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 |
|---|---|---|---|---|
| Orthovisc inj per dose HCPCS J7324 | $295.88 | $455.20 | $100.33 – $573.60 | 4 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $786.13 | $1,209.43 | $442.95 – $442.95 | 5 |
| Ortho wrst/hnd w/jnt cstm w/fit&adj HCPCS L3905 | $1,690.06 | $2,600.09 | $1,082.62 – $1,082.62 | 5 |
| Oscillation chest wall mechanical per session CPT 94669 | $401.62 | $617.88 | $20.87 – $29.43 | 2 |
| O shoe add felt w leath insl HCPCS L3520 | not published | not published | $38.11 – $38.11 | 5 |
| O shoe add horseshoe toe tap HCPCS L3560 | not published | not published | $27.48 – $27.48 | 5 |
| O shoe add instep extension HCPCS L3570 | not published | not published | $102.26 – $102.26 | 5 |
| O shoe add instep velcro clo HCPCS L3580 | not published | not published | $77.81 – $77.81 | 5 |
| O shoe add standard toe tap HCPCS L3550 | not published | not published | $10.65 – $10.65 | 5 |
| O shoe convert to sof counte HCPCS L3590 | not published | not published | $64.07 – $64.07 | 5 |
| Osmolality blood CPT 83930 | $23.92 | $36.80 | $4.40 – $13.72 | 10 |
| Osmolality urine CPT 83935 | $24.67 | $37.96 | $4.55 – $13.72 | 10 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $250.27 – $366.64 | 2 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $447.60 – $635.36 | 2 |
| Osteoart algrft w/surf & b1 CPT 20932 | not published | not published | $528.99 – $798.57 | 2 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $1,026.80 – $1,507.20 | 2 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $736.31 – $1,084.23 | 2 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $918.39 – $1,359.77 | 2 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | not published | not published | $33.67 – $64.43 | 2 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | not published | not published | $42.13 – $80.72 | 2 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | not published | not published | $50.11 – $98.60 | 2 |
| Osteoplasty humerus CPT 24420 | not published | not published | $817.40 – $1,110.75 | 2 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | not published | not published | $1,255.59 – $1,783.17 | 2 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | not published | not published | $257.11 – $401.15 | 2 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | not published | not published | $1,201.03 – $1,757.21 | 2 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | not published | not published | $1,414.49 – $1,875.83 | 2 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $632.36 – $916.61 | 2 |
| Osteot mlt relignmt imed rod CPT 27712 | not published | not published | $829.54 – $1,223.73 | 2 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $515.14 – $746.59 | 2 |
| Ostomy clamp, replacement HCPCS A4363 | not published | not published | $1.80 – $2.87 | 6 |
| Ostomy irrigation set HCPCS A4400 | not published | not published | $59.20 – $59.20 | 5 |
| Ost pch drain 2 piece system HCPCS A4426 | not published | not published | $3.89 – $3.98 | 6 |
| Ost pch drain for barrier fl HCPCS A4425 | not published | not published | $3.40 – $5.10 | 6 |
| Ost pch drain w bar & filter HCPCS A4424 | not published | not published | $4.89 – $6.78 | 6 |
| Ost pch for bar w flange/flt HCPCS A4419 | not published | not published | $1.84 – $2.46 | 6 |
| Ost skn barr extnd >4 sq HCPCS A4410 | not published | not published | $11.18 – $12.88 | 6 |
| Ost urine pch w b/bltin conv HCPCS A4430 | not published | not published | $9.56 – $12.14 | 6 |
| Other bone graft microvasc CPT 20962 | not published | not published | $1,980.96 – $2,970.22 | 2 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $15.41 – $52.04 | 10 |
| Oth resp proc, group HCPCS G0239 | $86.78 | $133.51 | $11.66 – $15.75 | 2 |
| Oth resp proc, indiv HCPCS G0238 | $86.78 | $133.51 | $9.21 – $12.49 | 2 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | not published | not published | $41.56 – $49.23 | 3 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | not published | not published | $6.47 – $11.16 | 2 |
| Otoplasty 69300 CPT 69300 | not published | not published | $351.67 – $530.45 | 2 |
| Ot re-evaluation patient/family CPT 97168 | $169.70 | $261.08 | $52.01 – $57.74 | 3 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $70.43 | $108.36 | $15.70 – $23.03 | 3 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $72.64 | $111.76 | $16.74 – $24.11 | 3 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $1,210.74 – $1,735.65 | 2 |
| Outrigger HCPCS L1080 | not published | not published | $63.59 – $63.59 | 5 |
