Newark Wayne Community Hospital
1200 Driving Park Avenue, Newark, NY · Rochesterregional · · NPI 1770671182
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 |
|---|---|---|---|---|
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $201.75 | $310.38 | $22.45 – $46.78 | 3 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $15.17 – $31.61 | 2 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $15.90 – $20.70 | 3 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $620.05 – $1,292.00 | 2 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $708.43 – $1,476.16 | 2 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $700.40 – $1,459.42 | 2 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $765.56 – $1,595.20 | 2 |
| Lso corset front HCPCS L0972 | not published | not published | $273.03 – $273.03 | 1 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $119.15 – $119.15 | 1 |
| Lso full corset HCPCS L0976 | not published | not published | $382.88 – $382.88 | 1 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $404.78 – $404.78 | 1 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $3,296.46 – $3,296.46 | 1 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $1,686.98 – $1,686.98 | 1 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $230.00 – $230.00 | 1 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $2,436.51 – $2,436.51 | 1 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $3,613.51 – $3,613.51 | 1 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $536.98 | $826.13 | $716.73 – $716.73 | 1 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $407.28 – $407.28 | 1 |
| Lso s/c shell/panel custom HCPCS L0640 | $1,959.48 | $3,014.58 | $2,615.44 – $2,615.44 | 1 |
| Lso s/c shell/panel prefab HCPCS L0639 | $2,011.64 | $3,094.83 | $2,685.06 – $2,685.06 | 1 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $18.91 – $34.30 | 5 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.86 – $4.73 | 3 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $152.32 – $152.32 | 1 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $187.64 – $187.64 | 1 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $77.66 – $161.82 | 3 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $186.80 – $186.80 | 1 |
| Lumbar sling HCPCS L1090 | not published | not published | $240.88 – $240.88 | 1 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,377.95 – $2,871.23 | 2 |
| Lumizyme injection HCPCS J0221 | not published | not published | $192.62 – $246.12 | 4 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $870.76 | $1,339.63 | $31.33 – $65.28 | 2 |
| Lung function test (mbc/mvv) CPT 94200 | $335.52 | $516.18 | $12.93 – $26.94 | 2 |
| Lung Function Test (Spirometry) CPT 94010 | $482.35 | $742.07 | $20.23 – $42.15 | 2 |
| Lung perfusion imaging CPT 78580 | $1,067.57 | $1,642.41 | $166.57 – $347.08 | 3 |
| Lung transplant double CPT 32853 | not published | not published | $3,994.57 – $8,323.49 | 2 |
| Lung transplant single CPT 32851 | not published | not published | $2,872.66 – $5,985.76 | 2 |
| Lung transplant with bypass CPT 32852 | not published | not published | $3,141.52 – $6,545.99 | 2 |
| Lung transplant with bypass CPT 32854 | not published | not published | $4,235.07 – $8,824.62 | 2 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,327.09 – $2,765.26 | 2 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $194.67 – $248.74 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $39.45 – $50.40 | 4 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $287.60 – $367.49 | 3 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $361.46 | $556.10 | $229.50 – $293.25 | 3 |
| Lvad shower bag heartmate HCPCS Q0501 | $877.50 | $1,350.00 | $1,278.87 – $1,278.87 | 1 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $25.49 – $53.11 | 2 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $721.31 – $721.31 | 1 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $17.24 – $31.28 | 4 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $635.64 – $1,324.48 | 2 |
| Lymphatics/lymph node imaging CPT 78195 | $1,129.74 | $1,738.06 | $244.87 – $510.24 | 3 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $31.44 – $57.03 | 4 |
| Lymphocyte transformation mitogen CPT 86353 | $177.43 | $272.97 | $38.37 – $76.49 | 6 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $46.08 – $295.64 | 4 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $40.93 – $74.24 | 4 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,652.99 | $4,081.52 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75805 | $5,398.13 | $8,304.81 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $5,491.15 | $8,447.92 | not published | 0 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $133.21 – $277.57 | 2 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $134.07 – $279.36 | 2 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $177.10 – $369.02 | 2 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $15.10 – $15.10 | 1 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $6.90 – $14.38 | 2 |
| Macroscopic exam arthropod CPT 87168 | $15.44 | $23.76 | $3.67 – $6.66 | 6 |
| Macroscopic exam parasite CPT 87169 | $15.44 | $23.76 | $2.32 – $6.72 | 7 |
| Magnesium CPT 83735 | $24.24 | $37.29 | $5.76 – $10.45 | 7 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $3.42 | $5.26 | $0.40 – $0.66 | 4 |
| Magnetic image bone marrow CPT 77084 | $1,006.36 | $1,548.25 | $227.90 – $474.88 | 3 |
| Makena, 10 mg HCPCS J1726 | $21.95 | $33.77 | $20.83 – $37.67 | 3 |
| Malaria antibody CPT 86750 | $47.72 | $73.41 | $8.20 – $20.58 | 7 |
| Male sling procedure CPT 53440 | not published | not published | $655.29 – $1,365.43 | 2 |
| Mammosite ced HCPCS C1728 | $4,974.45 | $7,653.00 | not published | 0 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,609.45 – $5,437.31 | 2 |
| Manipulate finger w/anesth CPT 26340 | $3,188.88 | $4,905.97 | $347.57 – $724.23 | 2 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $415.42 – $865.61 | 2 |
| Manipulation of hip joint CPT 27275 | not published | not published | $169.74 – $353.69 | 2 |
| Manipulation of spine CPT 22505 | not published | not published | $142.57 – $297.07 | 2 |
| Manipulat palm cord post inj CPT 26341 | $495.44 | $762.22 | $69.57 – $144.96 | 2 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $2.40 – $3.07 | 2 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $1.04 – $9.07 | 3 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $174.18 – $174.18 | 1 |
| Manual diff wbc count b-coat CPT 85009 | $14.87 | $22.87 | $3.28 – $7.91 | 6 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $119.78 – $249.59 | 2 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $115.98 – $241.67 | 2 |
| Map tachycard site(s) CPT 93609 | $5,480.44 | $8,431.44 | not published | 0 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $46.45 – $59.35 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $869.70 | $1,338.00 | not published | 0 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $1,011.53 – $2,107.73 | 2 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $233.12 – $233.12 | 1 |
| Mastectomy form HCPCS L8020 | not published | not published | $611.77 – $611.77 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $596.53 – $1,242.99 | 2 |
| Mast mod rad CPT 19307 | not published | not published | $1,062.20 – $2,213.31 | 2 |
| Mastoidectomy CPT 69501 | not published | not published | $608.03 – $1,266.95 | 2 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $803.96 – $1,675.21 | 2 |
| Mastoids complete CPT 70130 | $275.16 | $423.33 | $42.75 – $89.08 | 3 |
| Mastoid surgery revision CPT 69603 | not published | not published | $1,123.07 – $2,340.14 | 2 |
| Mastopexy CPT 19316 | not published | not published | $693.17 – $1,444.36 | 2 |
| Mast radical CPT 19305 | not published | not published | $1,033.93 – $2,154.40 | 2 |
| Mast rad urban type CPT 19306 | not published | not published | $1,108.70 – $2,310.20 | 2 |
| Mast simple complete CPT 19303 | not published | not published | $863.56 – $1,799.40 | 2 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $76.09 – $385.82 | 4 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $1,980.00 – $2,530.00 | 3 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $17.73 – $120.89 | 4 |
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.