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 |
|---|---|---|---|---|
| Ocular instrumnt screen bil CPT 99174 | not published | not published | $6.37 – $6.37 | 1 |
| Ocular instrumnt screen bil CPT 99177 | $22.16 | $34.09 | $5.16 – $5.16 | 1 |
| Ocular photodynamic ther CPT 67221 | not published | not published | $140.52 – $250.48 | 2 |
| Ocular reconst transplant CPT 65780 | not published | not published | $427.62 – $781.52 | 2 |
| Ocular reconst transplant CPT 65781 | not published | not published | $932.84 – $1,565.98 | 2 |
| Ocular reconst transplant CPT 65782 | not published | not published | $808.48 – $1,349.62 | 2 |
| Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 | not published | not published | $55.58 – $72.40 | 3 |
| Off base opioid tx, 60 m HCPCS G2087 | not published | not published | $289.75 – $318.28 | 2 |
| Off base opioid tx 70min HCPCS G2086 | not published | not published | $303.96 – $325.87 | 2 |
| Office consultation CPT 99241 | not published | not published | $22.25 – $25.20 | 2 |
| Off/op cnsltj new/est low 30 CPT 99243 | not published | not published | $66.75 – $151.95 | 3 |
| Off/op cnsltj new/est mod 40 CPT 99244 | not published | not published | $66.75 – $227.79 | 3 |
| Off/op consltj new/est hi 55 CPT 99245 | not published | not published | $66.75 – $277.67 | 3 |
| Off/op consltj new/est sf 20 CPT 99242 | not published | not published | $28.25 – $110.97 | 3 |
| Offset knee joint each HCPCS L2390 | not published | not published | $134.08 – $134.08 | 5 |
| Offset knee joint heavy duty HCPCS L2395 | not published | not published | $179.80 – $179.80 | 5 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | not published | not published | $0.69 – $0.93 | 3 |
| Olanzapine long-acting inj HCPCS J2358 | $5.92 | $9.10 | $2.92 – $3.37 | 4 |
| Ol dig e/m svc 11-20 min CPT 99422 | not published | not published | $18.71 – $43.64 | 2 |
| Ol dig e/m svc 21+ min CPT 99423 | not published | not published | $29.45 – $64.00 | 2 |
| Ol dig e/m svc 5-10 min CPT 99421 | not published | not published | $9.22 – $26.42 | 2 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $103.71 | $159.55 | $32.97 – $48.85 | 4 |
| Omental flap extra-abdom 49904 CPT 49904 | not published | not published | $1,048.27 – $1,576.28 | 2 |
| Omental flap intra-abdom 49905 CPT 49905 | not published | not published | $256.00 – $393.24 | 2 |
| Onc breast mrna 12 genes CPT 81522 | not published | not published | $2,347.04 – $4,647.60 | 8 |
| Onc breast mrna 58 genes CPT 81520 | $9,084.10 | $13,975.54 | $1,672.67 – $3,012.25 | 8 |
| Onc breast mrna 70 genes CPT 81521 | $11,352.85 | $17,465.92 | $2,347.04 – $4,647.60 | 8 |
| Onc brst mrna 11 genes CPT 81518 | not published | not published | $2,069.49 – $4,656.35 | 10 |
| Onc brst mrna 70 cnt 31 gene CPT 81523 | not published | not published | $2,347.04 – $4,647.60 | 8 |
| Onc cutan mlnma mrna 31 gene CPT 81529 | not published | not published | $4,358.96 – $8,631.60 | 8 |
| Oncology colon mrna CPT 81525 | not published | not published | $1,894.19 – $3,739.20 | 8 |
| Oncology colorectal scr CPT 81528 | not published | not published | $300.92 – $929.45 | 10 |
| Oncology gynecologic CPT 81535 | not published | not published | $351.15 – $695.35 | 8 |
| Oncology gynecologic CPT 81536 | not published | not published | $107.60 – $213.07 | 8 |
