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 |
|---|---|---|---|---|
| Tas congenital car anomal CPT 33741 | $453.86 | $2,063.00 | $100.58 – $1,174.83 | 7 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | $80.52 | $366.00 | $105.62 – $789.56 | 12 |
| Tavr perq femoral CPT 33361 | $731.72 | $3,326.00 | $951.33 – $1,892.01 | 7 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.21 – $0.42 | 15 |
| Tbp gene detc abnor alleles CPT 81344 | $90.64 | $412.00 | $90.42 – $149.33 | 12 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $32.59 – $62.38 | 4 |
| Tbs i&r fx rsk qhp CPT 77092 | $5.94 | $27.00 | $8.01 – $15.56 | 4 |
| Tbs techl calculation only CPT 77091 | not published | not published | $22.49 – $113.57 | 12 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $2.09 – $113.57 | 12 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $66.00 | $300.00 | $66.00 – $111.65 | 15 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $326.82 | $419.00 | $40.91 – $113.63 | 15 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $374.00 – $652.50 | 4 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $588.19 – $1,105.00 | 12 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $379.53 – $3,739.65 | 12 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $445.61 – $1,827.00 | 3 |
| Tc-99m diag per dose HCPCS A4641 | not published | not published | $62.00 – $62.00 | 1 |
| Tc-99m disofenin HCPCS A9510 | not published | not published | $31.42 – $104.14 | 4 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $755.90 – $1,748.25 | 12 |
| Tc-99m exametazime diag HCPCS A9521 | not published | not published | $582.98 – $1,748.25 | 12 |
| Tc-99m fanolesomab diag HCPCS A9566 | not published | not published | $164.00 – $1,077.12 | 2 |
| Tc-99m gluceptate HCPCS A9550 | not published | not published | $54.00 – $54.00 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $238.76 – $358.17 | 11 |
| Tc-99m labeled rbc HCPCS A9560 | not published | not published | $83.84 – $138.96 | 4 |
| Tc-99m maa HCPCS A9540 | not published | not published | $25.50 – $44.63 | 4 |
| Tc-99m mebrofenin HCPCS A9537 | not published | not published | $8.21 – $82.29 | 4 |
| Tc-99m medronate HCPCS A9503 | not published | not published | $11.05 – $19.34 | 4 |
| Tc-99m mertiatide HCPCS A9562 | not published | not published | $644.86 – $1,152.63 | 2 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $0.79 | $1.01 | $7.27 – $10.90 | 10 |
| Tc-99m oxidronate HCPCS A9561 | not published | not published | $1.96 – $65.46 | 3 |
| Tc-99m pentetate dtpa HCPCS A9539 | not published | not published | $12.24 – $49.07 | 3 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | not published | not published | $17.32 – $44.47 | 4 |
| Tc-99m pertechnetate per mci HCPCS A9512 | not published | not published | $1.29 – $2.48 | 4 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | not published | not published | $16.33 – $95.29 | 4 |
| Tc-99m sestamibi p study dose HCPCS A9500 | not published | not published | $93.77 – $588.01 | 3 |
| Tc-99m succimer (dmsa) HCPCS A9551 | not published | not published | $538.04 – $891.76 | 4 |
| Tc-99m sulfur colloid HCPCS A9541 | not published | not published | $239.99 – $397.76 | 4 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | not published | not published | $76.54 – $126.86 | 4 |
| Tc-99m tilmanocept diag HCPCS A9520 | not published | not published | $479.20 – $984.23 | 4 |
| Tca peel dermal 15789 CPT 15789 | $253.88 | $1,154.00 | $33.55 – $789.56 | 12 |
| Tcd emboli detect w/inj CPT 93893 | $36.08 | $164.00 | $48.43 – $137.16 | 15 |
| Tcd emboli detect without inj CPT 93892 | $35.64 | $162.00 | $48.01 – $137.16 | 15 |
| Tcd vasoreactivity study CPT 93890 | $101.20 | $460.00 | $140.61 – $140.61 | 1 |
| T-cell depletion of harvest CPT 38210 | $51.26 | $233.00 | $64.12 – $563.90 | 12 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $247.26 | $317.00 | $29.87 – $102.78 | 15 |
| T cells absolute cd 4 count CPT 86361 | $17.60 | $80.00 | $17.68 – $47.89 | 15 |
| T cells total count CPT 86359 | $198.90 | $255.00 | $23.98 – $80.00 | 15 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $110.11 – $401.66 | 15 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $106.66 – $401.66 | 15 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $177.33 – $401.66 | 15 |
| Tdh sdrl/ventr pnxr CPT 61105 | $292.38 | $1,329.00 | $41.55 – $748.82 | 7 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | $622.38 | $2,829.00 | $56.49 – $1,611.35 | 7 |
| Team conf without pat by hc pro CPT 99368 | $22.66 | $103.00 | $28.72 – $55.81 | 4 |
