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 |
|---|---|---|---|---|
| Closed tx humerus fx with manip 23605 CPT 23605 | $3,745.56 | $4,802.00 | $18.19 – $2,064.31 | 15 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $561.60 | $921.00 | $2.00 – $516.28 | 15 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $3,745.56 | $4,802.00 | $7.00 – $2,064.31 | 15 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $561.60 | $720.00 | $6.50 – $309.41 | 15 |
| Closed tx nose/jaw fx CPT 21345 | $396.88 | $1,804.00 | $38.86 – $1,910.65 | 15 |
| Closed tx orbit without manipulj CPT 21400 | $106.04 | $482.00 | $12.50 – $656.86 | 15 |
| Closed tx orbit w/manipulj CPT 21401 | $205.48 | $934.00 | $12.50 – $1,910.65 | 15 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $363.66 | $1,653.00 | $47.92 – $2,064.31 | 15 |
| Closed tx septal&nose fx CPT 21337 | $187.00 | $850.00 | $17.50 – $4,183.11 | 15 |
| Closed tx sesamoid fx 28530 CPT 28530 | $65.78 | $299.00 | $8.57 – $309.41 | 15 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | $561.60 | $720.00 | $5.72 – $342.19 | 15 |
| Closed tx vert fx w/manj CPT 22315 | $488.40 | $2,220.00 | $12.00 – $4,185.10 | 15 |
| Close kidney-skin fistula CPT 50520 | $718.52 | $3,266.00 | $74.70 – $1,849.67 | 7 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $543.66 | $697.00 | $11.87 – $299.53 | 15 |
| Close mastoid fistula CPT 69700 | $406.56 | $1,848.00 | $38.13 – $1,910.65 | 15 |
| Close median sternotomy separation 21750 CPT 21750 | $416.46 | $1,893.00 | $54.19 – $1,072.86 | 7 |
| Close mult vsd CPT 33675 | $1,196.80 | $5,440.00 | $108.82 – $3,094.73 | 7 |
| Close mult vsd w/resection CPT 33676 | $1,228.70 | $5,585.00 | $111.71 – $3,177.08 | 7 |
| Close nephrovisceral fistula CPT 50525 | $910.58 | $4,139.00 | $94.59 – $2,344.37 | 7 |
| Close nephrovisceral fistula CPT 50526 | $975.04 | $4,432.00 | $101.25 – $2,510.28 | 7 |
| Close tear duct opening CPT 68760 | $88.88 | $404.00 | $11.85 – $385.58 | 15 |
| Close tear duct opening CPT 68761 | $70.84 | $322.00 | $9.53 – $385.58 | 15 |
| Close tear system fistula CPT 68770 | $379.72 | $1,726.00 | $50.77 – $3,009.20 | 15 |
| Clostridium toxin a w/optic CPT 87803 | $10.56 | $48.00 | $10.56 – $18.16 | 15 |
| Clos txnose fx without stablz 21315 CPT 21315 | $3,466.32 | $4,444.00 | $29.69 – $1,910.65 | 15 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | $532.84 | $2,422.00 | $62.67 – $1,373.51 | 7 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | $977.68 | $4,444.00 | $114.74 – $2,523.32 | 7 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | $621.72 | $2,826.00 | $73.25 – $1,604.73 | 7 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | $859.10 | $3,905.00 | $93.98 – $2,215.96 | 7 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $1,191.84 | $1,528.00 | $16.38 – $656.86 | 15 |
| Closure of eyelid by suture CPT 67875 | $58.30 | $265.00 | $77.47 – $1,249.28 | 15 |
| Closure of salivary fistula CPT 42600 | $221.10 | $1,005.00 | $26.39 – $4,183.11 | 15 |
| Closure of valve CPT 33600 | $1,047.64 | $4,762.00 | $95.35 – $2,706.88 | 7 |
| Closure of valve CPT 33602 | $1,017.50 | $4,625.00 | $92.58 – $2,627.71 | 7 |
| Closure of windpipe lesion 31820 CPT 31820 | $204.60 | $930.00 | $27.24 – $4,183.11 | 15 |
| Closure paravalvlr leak pq CPT 33999 | not published | $0.01 | $373.20 – $797.47 | 10 |
| Closure ureter/bowel fistula CPT 50930 | $678.26 | $3,083.00 | $71.46 – $1,746.79 | 7 |
| Closure ureter/skin fistula CPT 50920 | $544.50 | $2,475.00 | $57.38 – $1,401.56 | 7 |
| Clot factor fletcher fact CPT 85292 | $12.32 | $56.00 | $12.50 – $41.87 | 15 |
| Clot factor viii reltd antgn CPT 85244 | $13.64 | $62.00 | $12.98 – $45.15 | 15 |
| Clot factor wght kininogen CPT 85293 | $12.32 | $56.00 | $12.04 – $41.87 | 15 |
| Clot factor xii hageman CPT 85280 | $12.76 | $58.00 | $12.30 – $21.09 | 15 |
| Clot factor xiii fibrin scrn CPT 85291 | $6.16 | $28.00 | $4.20 – $12.80 | 15 |
