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 |
|---|---|---|---|---|
| Prothrombin complex kcentra HCPCS J7168 | not published | not published | $2.86 – $3.41 | 3 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $14.29 | $21.98 | $2.63 – $4.73 | 8 |
| Proton treatment complex CPT 77525 | not published | not published | $1,032.87 – $1,857.59 | 2 |
| Proton trmt intermediate CPT 77523 | not published | not published | $970.01 – $1,996.62 | 2 |
| Proton trmt simple w/comp CPT 77522 | not published | not published | $817.40 – $1,465.66 | 2 |
| Proton trmt simple without comp CPT 77520 | not published | not published | $780.73 – $1,099.02 | 2 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $6.48 – $11.69 | 8 |
| Provide inr test mater/equip HCPCS G0249 | not published | not published | $53.69 – $76.52 | 2 |
| Prpertl pel pack hemrrg trma 49013 CPT 49013 | not published | not published | $331.40 – $496.35 | 2 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $460.44 – $649.85 | 2 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $223.89 | $344.44 | $55.27 – $109.05 | 2 |
| Pr prolonged e&m service office outpatient each 15 minutes (g2212) HCPCS G2212 | not published | not published | $22.90 – $41.15 | 2 |
| Prq av fstl crtj uxtr 1 acs CPT 36836 | not published | not published | $259.01 – $351.38 | 2 |
| Prq av fstl crt uxtr sep acs CPT 36837 | not published | not published | $330.49 – $457.45 | 2 |
| Prq card revasc mi 1 vsl CPT 92941 | not published | not published | $478.87 – $793.70 | 2 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | not published | not published | $731.57 – $731.57 | 1 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | not published | not published | $425.34 – $705.73 | 2 |
| Prq skel fix clcnl fx w/mnpj CPT 28406 | not published | not published | $449.50 – $588.01 | 2 |
| Prq skel fix epcndylr hum fx CPT 24566 | not published | not published | $563.67 – $798.44 | 2 |
| Prq skel fix sprcndlr hum fx CPT 24538 | not published | not published | $613.48 – $830.50 | 2 |
| Prq skel fix talus fx w/mnpj CPT 28436 | not published | not published | $405.61 – $514.83 | 2 |
| Prq skel fix tarsl fx w/mnpj CPT 28456 | not published | not published | $313.09 – $381.04 | 2 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | not published | not published | $376.72 – $706.58 | 2 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | not published | not published | $424.01 – $424.01 | 1 |
| Prq trlml c athrc st angiop1 CPT 92933 | not published | not published | $449.52 – $793.07 | 2 |
| Prq trl rvs ch occ ant&rtrgr CPT 92945 | not published | not published | $530.18 – $530.18 | 1 |
| Prq trluml c angiop 1art&/br CPT 92920 | not published | not published | $314.42 – $635.09 | 2 |
| Prq trluml c athrc 1 art&/br CPT 92924 | not published | not published | $381.20 – $757.16 | 2 |
| Prq trluml revsc ch occ ant CPT 92943 | not published | not published | $514.98 – $794.34 | 2 |
| Pr removal drug delivery implant CPT 11982 | $417.74 | $642.68 | $51.82 – $86.24 | 2 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $255.27 | $392.72 | $34.41 – $52.81 | 2 |
| Pr removal intrauterine device CPT 58301 | $436.20 | $671.08 | $47.50 – $70.35 | 2 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $842.52 | $1,296.18 | $136.49 – $216.74 | 2 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $444.52 | $683.87 | $44.34 – $61.44 | 2 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $444.52 | $683.87 | $45.36 – $64.83 | 2 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $444.52 | $683.87 | $35.92 – $49.70 | 2 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $444.52 | $683.87 | $46.83 – $65.34 | 2 |
| Pr robotic surgical system HCPCS S2900 | $0.01 | $0.01 | not published | 0 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $539.80 – $794.27 | 2 |
| Pr subsequent hospital care e/m normal newborn per day CPT 99462 | not published | not published | $29.78 – $52.76 | 2 |
| Prtl exc bone olecrn process CPT 24147 | not published | not published | $487.49 – $693.89 | 2 |
| Prtl exc bone radial h/n CPT 24145 | not published | not published | $461.91 – $658.99 | 2 |
| Prtl exchange transfuse nb CPT 36456 | not published | not published | $69.08 – $116.46 | 2 |
| Prtl excision bone clavicle CPT 23180 | not published | not published | $534.52 – $732.28 | 2 |
| Prtl excision bone scapula CPT 23182 | not published | not published | $523.09 – $733.00 | 2 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,929.15 | $2,967.92 | $117.14 – $175.77 | 2 |
| Pr visit complexity e&m service serious/complex condition HCPCS G2211 | not published | not published | $12.07 – $21.50 | 2 |
