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 |
|---|---|---|---|---|
| Opn impltj nea sacral nerve CPT 64581 | not published | not published | $485.09 – $749.48 | 2 |
| Opn mpltj hpglsl nstm ary pg CPT 64582 | not published | not published | $596.01 – $880.43 | 2 |
| Opn tx complx malar fx CPT 21365 | not published | not published | $791.56 – $1,242.32 | 2 |
| Opn tx complx malar w/grft CPT 21366 | not published | not published | $932.48 – $1,422.66 | 2 |
| Opn tx depress front sinus fx 21343 CPT 21343 | not published | not published | $801.79 – $1,202.66 | 2 |
| Opn tx dprsd zygomatic arch CPT 21356 | not published | not published | $310.80 – $422.19 | 2 |
| Opn tx nasomax fx multple CPT 21347 | not published | not published | $772.68 – $1,132.91 | 2 |
| Opn tx nasomax fx w/fixj CPT 21346 | not published | not published | $751.08 – $1,067.31 | 2 |
| Opn tx nasomax fx w/graft CPT 21348 | not published | not published | $781.31 – $1,211.20 | 2 |
| Opn tx orbit fx combined CPT 21387 | not published | not published | $574.78 – $877.77 | 2 |
| Opn tx orbit fx periorbital CPT 21386 | not published | not published | $516.60 – $776.04 | 2 |
| Opn tx orbit fx transantral CPT 21385 | not published | not published | $552.08 – $841.53 | 2 |
| Opn tx orbit fx w/bone grft CPT 21408 | not published | not published | $666.73 – $1,007.50 | 2 |
| Opn tx orbit fx w/implant CPT 21407 | not published | not published | $475.86 – $723.71 | 2 |
| Opn tx orbit fx without impl 21406 CPT 21406 | not published | not published | $444.11 – $642.61 | 2 |
| Opn tx orbit periorbtl implt CPT 21390 | not published | not published | $584.09 – $897.96 | 2 |
| Opn tx orbit periorbt w/grft CPT 21395 | not published | not published | $734.47 – $1,128.56 | 2 |
| Oprelvekin injection HCPCS J2355 | not published | not published | $423.14 – $423.14 | 1 |
| Opscpy extnd on/mac draw CPT 92202 | not published | not published | $9.84 – $17.56 | 2 |
| Opscpy extnd rta draw uni/bi CPT 92201 | not published | not published | $15.43 – $27.13 | 2 |
| Optical endomicroscpy interp CPT 88375 | not published | not published | $37.76 – $49.81 | 3 |
| Optokinetic nystagmus test CPT 92534 | not published | not published | $7.44 – $7.44 | 1 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $500.56 – $727.82 | 2 |
| Optx acromclv dislc aqt/chrn CPT 23550 | not published | not published | $442.07 – $633.07 | 2 |
| Optx acute shoulder dislc CPT 23660 | not published | not published | $450.49 – $647.95 | 2 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $547.36 – $802.85 | 2 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $554.59 – $800.46 | 2 |
| Optx complicated mndblr fx CPT 21470 | not published | not published | $855.61 – $1,340.86 | 2 |
| Optx cranfcl sep comp mlt CPT 21433 | not published | not published | $1,250.12 – $1,946.93 | 2 |
| Optx cranfcl sep w/wiring CPT 21432 | not published | not published | $550.12 – $800.70 | 2 |
| Optx crnfcl sep comp mlt int CPT 21436 | not published | not published | $1,477.88 – $2,283.42 | 2 |
| Optx crnfc sep comp int&/xtr CPT 21435 | not published | not published | $1,033.08 – $1,567.68 | 2 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $445.70 – $631.64 | 2 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $599.64 – $868.73 | 2 |
| Optx lunate dislocation CPT 25695 | not published | not published | $490.35 – $703.38 | 2 |
| Optx medial ankle fx CPT 27766 | not published | not published | $474.20 – $675.45 | 2 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $599.35 – $931.10 | 2 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $796.48 – $1,114.63 | 2 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | $372.62 – $567.86 | 2 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | $466.95 – $702.86 | 2 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $485.62 – $737.83 | 2 |
| Optx palatal/max fx comp CPT 21423 | not published | not published | $590.99 – $864.37 | 2 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $815.39 – $1,210.03 | 2 |
| Optx post ankle fx CPT 27769 | not published | not published | $552.27 – $812.13 | 2 |
| Optx prox humrl fx w/int fix CPT 23615 | $13,931.12 | $21,432.50 | $672.49 – $983.90 | 2 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $915.82 – $1,380.16 | 2 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $517.92 – $744.80 | 2 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $486.47 – $700.14 | 2 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $473.41 – $674.05 | 2 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $602.15 – $877.42 | 2 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $730.37 – $1,061.03 | 2 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $690.55 – $1,003.53 | 2 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $523.58 – $749.69 | 2 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $731.52 – $1,090.10 | 2 |
