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 |
|---|---|---|---|---|
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | not published | not published | $3.88 – $5.11 | 6 |
| Powder prem protct 1oz HCPCS A4371 | not published | not published | $5.20 – $7.71 | 6 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $83.02 – $188.62 | 10 |
| Pq biliary strict dil s&i CPT 74363 | $986.64 | $1,517.91 | $77.40 – $261.69 | 2 |
| Pq dr cath chg w cont s&i CPT 75984 | $1,965.20 | $3,023.39 | $46.32 – $74.95 | 3 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | not published | not published | $347.53 – $539.10 | 2 |
| Pq thr inj ext pse CPT 36002 | $1,673.76 | $2,575.01 | $75.65 – $118.60 | 2 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | not published | not published | $148.67 – $233.84 | 2 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | not published | not published | $315.83 – $491.85 | 2 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | not published | not published | $297.94 – $461.10 | 2 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $243.93 – $401.23 | 4 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | not published | not published | $83.23 – $104.04 | 3 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | not published | not published | $571.58 – $737.16 | 2 |
| Pr application of long arm splint CPT 29105 | $368.32 | $566.65 | $30.75 – $48.62 | 3 |
| Pr application splint static short arm CPT 29125 | $255.27 | $392.72 | $32.45 – $44.11 | 3 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | $87.68 | $134.90 | $4.02 – $6.33 | 2 |
| Pr biopsy skin punch single lesion CPT 11104 | $497.06 | $764.71 | $31.63 – $54.63 | 2 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $464.06 – $680.99 | 2 |
| Pr correction hammertoe CPT 28285 | not published | not published | $306.38 – $429.81 | 2 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $83.12 | $127.88 | $8.94 – $34.38 | 3 |
| Prcrd drg 0-5yr or w/anomly CPT 33018 | $3,377.96 | $5,196.86 | $204.04 – $315.97 | 2 |
| Prcrd drg 6+yr without anomly CPT 33017 | $3,377.96 | $5,196.86 | $174.00 – $276.02 | 2 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $115.46 – $178.07 | 2 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | not published | not published | $62.43 – $95.00 | 3 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | not published | not published | $89.00 – $132.79 | 3 |
| Prealbumin CPT 84134 | $52.79 | $81.22 | $7.39 – $17.51 | 10 |
| Pr ecg 12 lead report only CPT 93010 | not published | not published | $6.99 – $14.23 | 3 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | not published | not published | $14.94 – $30.40 | 3 |
| Prednisolone acetate inj HCPCS J2650 | not published | not published | $0.40 – $0.40 | 1 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $24.78 | $38.12 | $0.14 – $2.93 | 4 |
| Prednisone 1 mg tablet HCPCS J7512 | $0.25 | $0.39 | $0.00 – $0.23 | 3 |
| Prefab glove for term device HCPCS L6890 | not published | not published | $277.64 – $277.64 | 5 |
| Prefab stnlss steel crown pe HCPCS D2931 | $155.35 | $239.00 | not published | 0 |
| Prefab stnlss steel crwn pri HCPCS D2930 | $143.65 | $221.00 | not published | 0 |
| Pregabalin - sendout CPT 80366 | $106.69 | $164.14 | $11.96 – $11.96 | 1 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $146.95 – $259.12 | 2 |
| Pregnancy associated plasma protein-a CPT 84163 | $54.49 | $83.83 | $10.03 – $28.10 | 10 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $323.71 | $498.02 | $72.45 – $98.99 | 3 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $323.71 | $498.02 | $57.51 – $79.48 | 3 |
| Pregnancy Ultrasound (limited) CPT 76815 | $323.71 | $498.02 | $41.41 – $56.66 | 3 |
| Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 | $333.37 | $512.88 | $164.96 – $164.96 | 1 |
| Prenatal Care Only (4-6 visits) CPT 59425 | not published | not published | $315.47 – $389.80 | 2 |
| Prenatal Care Only (7+ visits) CPT 59426 | not published | not published | $578.43 – $694.69 | 2 |
| Prep ak ischial direct form HCPCS L5570 | not published | not published | $2,800.49 – $2,800.49 | 5 |
| Prep ak ischial laminated HCPCS L5590 | not published | not published | $3,265.93 – $3,265.93 | 5 |
| Prep ak ischial plast molded HCPCS L5560 | not published | not published | $2,780.34 – $2,780.34 | 5 |
| Prep ak ischial thermo mold HCPCS L5580 | not published | not published | $3,174.22 – $3,174.22 | 5 |
| Preparation for bladder xray CPT 51605 | not published | not published | $29.05 – $43.62 | 2 |
| Preparation palate mold CPT 42280 | not published | not published | $80.89 – $124.62 | 2 |
| Prepare donor heart CPT 33944 | not published | not published | $685.13 – $685.13 | 1 |
