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 |
|---|---|---|---|---|
| Urinalysis qual/semiquant excpt ia CPT 81005 | $1.32 | $6.00 | $1.14 – $4.78 | 15 |
| Urinalysis (with microscopy) CPT 81001 | $17.16 | $22.00 | $2.09 – $4.80 | 15 |
| Urinalysis (without microscopy) CPT 81003 | $11.70 | $15.00 | $1.43 – $4.96 | 15 |
| Urinary bldr retent nuc study CPT 78730 | $4.62 | $21.00 | $6.12 – $55.31 | 8 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $2.29 – $4.84 | 11 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $4.33 – $9.16 | 11 |
| Urinary reflex study CPT 51792 | $34.54 | $157.00 | $35.86 – $87.85 | 14 |
| Urinary suspensory HCPCS A5105 | not published | not published | $29.37 – $62.10 | 11 |
| Urine Culture Test CPT 87086 | $42.90 | $55.00 | $5.13 – $12.80 | 15 |
| Urine flow measurement 51736 CPT 51736 | $5.06 | $23.00 | $4.50 – $166.26 | 15 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $4.69 – $9.93 | 11 |
| Urine pregnancy test CPT 81025 | $45.24 | $58.00 | $4.00 – $9.38 | 15 |
| Urine screen for bacteria CPT 81007 | $19.80 | $90.00 | $1.63 – $32.68 | 15 |
| Urine shunt to intestine CPT 50815 | $754.60 | $3,430.00 | $79.52 – $1,943.35 | 7 |
| Urine specimen collect mult HCPCS P9615 | $6.16 | $28.00 | $3.10 – $9.91 | 11 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $63.43 – $163.32 | 3 |
| Urography, antegrade CPT 74425 | $1,148.94 | $1,473.00 | $15.75 – $460.65 | 15 |
| Urography inf drip &/or bolus CPT 74410 | $572.52 | $734.00 | $18.84 – $229.62 | 15 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $457.73 – $676.22 | 3 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $8.81 – $13.52 | 3 |
| Use 1st target lesion CPT 76982 | $17.38 | $79.00 | $23.22 – $137.16 | 12 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,102.01 – $2,330.05 | 11 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $9.66 – $18.81 | 15 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $82.60 – $171.87 | 12 |
| U/s trtmt, not leiomyomata HCPCS C9734 | not published | not published | $7,766.82 – $16,596.43 | 10 |
| Vaccine Administration (one shot) CPT 90471 | $145.86 | $187.00 | $16.00 – $91.80 | 12 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $42.00 – $187.89 | 10 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $42.00 – $170.92 | 9 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $42.00 – $181.19 | 9 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $42.00 – $102.03 | 9 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $42.00 – $76.19 | 9 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $15.00 – $59.85 | 9 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $15.00 – $180.60 | 9 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $15.00 – $112.35 | 9 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $15.00 – $226.31 | 8 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $15.00 – $206.85 | 9 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $15.00 – $44.21 | 8 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $13.50 – $29.40 | 9 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $15.00 – $145.95 | 10 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $15.00 – $253.59 | 9 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $15.00 – $69.30 | 9 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $28.24 – $36.00 | 3 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $15.00 – $87.34 | 10 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $31.46 | $142.98 | $15.00 – $156.07 | 10 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $68.53 | $311.50 | $15.00 – $319.80 | 10 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $15.00 – $54.60 | 10 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $15.00 – $573.34 | 9 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $120.50 – $362.00 | 5 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $15.00 – $144.74 | 10 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $15.00 – $97.10 | 9 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $15.00 – $25.41 | 9 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $15.00 – $25.98 | 9 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $15.00 – $24.27 | 8 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $15.00 – $94.70 | 8 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $15.00 – $27.57 | 8 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $15.00 – $25.98 | 8 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $9.68 – $16.50 | 8 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $15.00 – $32.30 | 8 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $15.00 – $89.85 | 8 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $77.22 | $99.00 | $15.00 – $42.83 | 9 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $10.13 – $15.30 | 9 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $15.00 – $433.43 | 9 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $15.00 – $300.84 | 8 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $15.00 – $474.77 | 9 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $15.00 – $474.77 | 9 |
| Vaccine mmr live subcutaneous CPT 90707 | $40.90 | $185.91 | $15.00 – $196.65 | 9 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $15.00 – $471.45 | 9 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $51.52 | $234.17 | $15.00 – $296.01 | 10 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $15.00 – $535.21 | 10 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $15.00 – $303.52 | 9 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $124.28 | $564.92 | $15.00 – $588.00 | 10 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $15.00 – $74.55 | 9 |
| Vaccine rabies im CPT 90675 | $191.23 | $869.22 | $15.00 – $463.58 | 16 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | $134.99 | $613.60 | $15.00 – $445.48 | 8 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $15.00 – $807.51 | 8 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $15.00 – $807.51 | 8 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $15.00 – $426.89 | 8 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $15.00 – $213.29 | 9 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $15.00 – $175.35 | 9 |
| Vaccine tdap >=7 years im CPT 90715 | $20.66 | $93.90 | $15.00 – $92.40 | 10 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $17.93 | $81.50 | $15.00 – $66.15 | 10 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $15.00 – $274.27 | 9 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $15.00 – $341.22 | 9 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $15.00 – $325.20 | 9 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $16.00 | 14 |
| Vacuum drain bottle/tube kit HCPCS A7048 | not published | not published | $29.75 – $70.00 | 11 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | not published | not published | $284.36 – $601.25 | 11 |
| Vad cable power module dc input HCPCS Q0478 | not published | not published | $111.62 – $236.03 | 11 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | not published | not published | $2,537.24 – $5,364.69 | 11 |
| Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 | $615.12 | $2,796.00 | $97.41 – $6,367.34 | 15 |
| Vag hyst incl t/o complex CPT 58291 | $767.58 | $3,489.00 | $121.61 – $6,367.34 | 15 |
| Vag hyst including t/o CPT 58262 | $573.10 | $2,605.00 | $90.90 – $6,367.34 | 15 |
| Vag hyst t/o & repair compl CPT 58292 | $808.50 | $3,675.00 | $128.15 – $9,538.29 | 15 |
| Vag hyst w/enterocele compl 58294 CPT 58294 | $751.30 | $3,415.00 | $119.01 – $6,367.34 | 15 |
| Vag hyst w/enterocele repair CPT 58270 | $552.64 | $2,512.00 | $87.61 – $6,367.34 | 15 |
| Vaginal bx CPT 58999 | $471.12 | $604.00 | $121.43 – $259.48 | 10 |
| Vaginal delivery after cesarean delivery 59612 CPT 59612 | $558.80 | $2,540.00 | $723.64 – $4,101.16 | 14 |
| Vaginal Delivery (full care) CPT 59400 | $1,488.96 | $6,768.00 | $1,950.92 – $4,966.50 | 9 |
| Vaginal hysterectomy CPT 58260 | $518.32 | $2,356.00 | $82.26 – $6,367.34 | 15 |
| Vaginectomy partial w/nodes CPT 57109 | $1,071.84 | $4,872.00 | $169.74 – $4,101.16 | 14 |
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.