| Team conf without pat by phys CPT 99367 | $34.98 | $159.00 | $44.12 – $85.82 | 4 |
| Team conf w/pat by hc prof CPT 99366 | $25.74 | $117.00 | $32.83 – $107.00 | 5 |
| Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution HCPCS J9274 | not published | not published | $157.74 – $307.18 | 15 |
| Tee w or without fol w/cont,cong HCPCS C8926 | not published | not published | $476.91 – $1,019.07 | 10 |
| Tee w or without fol w/cont, mon HCPCS C8927 | not published | not published | $476.91 – $1,019.07 | 10 |
| Teflon or equal cable lining HCPCS L6665 | not published | not published | $32.47 – $68.66 | 11 |
| Telavancin injection HCPCS J3095 | not published | not published | $5.43 – $10.57 | 15 |
| Telehealth original site facility fee HCPCS Q3014 | not published | not published | $25.15 – $29.96 | 3 |
| Telethx isodose plan cplx CPT 77307 | $95.26 | $433.00 | $109.58 – $472.18 | 15 |
| Telethx isodose plan simple CPT 77306 | $45.76 | $208.00 | $59.45 – $472.18 | 15 |
| Temozolomide HCPCS J8700 | not published | not published | $0.27 – $0.51 | 8 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | not published | not published | $7.55 – $14.71 | 15 |
| Temperature gradient studies CPT 93740 | $5.06 | $23.00 | $1.12 – $201.81 | 12 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $23.46 – $45.68 | 15 |
| Tendon lengthening CPT 26476 | $392.70 | $1,785.00 | $52.79 – $4,185.10 | 15 |
| Tendon lngth upr a/e ea tdn CPT 24305 | $364.10 | $1,655.00 | $47.79 – $4,185.10 | 15 |
| Tendon shortening CPT 26477 | $383.90 | $1,745.00 | $42.16 – $4,185.10 | 15 |
| Tendon transfer with graft CPT 26492 | $569.36 | $2,588.00 | $9.64 – $4,185.10 | 15 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $6,388.89 | $29,040.41 | $124.93 – $243.29 | 15 |
| Teniposide, 50 mg HCPCS Q2017 | not published | not published | $291.47 – $3,257.21 | 4 |
| Tenodesis biceps tdn at elbw CPT 24340 | $379.72 | $1,726.00 | $8.00 – $9,214.43 | 15 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | $367.18 | $1,669.00 | $30.00 – $4,185.10 | 15 |
| Tenolysis triceps CPT 24332 | $386.76 | $1,758.00 | $12.00 – $4,185.10 | 15 |
| Tenoplasty elbow to sho 1 CPT 24320 | $487.52 | $2,216.00 | $63.86 – $9,214.43 | 15 |
| Tenosynovectomy radic 26145 CPT 26145 | $324.94 | $1,477.00 | $5.00 – $2,064.31 | 15 |
| Tenotomy hip flexor open CPT 27005 | $451.22 | $2,051.00 | $58.98 – $1,153.61 | 7 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | $183.70 | $835.00 | $16.00 – $4,185.10 | 15 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $150.26 | $683.00 | $12.50 – $2,064.31 | 15 |
| Tension based scoliosis orth HCPCS L1005 | not published | not published | $1,940.36 – $4,102.67 | 11 |
| Tens suppl 2 lead per month HCPCS A4595 | not published | not published | $9.11 – $23.51 | 11 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $151.69 | $689.50 | $1.65 – $3.88 | 8 |
| Teriparatide injection HCPCS J3110 | not published | not published | $51.34 – $65.68 | 4 |
| Term dev auto grasp feature HCPCS L6881 | not published | not published | $2,483.30 – $5,250.63 | 11 |
| Term device, multi art digit HCPCS L6715 | not published | not published | $1,917.71 – $4,054.77 | 11 |
| Term dev mech hand vol close HCPCS L6709 | not published | not published | $837.64 – $1,771.09 | 11 |
| Term dev mech hand vol open HCPCS L6708 | not published | not published | $517.56 – $1,094.32 | 11 |
| Term dev mech hook vol close HCPCS L6707 | not published | not published | $909.90 – $1,923.88 | 11 |
| Term dev mech hook vol open HCPCS L6706 | not published | not published | $215.89 – $456.48 | 11 |
| Term dev modifier wrist unit HCPCS L6805 | not published | not published | $222.72 – $470.92 | 11 |
| Term dev, passive hand mitt HCPCS L6703 | not published | not published | $218.82 – $462.68 | 11 |
| Term dev precision pinch dev HCPCS L6810 | not published | not published | $121.40 – $256.70 | 11 |
| Term dev, sport/rec/work att HCPCS L6704 | not published | not published | $362.36 – $766.16 | 11 |
| Tert gene targeted seq alys CPT 81345 | $122.32 | $556.00 | $122.23 – $201.87 | 12 |
| Test for chlorohydrocarbons CPT 82441 | $3.96 | $18.00 | $3.82 – $13.28 | 15 |
| Test for porphobilinogen CPT 84106 | $3.96 | $18.00 | $2.72 – $9.47 | 15 |
| Test for urine cystines CPT 82615 | $50.70 | $65.00 | $4.14 – $10.41 | 15 |
| Testicular imaging w/vasc flow CPT 78761 | $20.90 | $95.00 | $27.63 – $518.31 | 15 |
| Testosterone pellet 75 mg HCPCS S0189 | not published | not published | $107.24 – $137.19 | 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.