| Oncology lung CPT 81538 | not published | not published | $119.26 – $3,445.20 | 10 |
| Oncology prostate prob score CPT 81539 | $1,790.17 | $2,754.11 | $364.87 – $912.00 | 8 |
| Oncology thyroid CPT 81545 | not published | not published | $2,425.24 – $2,425.24 | 1 |
| Oncology tissue of origin CPT 81504 | not published | not published | $0.01 – $624.00 | 8 |
| Oncology tum unknown origin CPT 81540 | not published | not published | $1,769.70 – $4,500.00 | 8 |
| Onco (ovar) five proteins CPT 81503 | not published | not published | $308.00 – $1,076.40 | 8 |
| Onco (ovar) two proteins CPT 81500 | not published | not published | $0.01 – $312.60 | 8 |
| Oncoprotein dcp CPT 83951 | $171.25 | $263.46 | $42.93 – $144.92 | 10 |
| Oncoprotein her-2/neu CPT 83950 | $163.10 | $250.92 | $36.57 – $144.92 | 10 |
| Onc prostate 3 genes CPT 81551 | not published | not published | $1,230.18 – $2,436.00 | 8 |
| Onc prostate mrna 22 cnt gen CPT 81542 | not published | not published | $2,347.04 – $4,647.60 | 8 |
| Onc prostate mrna 46 genes CPT 81541 | $11,352.85 | $17,465.92 | $2,347.04 – $4,647.60 | 8 |
| Onc thyr mrna 10,196 gen alg CPT 81546 | not published | not published | $2,181.60 – $4,320.00 | 8 |
| Onc uveal mlnma mrna 15 gene CPT 81552 | not published | not published | $4,712.26 – $9,331.20 | 8 |
| Ondansetron 4 mg s0119 HCPCS S0119 | not published | not published | $0.43 – $0.55 | 3 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $0.10 | $0.15 | $0.01 – $0.14 | 3 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $0.23 | $0.36 | $0.09 – $0.22 | 4 |
| One-way allow prorated trip HCPCS P9604 | $58.78 | $90.43 | $9.44 – $77.74 | 4 |
| One way chest drain valve HCPCS A7040 | not published | not published | $56.24 – $56.24 | 5 |
| Oocyte identification CPT 89254 | not published | not published | $452.56 – $452.56 | 1 |
| Oophorectomy partial or total 58943 CPT 58943 | not published | not published | $919.01 – $1,236.15 | 2 |
| Open ablate liver tumor cryo CPT 47381 | not published | not published | $1,118.61 – $1,628.76 | 2 |
| Open ablate liver tumor rf CPT 47380 | not published | not published | $1,091.19 – $1,603.66 | 2 |
| Open aortic tube prosth repair 34830 CPT 34830 | not published | not published | $1,295.19 – $1,937.98 | 2 |
| Open aortofemor prosth repr CPT 34832 | not published | not published | $1,391.63 – $2,067.40 | 2 |
| Open aortoiliac prosth repr 34831 CPT 34831 | not published | not published | $1,419.54 – $2,138.46 | 2 |
| Open bx/exc inguinofem nodes CPT 38531 | not published | not published | $351.26 – $487.27 | 2 |
| Open bx of lung pleura 32098 CPT 32098 | not published | not published | $585.81 – $841.18 | 2 |
| Open cor endarterect w cabg/ea ves 33572 CPT 33572 | not published | not published | $169.73 – $254.89 | 2 |
| Open nasoethmoid fx with fixj CPT 21339 | not published | not published | $575.29 – $835.08 | 2 |
| Open nasoethmoid fx without fixj CPT 21338 | not published | not published | $514.80 – $736.60 | 2 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | $504.12 – $765.90 | 2 |
| Open skull for drainage 61312 CPT 61312 | not published | not published | $1,592.69 – $2,261.90 | 2 |
| Open tenotomy tendon flexor foot single or multiple 28230 CPT 28230 | not published | not published | $223.55 – $322.31 | 2 |
