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 |
|---|---|---|---|---|
| Above knee cushion socket HCPCS L5648 | not published | not published | $407.37 – $861.33 | 11 |
| Above knee flex cover system HCPCS L5964 | not published | not published | $651.46 – $1,377.42 | 11 |
| Above knee hydracadence HCPCS L5610 | not published | not published | $1,281.04 – $2,708.61 | 11 |
| Above knee leather socket HCPCS L5642 | not published | not published | $385.04 – $814.13 | 11 |
| Above knee manual lock HCPCS L5925 | not published | not published | $207.90 – $439.59 | 11 |
| Above knee wood socket HCPCS L5644 | not published | not published | $365.46 – $772.71 | 11 |
| Abrasion lesions add-on CPT 15787 | $10.56 | $48.00 | $13.51 – $26.26 | 7 |
| Abrasion lesion single CPT 15786 | $83.38 | $379.00 | $11.01 – $256.30 | 12 |
| Abscess drain retroperitoneal surg code CPT 49406 | $3,791.58 | $4,861.00 | $155.56 – $2,089.89 | 15 |
| Absorpt drg >16<=48 in w/bdr HCPCS A6255 | not published | not published | $2.19 – $4.63 | 11 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | not published | not published | $2.34 – $4.96 | 11 |
| Absorpt drg <=16 sq in w/bdr HCPCS A6254 | not published | not published | $0.86 – $1.82 | 11 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | not published | not published | $1.43 – $3.03 | 11 |
| Absorpt drg > 48 sq in without b HCPCS A6253 | not published | not published | $4.56 – $9.65 | 11 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $74.58 | $339.00 | $17.95 – $192.65 | 7 |
| Access thoracic lymph duct CPT 38794 | $173.80 | $790.00 | $25.09 – $443.90 | 7 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | not published | not published | $0.05 – $0.08 | 8 |
| Acetaminophen level CPT 80143 | $98.28 | $126.00 | $12.30 – $20.32 | 12 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $25.41 | $115.50 | $16.25 – $28.21 | 8 |
| Acetone qualitative CPT 82009 | $24.18 | $31.00 | $2.88 – $8.43 | 15 |
| Acetylcholine receptor modulating antibody CPT 86043 | $63.18 | $81.00 | $7.95 – $15.42 | 15 |
| Acetylcholinesterase assay CPT 82013 | $7.92 | $36.00 | $7.10 – $16.00 | 15 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $423.54 | $1,925.18 | $0.35 – $0.72 | 8 |
| Acetylcysteine non-comp unit HCPCS J7608 | $22.82 | $103.74 | $8.15 – $12.58 | 8 |
| Acid perfusion of esophagus CPT 91030 | $27.94 | $127.00 | $9.45 – $684.40 | 15 |
| Acne surgery 10040 CPT 10040 | $32.12 | $146.00 | $4.23 – $256.30 | 15 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $136.16 – $388.50 | 4 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $79.86 | $363.00 | $106.96 – $369.54 | 4 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $30.58 | $139.00 | $38.64 – $119.31 | 15 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | $21.12 | $96.00 | $28.63 – $55.73 | 7 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $30.14 | $137.00 | $41.02 – $79.83 | 7 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $55.66 | $253.00 | $73.84 – $207.24 | 12 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | not published | not published | $77.79 – $225.44 | 15 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $5.50 | $25.00 | $7.45 – $38.43 | 11 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $34.32 | $44.00 | $12.65 – $40.00 | 8 |
| Acoustic immitance testing CPT 92570 | $17.82 | $81.00 | $23.76 – $201.81 | 15 |
| Acoustic refl threshold tst CPT 92568 | $9.24 | $42.00 | $9.98 – $50.63 | 15 |
| Acromp/acromionectomy prtl CPT 23130 | $387.20 | $1,760.00 | $50.87 – $4,185.10 | 15 |
| Acth stimulation panel CPT 80402 | $57.20 | $260.00 | $55.26 – $192.22 | 15 |
| Acth stimulation panel CPT 80406 | $51.48 | $234.00 | $49.12 – $173.02 | 15 |
| Actigraphy testing CPT 95803 | $25.52 | $116.00 | $34.20 – $76.62 | 12 |
| Actinotherapy uv light CPT 96900 | not published | not published | $20.08 – $50.63 | 12 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $23.10 | $105.00 | $14.78 – $52.98 | 12 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | $14.96 | $68.00 | $20.93 – $77.00 | 8 |
| Acup 1/> without estim ea add 15 CPT 97811 | $14.74 | $67.00 | $20.65 – $68.00 | 8 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $19.14 | $87.00 | $14.78 – $48.71 | 12 |
| Acute hepatitis panel CPT 80074 | $251.16 | $322.00 | $31.44 – $84.26 | 15 |
| Acute venous thrombus image CPT 78456 | $28.60 | $130.00 | $38.05 – $1,683.89 | 15 |
| Acyclovir 400 mg tablet HCPCS J8499 | not published | not published | $24.00 – $24.00 | 1 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $26.95 | $122.50 | $0.03 – $0.07 | 8 |
