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 |
|---|---|---|---|---|
| Small bowel endoscopy br/wa CPT 44381 | $51.48 | $234.00 | $61.51 – $2,446.86 | 15 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $162.14 | $737.00 | $207.94 – $7,678.31 | 15 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.01 – $302.40 | 15 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $28.86 | $37.00 | $3.00 – $5.88 | 15 |
| Smear gram stain CPT 87205 | $22.62 | $29.00 | $2.01 – $7.20 | 15 |
| Smear nasal eosinophil CPT 89190 | $3.96 | $18.00 | $3.02 – $10.62 | 15 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $31.98 | $50.00 | $3.81 – $7.20 | 15 |
| Smear wet mount CPT 87210 | $30.42 | $39.00 | $2.66 – $9.31 | 15 |
| Smn1 gene full gene sequence CPT 81336 | $198.88 | $904.00 | $198.89 – $385.73 | 15 |
| Smn1 gen nown famil seq vrnt CPT 81337 | $122.32 | $556.00 | $122.23 – $237.06 | 15 |
| Smpd1 gene common variants CPT 81330 | $31.24 | $142.00 | $31.02 – $193.97 | 15 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $33.70 – $108.38 | 15 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $652.17 – $1,378.93 | 11 |
| So cap design without jnts cf HCPCS L3671 | not published | not published | $497.16 – $1,051.19 | 11 |
| Socket insert above knee HCPCS L5658 | not published | not published | $238.35 – $503.96 | 11 |
| Socket insert below knee HCPCS L5655 | not published | not published | $173.74 – $367.35 | 11 |
| Socket insert knee articulat HCPCS L5656 | not published | not published | $244.75 – $517.49 | 11 |
| Socket insert symes HCPCS L5654 | not published | not published | $205.21 – $433.87 | 11 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $362.25 – $765.93 | 11 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $434.71 – $919.13 | 11 |
| Sock fracture or equal each HCPCS L3995 | not published | not published | $20.27 – $42.86 | 11 |
| Sock wool above knee HCPCS L8430 | not published | not published | $13.70 – $28.96 | 11 |
| Sodium 24 hour urine CPT 84300 | $27.30 | $35.00 | $3.09 – $10.75 | 15 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $5.39 | $24.50 | $2.15 – $5.00 | 9 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $4.62 | $21.00 | $1.25 – $1.95 | 8 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $4.04 | $18.38 | $0.63 – $1.01 | 8 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $5.00 | $22.75 | $0.14 – $0.20 | 4 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $97.94 | $445.20 | $1.99 – $3.08 | 8 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | not published | not published | $69.23 – $103.84 | 8 |
| Sodium serum/plasma/whole blood CPT 84295 | $24.96 | $32.00 | $3.06 – $10.40 | 15 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | not published | not published | $0.79 – $1.21 | 4 |
| Soft interface below knee se HCPCS L2820 | not published | not published | $50.44 – $106.63 | 11 |
| Software meas of cardiac vol HCPCS G0183 | not published | not published | $53.15 – $113.57 | 10 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $887.91 – $1,466.39 | 11 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $789.25 – $1,303.45 | 11 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $2,170.42 – $3,584.48 | 11 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $502.35 – $1,140.52 | 14 |
| Solid skin barrier HCPCS A4362 | not published | not published | $0.90 – $5.29 | 11 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $4.71 – $9.97 | 11 |
| Somatosensory testing CPT 95927 | $16.50 | $75.00 | $22.14 – $401.66 | 15 |
| Somatropin injection HCPCS J2941 | not published | not published | $35.55 – $155.10 | 12 |
| So neo gsap dna/dna&rna CPT 81459 | $6,995.82 | $8,969.00 | $1,973.10 – $3,827.01 | 14 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $502.35 – $977.59 | 14 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $18.20 – $27.30 | 11 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $96.83 – $204.72 | 11 |
| Spacer bag/reservoir HCPCS A4627 | not published | not published | $7.13 – $57.00 | 4 |
| Sp bone agrft morsel add-on CPT 20937 | $102.96 | $468.00 | $132.83 – $264.53 | 4 |
| Sp bone agrft struct add-on CPT 20938 | $112.64 | $512.00 | $145.75 – $291.38 | 4 |
| Sp bone algrft morsel add-on CPT 20930 | $53.68 | $244.00 | $94.15 – $215.99 | 4 |
| Special casting material HCPCS A4590 | not published | not published | $16.36 – $51.45 | 4 |
| Special physics consult CPT 77370 | not published | not published | $80.14 – $220.85 | 15 |