| Open thrombectomy of av fistula without revision 36831 CPT 36831 | not published | not published | $458.16 – $682.13 | 2 |
| Open tx compl front sinus fx CPT 21344 | not published | not published | $1,001.59 – $1,547.86 | 2 |
| Open tx iliac spine uni/bil HCPCS G0412 | not published | not published | $545.82 – $838.13 | 2 |
| Open tx nose fx w/skele fixj CPT 21330 | not published | not published | $402.82 – $618.84 | 2 |
| Open tx nose & septal fx CPT 21335 | not published | not published | $533.41 – $800.76 | 2 |
| Open tx post pelvic fxcture HCPCS G0415 | not published | not published | $1,010.28 – $1,580.69 | 2 |
| Open tx rib 1-3 fx w/fix 21811 CPT 21811 | not published | not published | $441.74 – $657.89 | 2 |
| Open tx rib 4-6 fx w/fix 21812 CPT 21812 | not published | not published | $531.83 – $806.83 | 2 |
| Open tx rib 7+ fx w/fix 21813 CPT 21813 | not published | not published | $720.35 – $1,086.36 | 2 |
| Open tx/sternum fracture 21825 CPT 21825 | not published | not published | $458.23 – $598.78 | 2 |
| Open wedge/bx lung infiltr CPT 32096 | not published | not published | $619.99 – $888.01 | 2 |
| Open wedge bx lung nodule 32097 CPT 32097 | not published | not published | $624.70 – $887.47 | 2 |
| Ophthalmic biometry CPT 92136 | not published | not published | $14.66 – $53.31 | 3 |
| Ophthalmic endoscope add-on CPT 66990 | not published | not published | $58.84 – $106.02 | 2 |
| Ophthalmic mitomycin HCPCS J7315 | not published | not published | $344.64 – $516.00 | 3 |
| Ophthalmodynamometry CPT 92260 | not published | not published | $7.59 – $12.94 | 2 |
| Ophth Ultrasound b & quant a CPT 76510 | not published | not published | $24.76 – $50.38 | 3 |
| Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 | not published | not published | $35.95 – $53.45 | 3 |
| Oph Ultrasound dx quan a-scan only CPT 76511 | not published | not published | $18.21 – $37.06 | 3 |
| Opioids & opiate analogs 3/4 CPT 80363 | not published | not published | $5.05 – $14.31 | 3 |
| Opn abltj 1/> rnl mas crysrg CPT 50250 | not published | not published | $900.45 – $1,383.24 | 2 |
| Opn ax/subcla art expos CPT 34715 | not published | not published | $218.12 – $338.64 | 2 |
| Opn exc/dst ntra-abd CPT 49189 | not published | not published | $1,746.54 – $2,181.95 | 2 |
| Opn exc/dst ntra-abd 10.1-20 CPT 49188 | not published | not published | $1,506.83 – $1,875.77 | 2 |
| Opn exc/dstr ntra-abd >30 cm CPT 49190 | not published | not published | $2,148.85 – $2,691.51 | 2 |
| Opn exc/dstr ntra-abd 5.1-10 CPT 49187 | not published | not published | $1,258.03 – $1,569.84 | 2 |
| Opn exc/dstr ntra-abd 5 cm/< CPT 49186 | not published | not published | $994.41 – $1,231.33 | 2 |
| Opn fem art expos cndt crtj 34714 CPT 34714 | not published | not published | $198.57 – $301.48 | 2 |
| Opn ilac art expos cndt crtj CPT 34833 | not published | not published | $287.03 – $447.10 | 2 |
| Opn impltj crnl nrv nea&pg CPT 64568 | not published | not published | $529.84 – $699.21 | 2 |
| Opn impltj nea neuromuscular CPT 64580 | not published | not published | $255.40 – $339.86 | 2 |
| Opn impltj nea perph nerve CPT 64575 | not published | not published | $241.16 – $368.19 | 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.