| #acylcarnitineprfl CPT 82017 | $88.92 | $114.00 | $9.78 – $18.39 | 12 |
| Acylcarnitines qual CPT 82016 | $11.00 | $50.00 | $10.88 – $17.97 | 12 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $24.72 – $207.24 | 11 |
| Adaptive behavior tx by tech CPT 97153 | not published | not published | $20.37 – $119.31 | 11 |
| Adding walker to prev cast CPT 29440 | $17.16 | $78.00 | $18.90 – $203.53 | 15 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $250.10 – $528.81 | 11 |
| Add le poly knee custom kafo HCPCS L2387 | not published | not published | $112.08 – $236.98 | 11 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $337.62 – $713.86 | 11 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $208.42 – $440.69 | 11 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $223.68 – $472.95 | 11 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $186.17 – $393.63 | 11 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $441.56 – $933.61 | 11 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $225.08 – $475.89 | 11 |
| Add up-ex prosthes lock mech HCPCS L6698 | not published | not published | $307.77 – $650.75 | 11 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $19.23 | $87.41 | $0.30 – $0.65 | 8 |
| Adenovirus ag ia CPT 87301 | $7.92 | $36.00 | $5.69 – $13.06 | 12 |
| Adenovirus antibody,serum - quest CPT 86603 | $8.36 | $38.00 | $6.21 – $28.46 | 15 |
| Adenovirus assay w/optic CPT 87809 | $14.52 | $66.00 | $10.78 – $23.72 | 15 |
| Adenovirus vaccine type 4 CPT 90476 | not published | not published | $11.51 – $11.51 | 1 |
| Adhesiolysis tube ovary 58740 CPT 58740 | $559.46 | $2,543.00 | $88.20 – $2,181.00 | 8 |
| Adhesive, liquid or equal HCPCS A4364 | not published | not published | $2.12 – $4.48 | 11 |
| Adh-sendout CPT 84588 | $22.44 | $102.00 | $19.93 – $57.60 | 15 |
| Adj gastric band via subq port CPT 43999 | not published | $0.01 | $565.94 – $1,209.32 | 10 |
| Adjmt/revj ext fixj sys anes CPT 20693 | $281.16 | $1,278.00 | $36.71 – $9,214.43 | 15 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $470.36 | $2,138.00 | $62.07 – $2,359.45 | 15 |
| Adjustment gastric band HCPCS S2083 | $27.72 | $126.00 | $74.25 – $203.00 | 2 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $185.57 | $843.50 | $0.22 – $2.00 | 5 |
| Admin ecg contrast agent CPT 93352 | $962.52 | $1,234.00 | $28.08 – $103.95 | 5 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | not published | not published | $26.83 – $91.80 | 15 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | not published | not published | $42.96 – $98.69 | 15 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | not published | not published | $125.33 – $427.83 | 15 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | not published | not published | $97.14 – $427.83 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | not published | not published | $36.68 – $91.80 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $40.92 | $186.00 | $42.96 – $110.25 | 15 |
| Administration immunization each additional component CPT 90461 | $109.20 | $140.00 | $7.18 – $53.00 | 5 |
| Administration immunization each additional vaccine CPT 90472 | $109.20 | $140.00 | $11.97 – $53.00 | 5 |
| Administration immunization first component each vaccine CPT 90460 | $145.86 | $187.00 | $18.75 – $53.00 | 5 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $13.61 – $91.80 | 12 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $9.82 – $53.00 | 5 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $18.54 – $53.00 | 5 |
| Administration vaccine hepatitis b HCPCS G0010 | $94.38 | $121.00 | $16.83 – $59.51 | 11 |
| Administration vaccine influenza virus HCPCS G0008 | $94.38 | $121.00 | $15.00 – $59.51 | 14 |
| Administration vaccine pneumococcal HCPCS G0009 | $94.38 | $121.00 | $15.00 – $59.51 | 14 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $16.03 – $53.00 | 5 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $30.41 – $59.22 | 15 |
| Adrenal cortex & medulla img CPT 78075 | $21.78 | $99.00 | $26.25 – $1,683.89 | 15 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | $768.68 | $3,494.00 | $90.75 – $1,992.25 | 7 |
| Adrenalin epinephrine inject HCPCS J0171 | $115.50 | $525.00 | $0.76 – $2.10 | 4 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $43.78 | $199.00 | $58.06 – $184.00 | 8 |
| Adv prim care mgmt lvl 1 HCPCS G0556 | $7.70 | $35.00 | $10.17 – $38.43 | 11 |
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.