| Special pump services CPT 99190 | not published | not published | $350.66 – $761.49 | 4 |
| Special pump services CPT 99191 | not published | not published | $245.59 – $533.03 | 4 |
| Special pump services CPT 99192 | not published | not published | $175.50 – $381.38 | 4 |
| Special radiation dosimetry CPT 77331 | $28.60 | $130.00 | $15.51 – $171.26 | 15 |
| Special radiation treatment CPT 77470 | $66.66 | $303.00 | $15.75 – $746.15 | 15 |
| Special supplies phys/qhp CPT 99070 | $3.96 | $18.00 | $59.00 – $59.00 | 1 |
| Special teletx port plan CPT 77321 | $31.02 | $141.00 | $21.32 – $472.18 | 15 |
| Specific gravity body fluid CPT 84315 | $17.94 | $23.00 | $1.24 – $3.58 | 12 |
| Specimen fat stain CPT 89125 | $3.96 | $18.00 | $2.74 – $9.54 | 15 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | not published | not published | $156.51 – $363.47 | 14 |
| Speech audiometry complete CPT 92556 | not published | not published | $15.75 – $76.62 | 15 |
| Speech evaluation complex CPT 70371 | $25.74 | $117.00 | $33.99 – $311.79 | 15 |
| Speech recep thresh CPT 92555 | not published | not published | $6.83 – $76.62 | 15 |
| Speech Therapy Session (one-on-one) CPT 92507 | not published | not published | $22.79 – $121.75 | 15 |
| Sperm antibody test CPT 89325 | $7.04 | $32.00 | $6.79 – $11.63 | 12 |
| Sperm evaluation test CPT 89329 | $12.76 | $58.00 | $12.93 – $21.35 | 12 |
| Sperm identification CPT 89257 | $80.30 | $365.00 | $32.25 – $68.92 | 10 |
| Sperm isolation complex CPT 89261 | $37.84 | $172.00 | $9.29 – $68.92 | 11 |
| Sperm isolation simple CPT 89260 | $24.20 | $110.00 | $32.25 – $68.92 | 11 |
| Sperm washing 58323 CPT 58323 | $7.48 | $34.00 | $9.75 – $259.48 | 12 |
| Sphenoid sinus surgery CPT 31051 | $420.64 | $1,912.00 | $56.72 – $7,630.39 | 15 |
| Sphincteroplasty inc/prolapse adult 46750 CPT 46750 | $462.00 | $2,100.00 | $54.82 – $3,537.31 | 15 |
| Spinal bone allograftstructural 20931 CPT 20931 | $68.20 | $310.00 | $87.60 – $175.13 | 4 |
| Spinal bone autograftlocal 20936 CPT 20936 | $57.20 | $260.00 | $100.57 – $229.87 | 4 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,620.84 | $2,078.00 | $69.12 – $893.26 | 15 |
| Spine device implant surgery HCPCS C9757 | not published | not published | $7,766.82 – $16,596.43 | 10 |
| Spine X-ray (single view, one level) CPT 72020 | $283.14 | $363.00 | $6.35 – $113.57 | 15 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | $84.48 | $384.00 | $112.98 – $401.66 | 12 |
| Spirometry up to 2 yrs old CPT 94011 | $51.92 | $236.00 | $69.19 – $201.81 | 12 |
| Spleen imaging CPT 78185 | $10.12 | $46.00 | $13.14 – $518.31 | 15 |
| Splenectomy total open 38100 CPT 38100 | $710.82 | $3,231.00 | $101.68 – $1,831.00 | 7 |
| Splice spleen/kidney veins CPT 37181 | $1,429.34 | $6,497.00 | $129.86 – $3,685.86 | 7 |
| Splicing of ureters CPT 50770 | $710.16 | $3,228.00 | $74.81 – $1,829.27 | 7 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | not published | not published | $7.96 – $15.86 | 2 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | not published | not published | $242.94 – $513.65 | 11 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | not published | not published | $28.56 – $60.39 | 11 |
| Splint finger 4 prong foam sm HCPCS A4570 | not published | not published | $7.34 – $54.00 | 4 |
| Splint finger fold over sm HCPCS L3924 | not published | not published | $53.25 – $112.60 | 11 |
| Splint finger frog med HCPCS L3927 | not published | not published | $19.29 – $40.79 | 11 |
| Splint fing stax assort 1-7in HCPCS Q4049 | not published | not published | $1.36 – $16.12 | 11 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | not published | not published | $33.26 – $112.60 | 11 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $426.36 | $1,938.00 | $56.10 – $4,722.15 | 15 |
| Split blood or products CPT 86985 | not published | not published | $19.87 – $221.03 | 12 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $44.57 – $94.22 | 11 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $80.30 | $365.00 | $105.69 – $227.68 | 10 |
| Spontaneous nystagmus study CPT 92531 | not published | not published | $12.43 – $25.59 | 4 |
| Sprchoroidal spc njx rx agt CPT 67516 | not published | not published | $78.53 – $427.83 | 12 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $456.33 – $964.86 | 11 |
| Sputum specimen collection CPT 89220 | not published | not published | $10.09 – $221.03 | 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.