoblj CPT 76019 | $120.95 | $186.07 | $102.26 – $208.09 | 3 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $50.71 | $78.01 | $8.94 – $18.18 | 3 |
| Mr sfty med physics xm cstmz CPT 76017 | $500.44 | $769.91 | $152.32 – $309.96 | 3 |
| Mr spectroscopy CPT 76390 | not published | not published | $262.50 – $439.70 | 2 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $153.23 – $344.77 | 10 |
| Msh2 gene full seq CPT 81295 | $846.20 | $1,301.85 | $153.23 – $458.04 | 10 |
| Msh2 gene known variants CPT 81296 | not published | not published | $39.89 – $405.28 | 10 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $90.00 – $367.42 | 10 |
| Msh6 gene full seq CPT 81298 | $1,422.93 | $2,189.13 | $290.71 – $770.22 | 10 |
| Msh6 gene known variants CPT 81299 | not published | not published | $39.89 – $369.60 | 10 |
| Mt bone graft microvasc CPT 20957 | not published | not published | $2,003.60 – $3,071.70 | 2 |
| Mthfr gene analy common variants CPT 81291 | $191.54 | $294.67 | $46.50 – $78.41 | 8 |
| M.tuberculo dna dir probe CPT 87555 | $78.79 | $121.21 | $17.91 – $32.26 | 8 |
| M.tuberculo dna quant CPT 87557 | not published | not published | $20.87 – $51.41 | 8 |
| Mucin synovial fluid CPT 83872 | not published | not published | $3.91 – $7.03 | 8 |
| Mucopolysaccharides CPT 83864 | not published | not published | $19.00 – $45.79 | 10 |
| Mucormycosis antibody CPT 86732 | not published | not published | $10.00 – $18.00 | 8 |
| Mult fam adapt bhv tx gdn CPT 97157 | not published | not published | $10.36 – $10.36 | 1 |
| Multi-axial knee/shin system HCPCS L5840 | not published | not published | $4,341.90 – $4,341.90 | 5 |
| Multi-axial rotation unit HCPCS L5986 | not published | not published | $775.79 – $775.79 | 5 |
| Multi den insert custom mold HCPCS A5513 | not published | not published | $55.16 – $55.16 | 5 |
| Multi den insert direct form HCPCS A5512 | not published | not published | $36.96 – $36.96 | 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.