| PSA (Prostate) Test CPT 84153 | $66.59 | $102.44 | $12.25 – $41.38 | 10 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | $42.77 | $65.80 | $1.84 – $17.69 | 3 |
| Psychoanalysis CPT 90845 | not published | not published | $75.21 – $107.62 | 2 |
| Psychophysiological therapy CPT 90875 | not published | not published | $42.00 – $67.60 | 2 |
| Psychophysiological therapy CPT 90876 | not published | not published | $72.00 – $117.23 | 2 |
| Psychotherapy group therapy CPT 90853 | $225.39 | $346.75 | $20.81 – $48.00 | 4 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $240.84 | $370.52 | $47.44 – $79.95 | 4 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $312.53 | $480.82 | $65.50 – $106.28 | 4 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $300.20 | $461.85 | $78.75 – $159.79 | 4 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | $341.19 | $524.91 | $84.36 – $147.46 | 3 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | $170.61 | $262.47 | $60.05 – $112.05 | 3 |
| Psycl/nrpsyc tech 1st CPT 96138 | $42.77 | $65.80 | $30.76 – $46.62 | 3 |
| Psy evaluation of records CPT 90885 | not published | not published | $54.60 – $54.60 | 1 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | $42.77 | $65.80 | $18.11 – $58.37 | 3 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | $57.55 | $88.54 | $14.04 – $54.00 | 3 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | $21.38 | $32.90 | $28.92 – $46.62 | 3 |
| Psytx complex interactive CPT 90785 | $98.33 | $151.28 | $4.25 – $16.52 | 3 |
| Psytx pt w/e&m 16-37 min CPT 90833 | $66.36 | $102.09 | $13.24 – $78.21 | 4 |
| Psytx pt w/e&m 38-52 min CPT 90836 | $142.72 | $219.57 | $50.00 – $98.94 | 4 |
| Psytx pt w/e&m 53+ min CPT 90838 | $376.45 | $579.15 | $58.47 – $130.95 | 4 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $55.13 | $84.81 | $2.76 – $49.23 | 3 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $63.26 | $97.32 | $14.66 – $17.25 | 4 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $45.07 | $69.34 | $6.20 – $12.00 | 4 |
| Pt application of modality traction mechanical CPT 97012 | $46.34 | $71.29 | $7.98 – $12.64 | 4 |
| Pt/caregiver traing home inr CPT 93792 | not published | not published | $59.00 – $79.38 | 2 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $39.72 – $360.00 | 8 |
| Pten gene full sequence CPT 81321 | $1,758.77 | $2,705.80 | $272.36 – $720.00 | 8 |
| Pten gene known fam variant CPT 81322 | not published | not published | $26.48 – $55.92 | 8 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $593.25 – $859.99 | 2 |
| Pt-focused hlth risk assmt CPT 96160 | $83.12 | $127.88 | $2.46 – $3.94 | 2 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $20.79 – $30.18 | 2 |
| Pt prgrm for implt neurostim HCPCS L8681 | not published | not published | $1,760.95 – $1,760.95 | 5 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $137.74 | $211.90 | $25.19 – $40.77 | 3 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $40.70 | $62.62 | $10.56 – $49.23 | 3 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $91.08 | $140.13 | $12.61 – $25.10 | 4 |
| Pt wheelchair management each 15 minutes CPT 97542 | $101.01 | $155.40 | $14.96 – $27.55 | 4 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $447.36 – $763.78 | 2 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $223.68 – $379.31 | 2 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $3,333.00 – $6,491.52 | 8 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $3,123.62 – $4,699.09 | 2 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $776.94 – $1,098.31 | 2 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $117.40 – $182.38 | 3 |
| Pulse ox continuous overnight monitoring CPT 94762 | $367.00 | $564.61 | $19.57 – $32.09 | 3 |
| Pulse ox multiple CPT 94761 | $72.83 | $112.04 | $3.47 – $4.54 | 3 |
| Pulse ox single CPT 94760 | $24.76 | $38.10 | $2.56 – $3.21 | 3 |
| Punc of shunt for asp or inj CPT 61070 | $648.41 | $997.55 | $42.21 – $63.64 | 2 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $277.38 | $426.74 | $10.95 – $17.78 | 2 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $842.52 | $1,296.18 | $75.39 – $106.55 | 2 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $34.39 – $54.08 | 2 |
| Puncture spinal lumbar diagnostic CPT 62270 | $648.41 | $997.55 | $47.68 – $71.40 | 2 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $97.94 – $206.40 | 2 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $70.70 – $300.00 | 2 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $37.26 – $57.58 | 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.