WESTFIELD MEMORIAL HOSPITAL INC
189 EAST MAIN STREET, WESTFIELD, NY · Ahn · · NPI 1942236427
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 |
|---|---|---|---|---|
| Rpr tga rcnstj rmvl plm bnd CPT 33779 | $1,408.66 | $6,403.00 | $128.03 – $3,644.82 | 7 |
| Rpr tga rcnstj rpr sbpl obst CPT 33781 | $1,400.30 | $6,365.00 | $127.26 – $3,623.87 | 7 |
| Rpr tga without surg enlgmnt vsd CPT 33770 | $1,283.70 | $5,835.00 | $116.68 – $3,320.37 | 7 |
| Rpr tga w/surg enlgmnt vsd CPT 33771 | $1,319.56 | $5,998.00 | $119.90 – $3,414.11 | 7 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | $223.08 | $1,014.00 | $29.87 – $9,214.43 | 15 |
| Rp therapy unlisted px CPT 79999 | not published | $0.01 | $135.29 – $289.10 | 10 |
| Rrp hypspad comp moblj&urtp CPT 54344 | $583.00 | $2,650.00 | $76.80 – $11,927.55 | 15 |
| Rsect hip tum incl femur CPT 27078 | $1,268.52 | $5,766.00 | $157.50 – $3,259.12 | 8 |
| Rsv assay w/optic CPT 87807 | $69.42 | $89.00 | $8.65 – $19.70 | 15 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $15.00 – $347.39 | 8 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $15.99 – $166.22 | 12 |
| Rtm dev sply cbt 16-30 d CPT 98978 | not published | not published | $22.51 – $74.02 | 12 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $22.51 – $72.26 | 12 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $22.51 – $72.26 | 12 |
| Rtm tx mgmt 1st 20 min CPT 98980 | $18.92 | $86.00 | $25.08 – $48.79 | 7 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | $18.48 | $84.00 | $24.80 – $48.24 | 7 |
| Rubella antibody igg CPT 86762 | $76.44 | $98.00 | $6.01 – $31.42 | 15 |
| Rubeola ag if CPT 87283 | $40.04 | $182.00 | $10.78 – $66.27 | 15 |
| Rubeola antibody igg CPT 86765 | $67.86 | $87.00 | $5.92 – $18.88 | 15 |
| Runx1 gene targeted seq alys CPT 81334 | $217.36 | $988.00 | $217.48 – $359.17 | 12 |
| Russell viper venom diluted CPT 85613 | $50.70 | $65.00 | $6.08 – $18.69 | 15 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $2,145.78 | $2,752.00 | $605.28 – $999.62 | 12 |
| Sach foot, replacement HCPCS L5971 | not published | not published | $135.83 – $287.20 | 11 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | not published | not published | $26.35 – $51.31 | 15 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $427.44 | $548.00 | $8.86 – $137.16 | 15 |
| Safety plan interven HCPCS G0560 | $26.62 | $121.00 | $35.49 – $82.04 | 6 |
| Salivary gland function exam CPT 78232 | $11.66 | $53.00 | $15.39 – $518.31 | 15 |
| Salivary gland imaging CPT 78230 | $12.98 | $59.00 | $17.44 – $518.31 | 15 |
| Salivary glnd img serial img CPT 78231 | $12.98 | $59.00 | $17.07 – $518.31 | 15 |
| Salmonella antibody CPT 86768 | $8.80 | $40.00 | $5.92 – $14.38 | 12 |
| Salpingostomy 58770 CPT 58770 | $531.96 | $2,418.00 | $84.44 – $4,101.16 | 12 |
| Same day nb discharge 99463 CPT 99463 | $66.22 | $301.00 | $50.38 – $171.88 | 14 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $1.24 – $6.83 | 3 |
| Sargramostim injection HCPCS J2820 | not published | not published | $40.76 – $79.37 | 15 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $33.95 – $56.06 | 11 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $42.00 – $187.75 | 9 |
| Sarscov coronavirus ag ia CPT 87426 | $23.32 | $106.00 | $23.32 – $55.90 | 15 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $46.20 | $210.00 | $30.94 – $76.62 | 14 |
| S bowel endoscope w/stent CPT 44379 | $248.16 | $1,128.00 | $329.05 – $7,678.31 | 15 |
| Sbrt management CPT 77435 | $400.62 | $1,821.00 | $525.77 – $1,022.52 | 8 |
| Sbrt w/positron emission del HCPCS G0563 | not published | not published | $2,263.92 – $4,837.63 | 10 |
| Sbsq ic vlbw inf<1,500 gm CPT 99478 | $81.18 | $369.00 | $90.12 – $212.02 | 7 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $94.38 | $429.00 | $91.00 – $338.00 | 10 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $45.54 | $207.00 | $51.00 – $157.50 | 10 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $66.22 | $301.00 | $71.00 – $227.00 | 10 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $24.42 | $111.00 | $32.37 – $111.00 | 10 |
| Sbsq psyc collab care mgmt CPT 99493 | $63.14 | $287.00 | $55.84 – $163.42 | 15 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $707.46 | $907.00 | $30.61 – $311.79 | 15 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $311.22 | $399.00 | $19.15 – $137.16 | 15 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $311.22 | $399.00 | $19.15 – $182.59 | 15 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $311.22 | $399.00 | $17.11 – $137.16 | 15 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $311.22 | $399.00 | $18.67 – $137.16 | 15 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $311.22 | $399.00 | $15.58 – $137.16 | 15 |