| Optx sho dislc fx CPT 23670 | not published | not published | $667.33 – $974.23 | 2 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $705.82 – $1,033.26 | 2 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $487.34 – $689.80 | 2 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $448.16 – $634.44 | 2 |
| Optx thigh fx CPT 27269 | not published | not published | $914.93 – $1,383.78 | 2 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $590.80 – $917.20 | 2 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $564.18 – $817.44 | 2 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $486.05 – $693.37 | 2 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $482.88 – $693.03 | 2 |
| Oral aprepitant HCPCS J8501 | not published | not published | $2.77 – $13.19 | 4 |
| Oral busulfan HCPCS J8510 | not published | not published | $13.58 – $150.00 | 3 |
| Oral everolimus HCPCS J7527 | not published | not published | $1.16 – $7.23 | 4 |
| Oral hiv-1/hiv-2 screen HCPCS G0435 | not published | not published | $7.99 – $14.38 | 8 |
| Oral methotrexate (jylamvo) HCPCS J8611 | not published | not published | $16.47 – $18.64 | 3 |
| Oral methotrexate (xatmep) HCPCS J8612 | not published | not published | $20.00 – $22.92 | 3 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $380.19 – $828.12 | 4 |
| Orbitocranial approach/skull CPT 61584 | not published | not published | $2,264.30 – $3,130.71 | 2 |
| Orbitocranial approach/skull CPT 61585 | not published | not published | $2,594.85 – $3,540.29 | 2 |
| Orbitocranial approach/skull CPT 61592 | not published | not published | $2,424.30 – $3,463.14 | 2 |
| Orchiectomy partial CPT 54522 | not published | not published | $442.36 – $670.22 | 2 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $535.82 – $808.66 | 2 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $325.11 – $518.19 | 2 |
| Organic acids total quant ea spec CPT 83918 | $69.19 | $106.44 | $15.73 – $51.70 | 10 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $42.77 – $50.31 | 4 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | not published | not published | $28.18 – $32.83 | 4 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $87.30 – $125.96 | 2 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | not published | not published | $6.27 – $18.72 | 4 |
| Ortho dvc repair per 15 min HCPCS L4205 | not published | not published | $29.95 – $29.95 | 5 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $559.44 | $860.68 | $315.21 – $315.21 | 5 |
| Ortho elbow w/lock w/ft&adj HCPCS L3760 | $968.88 | $1,490.58 | $545.90 – $545.90 | 5 |
| Ortho ewhf rigd without jnt cstm w HCPCS L3765 | $2,484.29 | $3,821.99 | $1,399.76 – $1,399.76 | 5 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $1,492.95 | $2,296.84 | $841.19 – $841.19 | 5 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $524.76 | $807.32 | $295.66 – $295.66 | 5 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $622.34 | $957.44 | $350.66 – $350.66 | 5 |
| Ortho hnd metcrpl fx prefb w/fit&adj HCPCS L3917 | $180.08 | $277.05 | $115.37 – $115.37 | 5 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $524.76 | $807.32 | $295.66 – $295.66 | 5 |
| Orthopantogram CPT 70355 | not published | not published | $7.57 – $10.44 | 3 |
| Orthopedic shoe add rub insl HCPCS L3510 | not published | not published | $35.09 – $35.09 | 5 |
| Orthop traing pfrmd phys/qhp CPT 92065 | not published | not published | $23.30 – $41.62 | 3 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $21.22 – $25.67 | 2 |
| Ortho shoe add full sole HCPCS L3540 | not published | not published | $61.04 – $61.04 | 5 |
| Ortho shoe add half sole HCPCS L3530 | not published | not published | $38.11 – $38.11 | 5 |
| Ortho shoe add leather insol HCPCS L3500 | not published | not published | $35.09 – $35.09 | 5 |
| Ortho shoe add march bar HCPCS L3595 | not published | not published | $50.33 – $50.33 | 5 |
| Ortho sidebar disconnect HCPCS L2768 | not published | not published | $156.26 – $156.26 | 5 |
| Orthosis lso rigd frm hyperex HCPCS L0472 | $868.65 | $1,336.39 | $556.45 – $556.45 | 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.