| Outrigger bil with vert extens HCPCS L1085 | not published | not published | $176.88 – $176.88 | 5 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $570.64 – $806.46 | 2 |
| Ovine, 1000 usp units HCPCS J3472 | not published | not published | $130.00 – $130.00 | 1 |
| Ovulation tests CPT 84830 | not published | not published | $8.45 – $15.24 | 8 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $0.57 – $3.50 | 4 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | not published | not published | $0.05 – $0.60 | 4 |
| Oxymorphone hcl injection HCPCS J2410 | not published | not published | $3.00 – $3.00 | 1 |
| Oxytetracycline injection HCPCS J2460 | not published | not published | $0.88 – $0.88 | 1 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | not published | not published | $0.83 – $1.04 | 3 |
| P-32 chromic phos ther per mci HCPCS A9564 | not published | not published | $167.04 – $167.04 | 1 |
| P-32 sod phosphate ther per mci HCPCS A9563 | not published | not published | $292.68 – $365.85 | 2 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $83.02 – $188.62 | 10 |
| Packing strips, non-impreg HCPCS A6407 | not published | not published | $2.66 – $2.66 | 5 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | not published | not published | $0.10 – $0.40 | 4 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $16.65 | $25.61 | $6.59 – $17.54 | 4 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $171.43 – $811.80 | 8 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $94.17 – $361.62 | 10 |
| Palifermin injection HCPCS J2425 | not published | not published | $18.05 – $38.69 | 4 |
| Palingen or palingen xplus HCPCS Q4173 | not published | not published | $103.97 – $480.00 | 2 |
| Palingen or promatrx HCPCS Q4174 | not published | not published | $1,415.10 – $1,494.00 | 2 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $29.43 | $45.28 | $9.55 – $16.37 | 4 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $1,804.91 – $2,090.71 | 2 |
| Palonosetron hcl HCPCS J2469 | not published | not published | $0.35 – $6.00 | 4 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $17.05 | $26.23 | $11.29 – $24.61 | 4 |
| Pancreatectomy CPT 48146 | not published | not published | $1,430.62 – $2,084.50 | 2 |
| Pancreatectomy CPT 48152 | not published | not published | $2,161.92 – $3,202.92 | 2 |
| Pancreatectomy CPT 48154 | not published | not published | $2,171.10 – $3,220.38 | 2 |
| Pancreatectomy 48153 CPT 48153 | not published | not published | $2,318.17 – $3,445.07 | 2 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $1,181.22 – $1,736.94 | 2 |
| Pancreatorrhaphy CPT 48545 | not published | not published | $1,022.44 – $1,488.44 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $113.73 – $182.19 | 4 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | not published | not published | $2.00 – $4.37 | 2 |
| Papaverin hcl injection HCPCS J2440 | not published | not published | $6.92 – $45.00 | 3 |
| Parathormone (pth) intact CPT 83970 | $149.38 | $229.81 | $27.50 – $92.88 | 10 |
| Parathyrdec/expl parathyr medstnl sternal/tthrc 60505 CPT 60505 | not published | not published | $989.56 – $1,551.05 | 2 |
| Parathyrd planar w/spect&ct CPT 78072 | not published | not published | $254.79 – $390.77 | 3 |
| Parathyroid autotransplantation 60512 CPT 60512 | not published | not published | $172.22 – $270.39 | 2 |
| Parathyroid planar imaging CPT 78070 | $812.30 | $1,249.69 | $117.97 – $292.30 | 3 |
| Parathyroid planar img w/tomo spect CPT 78071 | $812.30 | $1,249.69 | $208.40 – $335.10 | 3 |
| Paravaginal defect repair 57284 CPT 57284 | not published | not published | $605.69 – $879.75 | 2 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $703.37 – $993.70 | 2 |
| Paricalcitol HCPCS J2501 | $1.82 | $2.80 | $0.81 – $2.40 | 4 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $444.52 | $683.87 | $11.46 – $18.38 | 2 |
| Parotid duct diversion CPT 42507 | not published | not published | $363.19 – $565.29 | 2 |
| Parotid duct diversion CPT 42509 | not published | not published | $591.88 – $934.88 | 2 |
| Parotid duct diversion CPT 42510 | not published | not published | $442.25 – $693.65 | 2 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | not published | not published | $700.13 – $943.81 | 2 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $149.02 – $211.02 | 2 |
| Partial complicated cystectomy 51555 CPT 51555 | not published | not published | $933.02 – $1,438.16 | 2 |
| Partial exc bone humerus CPT 24140 | not published | not published | $535.76 – $782.21 | 2 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $344.43 – $497.89 | 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.