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 |
|---|---|---|---|---|
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $283.14 | $363.00 | $6.35 – $113.57 | 15 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $342.42 | $439.00 | $8.85 – $137.16 | 15 |
| X-ray male genital tract CPT 74440 | $11.00 | $50.00 | $14.45 – $311.79 | 12 |
| X-ray mandible ltd <4 views CPT 70100 | $283.14 | $363.00 | $7.18 – $113.57 | 15 |
| X-ray measurement of pelvis CPT 74710 | $10.56 | $48.00 | $30.40 – $30.40 | 1 |
| X-ray nose to rectum for foreign body child CPT 76010 | $283.14 | $363.00 | $6.09 – $113.57 | 15 |
| X-ray of mammary ducts CPT 77054 | $12.98 | $59.00 | $17.44 – $311.79 | 15 |
| X-ray optic foramina CPT 70190 | $6.60 | $30.00 | $8.83 – $113.57 | 15 |
| Xray place dist ext thor ao CPT 75959 | $5,119.92 | $6,564.00 | $0.02 – $262.80 | 7 |
| Xray place prox ext thor ao CPT 75958 | $4,009.20 | $5,140.00 | $0.01 – $296.35 | 7 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $15.18 | $69.00 | $15.75 – $460.65 | 15 |
| X-ray ribs 2 views left CPT 71100 | $283.14 | $363.00 | $8.58 – $113.57 | 15 |
| X-ray sella turcica CPT 70240 | $283.14 | $363.00 | $7.46 – $113.57 | 15 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,764.36 | $2,262.00 | $11.55 – $707.23 | 15 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $16.94 | $77.00 | $19.95 – $137.16 | 15 |
| X-ray small intestine follow-through study CPT 74248 | $801.84 | $1,028.00 | $27.08 – $55.06 | 8 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $354.12 | $454.00 | $7.88 – $113.57 | 15 |
| X-ray surgical specimen CPT 76098 | $1,764.36 | $2,262.00 | $8.49 – $707.23 | 15 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $283.14 | $363.00 | $10.25 – $113.57 | 15 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $17.16 | $78.00 | $15.75 – $229.62 | 15 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | not published | not published | $138.01 – $396.40 | 8 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $42.24 | $192.00 | $58.38 – $230.00 | 9 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $2,907.00 – $5,341.31 | 8 |
| Xylose absorption test blood &/or urine CPT 84620 | $8.36 | $38.00 | $3.00 – $14.07 | 15 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.12 – $2.18 | 15 |
| Yersinia antibody CPT 86793 | $8.80 | $40.00 | $5.92 – $18.16 | 15 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | not published | not published | $41,288.72 – $68,140.74 | 12 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $78.47 – $155.86 | 8 |
| Ziconotide injection HCPCS J2278 | not published | not published | $7.36 – $14.33 | 15 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | not published | not published | $1.43 – $2.14 | 8 |
| Zidovudine, oral, 100 mg HCPCS S0104 | not published | not published | $1.51 – $1.97 | 4 |
| Zika virus dna/rna amp probe CPT 87662 | $270.66 | $347.00 | $33.87 – $81.09 | 15 |
| Zika virus igm antibody CPT 86794 | $88.92 | $114.00 | $11.12 – $26.62 | 15 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $0.91 – $1.91 | 11 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | not published | not published | $2.96 – $9.38 | 8 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $5.80 – $11.29 | 15 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $24.38 – $47.48 | 14 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $231.00 | $1,050.00 | $4.91 – $11.08 | 8 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $15.00 – $437.85 | 9 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $127.55 – $210.64 | 12 |
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.