| Scan proc cranial extra CPT 61782 | $106.48 | $484.00 | $139.45 – $273.76 | 4 |
| Scan proc cranial intra 61781 CPT 61781 | $145.64 | $662.00 | $186.06 – $375.16 | 4 |
| Scan proc spinal CPT 61783 | $142.78 | $649.00 | $183.20 – $367.55 | 4 |
| Scap thorac prosth tiss shap HCPCS L6570 | not published | not published | $2,862.81 – $6,053.04 | 11 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $3,791.58 | $4,861.00 | $95.44 – $2,089.89 | 12 |
| Scope plantar fasciotomy CPT 29893 | $274.34 | $1,247.00 | $7.56 – $4,185.10 | 15 |
| Scr c/v cyto, automated sys HCPCS G0147 | $11.88 | $54.00 | $12.00 – $19.83 | 11 |
| Scr c/v cyto,autosys and md HCPCS G0141 | $15.18 | $69.00 | $19.65 – $26.93 | 3 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | $21.12 | $96.00 | $19.60 – $34.81 | 11 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | $29.04 | $132.00 | $27.30 – $47.93 | 11 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $17.60 | $80.00 | $17.48 – $28.87 | 11 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | $18.04 | $82.00 | $17.85 – $29.48 | 11 |
| Screen cerv/vag thin layer HCPCS G0123 | $13.20 | $60.00 | $13.38 – $22.08 | 11 |
| Screen c/v thin layer by md HCPCS G0124 | $15.18 | $69.00 | $19.65 – $26.93 | 3 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $112.86 | $513.00 | $74.57 – $1,175.98 | 11 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $112.64 | $512.00 | $74.37 – $1,175.98 | 11 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $11.88 | $54.00 | $11.91 – $29.15 | 14 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $18.66 – $30.81 | 14 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $30.80 | $140.00 | $19.00 – $50.52 | 14 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $15.84 | $72.00 | $15.90 – $26.25 | 11 |
| Screening Mammogram CPT 77067 | $293.28 | $376.00 | $29.58 – $114.78 | 15 |
| Screening pap smear by phys HCPCS P3001 | $15.18 | $69.00 | $19.65 – $26.93 | 3 |
| Screening prostate cancer PSA HCPCS G0103 | $102.18 | $131.00 | $12.75 – $21.05 | 11 |
| Screen pap by tech w md supv HCPCS P3000 | $11.88 | $54.00 | $12.00 – $19.83 | 11 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | not published | not published | $2.62 – $9.90 | 9 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $1,748.17 | $7,946.25 | $30.40 – $30.40 | 1 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $467.22 | $599.00 | $24.64 – $137.16 | 15 |
| Sc ther infusion reset pump CPT 96371 | not published | not published | $42.96 – $92.11 | 15 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | $511.94 | $2,327.00 | $42.53 – $1,314.03 | 7 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $9,661.86 | $12,387.00 | $191.54 – $380.93 | 10 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $12.76 | $58.00 | $4.52 – $130.20 | 7 |
| Sedimentation rate erythrocyte automated CPT 85652 | $14.04 | $18.00 | $1.78 – $4.80 | 15 |
| Seg acet and eth estr yearly HCPCS J7294 | not published | not published | $2,468.96 – $3,253.57 | 4 |
| Segmentectomy 32484 CPT 32484 | $874.94 | $3,977.00 | $113.56 – $2,255.72 | 7 |
| Select picture audiometry CPT 92583 | not published | not published | $35.86 – $87.02 | 15 |
| Self-adher band w>=3" <5"/yd HCPCS A6454 | not published | not published | $0.56 – $1.20 | 11 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | not published | not published | $22.34 – $51.67 | 12 |
| Self-meas bp 2 readg bid 30d CPT 99474 | $5.28 | $24.00 | $7.18 – $13.95 | 7 |
| Self-meas bp pt educaj/train CPT 99473 | not published | not published | $11.48 – $31.59 | 15 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | not published | not published | $11.75 – $34.00 | 5 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | not published | not published | $8.80 – $25.00 | 5 |
| Semen analysis HCPCS G0027 | $4.40 | $20.00 | $4.29 – $7.09 | 11 |
| Semen analysis presence/motility CPT 89321 | $7.92 | $36.00 | $7.95 – $13.13 | 12 |
| Semen analysis w/count CPT 89310 | $5.72 | $26.00 | $4.08 – $9.38 | 12 |
| Sensorimotor examination CPT 92060 | $22.44 | $102.00 | $18.54 – $76.62 | 15 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $11.41 – $112.97 | 15 |
| Separate eyelid adhesions CPT 68340 | $240.68 | $1,094.00 | $32.23 – $3,009.20 | 15 |
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.