| Prepare donor heart/lung CPT 33933 | not published | not published | $971.79 – $971.79 | 1 |
| Prepare donor intestine CPT 44715 | not published | not published | $360.04 – $360.04 | 1 |
| Prepare donor lung double CPT 32856 | not published | not published | $848.39 – $848.39 | 1 |
| Prepare donor lung single CPT 32855 | not published | not published | $565.47 – $565.47 | 1 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $281.91 – $456.03 | 2 |
| Prepare fecal microbiota CPT 44705 | not published | not published | $95.97 – $95.97 | 1 |
| Prepare heart-aorta conduit CPT 33404 | not published | not published | $1,351.99 – $1,947.32 | 2 |
| Prepare penis study CPT 54230 | not published | not published | $60.44 – $90.33 | 2 |
| Prepare sperm duct x-ray CPT 55300 | not published | not published | $136.65 – $213.06 | 2 |
| Prep bk ptb laminated socket HCPCS L5540 | not published | not published | $2,215.83 – $2,215.83 | 5 |
| Prep bk ptb open end socket HCPCS L5535 | not published | not published | $2,322.14 – $2,322.14 | 5 |
| Prep bk ptb plaster molded HCPCS L5510 | $2,782.42 | $4,280.65 | $1,782.34 – $1,782.34 | 5 |
| Prep bk ptb thermopls molded HCPCS L5530 | not published | not published | $2,114.56 – $2,114.56 | 5 |
| Prep cadaver renal allograft CPT 50323 | not published | not published | $187.98 – $187.98 | 1 |
| Prep corneal endo allograft CPT 65757 | not published | not published | $109.72 – $109.72 | 1 |
| Prep donor intestine/artery CPT 44721 | not published | not published | $278.24 – $483.78 | 2 |
| Prep donor intestine/venous CPT 44720 | not published | not published | $198.83 – $346.01 | 2 |
| Prep donor liver 3-segment CPT 47144 | not published | not published | $1,213.25 – $1,213.25 | 1 |
| Prep donor liver/arterial CPT 47147 | not published | not published | $277.91 – $424.25 | 2 |
| Prep donor liver lobe split CPT 47145 | not published | not published | $1,213.25 – $1,213.25 | 1 |
| Prep donor liver/venous CPT 47146 | not published | not published | $238.29 – $360.85 | 2 |
| Prep donor liver whole CPT 47143 | not published | not published | $970.61 – $970.61 | 1 |
| Prep donor pancreas CPT 48551 | not published | not published | $619.67 – $619.67 | 1 |
| Prep donor pancreas/venous CPT 48552 | not published | not published | $170.80 – $261.82 | 2 |
| Prep donor renal graft CPT 50325 | not published | not published | $187.98 – $187.98 | 1 |
| Prepj tum cav iort prtl mast CPT 19294 | not published | not published | $119.70 – $181.84 | 2 |
| Pre-plan 3d model w/ccta HCPCS C9793 | $2,209.21 | $3,398.79 | not published | 0 |
| Prep renal graft/arterial CPT 50328 | not published | not published | $137.69 – $210.88 | 2 |
| Prep renal graft/ureteral CPT 50329 | not published | not published | $131.69 – $200.90 | 2 |
| Prep renal graft/venous CPT 50327 | not published | not published | $157.60 – $240.75 | 2 |
| Prep skin to 100cm2 other CPT 15004 | not published | not published | $188.95 – $300.14 | 2 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $2,186.41 | $3,363.71 | $161.50 – $250.85 | 2 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | not published | not published | $32.32 – $50.84 | 2 |
| Pressure max expiratory/inspiratory CPT 94799 | $367.00 | $564.61 | not published | 0 |
| Pressure treatment esophagus CPT 43460 | not published | not published | $155.69 – $276.78 | 2 |
| Pressure velocity wire add ves CPT 93572 | not published | not published | $84.01 – $109.00 | 2 |
| Pre-tibial shell molded to p HCPCS L2340 | $871.42 | $1,340.64 | $558.21 – $558.21 | 5 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $364.21 | $560.33 | $10.80 – $10.80 | 1 |
| Pretreat rbc absorption reference CPT 86978 | $364.21 | $560.33 | $9.52 – $9.87 | 2 |
| Pretreat rbc density gradient separation reference CPT 86972 | $4,322.00 | $6,649.23 | $17.03 – $17.03 | 1 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $297.78 | $458.13 | $7.02 – $7.02 | 1 |
| Pretreat rbc w enzyme reference CPT 86971 | not published | not published | $9.52 – $9.52 | 1 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $294.41 | $452.94 | $74.50 – $200.48 | 4 |
| Preventive counseling group CPT 99411 | $47.97 | $73.80 | $24.69 – $24.69 | 1 |
| Preventive counseling group CPT 99412 | $60.89 | $93.68 | $31.32 – $31.32 | 1 |
| Prev med cnsl indiv apprx 15 CPT 99401 | $104.10 | $160.15 | $49.34 – $49.34 | 1 |
| Prev med cnsl indiv apprx 30 CPT 99402 | $159.13 | $244.81 | $81.76 – $81.76 | 1 |
| Prev med cnsl indiv apprx 45 CPT 99403 | $218.46 | $336.10 | $112.23 – $112.23 | 1 |
| Prev med cnsl indiv apprx 60 CPT 99404 | $279.88 | $430.59 | $72.00 – $143.76 | 2 |
| Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 | $403.93 | $621.43 | $95.86 – $95.86 | 1 |
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.