| Clot factor xiii fibrin stab CPT 85290 | $11.00 | $50.00 | $8.00 – $17.81 | 15 |
| Clotting assay whole blood CPT 85396 | $11.66 | $53.00 | $15.72 – $26.74 | 8 |
| Clozapine, 25 mg HCPCS S0136 | not published | not published | $0.65 – $0.85 | 4 |
| Clsd ostomy pouch w/flange HCPCS A5054 | not published | not published | $1.30 – $2.74 | 11 |
| Clsd ostomy pouch without barr HCPCS A5052 | not published | not published | $1.07 – $2.27 | 11 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $561.60 | $876.00 | $10.00 – $492.43 | 15 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $561.60 | $888.00 | $22.72 – $499.10 | 15 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $561.60 | $920.00 | $19.92 – $513.99 | 15 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | $153.78 | $699.00 | $3.00 – $2,064.31 | 15 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $151.36 | $688.00 | $20.00 – $387.52 | 15 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $3,745.56 | $4,802.00 | $18.20 – $2,064.31 | 15 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $561.60 | $720.00 | $18.20 – $374.20 | 15 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $122.54 | $557.00 | $16.10 – $311.98 | 15 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $561.60 | $720.00 | $13.83 – $312.52 | 15 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $701.22 | $1,110.00 | $32.20 – $626.63 | 15 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $561.60 | $887.00 | $16.04 – $497.16 | 15 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $561.60 | $720.00 | $6.62 – $309.41 | 15 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $470.36 | $2,138.00 | $7.25 – $2,064.31 | 15 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | $332.42 | $1,511.00 | $13.00 – $2,064.31 | 15 |
| Clsd tx fracture of radius 25500 CPT 25500 | $561.60 | $755.00 | $12.22 – $423.08 | 15 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | $561.60 | $720.00 | $10.46 – $309.41 | 15 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $701.22 | $899.00 | $12.07 – $309.41 | 15 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $561.60 | $946.00 | $11.59 – $529.14 | 15 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $3,745.56 | $4,802.00 | $7.16 – $2,064.31 | 15 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $561.60 | $758.00 | $9.17 – $425.08 | 15 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $3,745.56 | $4,802.00 | $10.91 – $2,064.31 | 15 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $166.54 | $757.00 | $7.06 – $424.92 | 15 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $561.60 | $1,201.00 | $12.00 – $677.36 | 15 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $561.60 | $1,018.00 | $21.76 – $573.99 | 15 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $561.60 | $971.00 | $28.21 – $546.92 | 15 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | $226.38 | $1,029.00 | $29.89 – $1,187.28 | 15 |
| Clsd tx mandibular fx without manip 21450 CPT 21450 | $290.84 | $1,322.00 | $3.27 – $748.67 | 15 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $142.12 | $646.00 | $18.69 – $361.43 | 15 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $561.60 | $838.00 | $16.60 – $469.39 | 15 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $561.60 | $864.00 | $9.88 – $485.87 | 15 |
| Clsd tx metacarp fx w/manip&ext fix ea bone 26607 CPT 26607 | $315.70 | $1,435.00 | $9.88 – $4,185.10 | 15 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $701.22 | $899.00 | $18.26 – $372.32 | 15 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $561.60 | $720.00 | $17.25 – $332.78 | 15 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $7,588.62 | $9,729.00 | $8.00 – $4,183.11 | 15 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $3,745.56 | $4,802.00 | $5.72 – $2,064.31 | 15 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $561.60 | $987.00 | $3.00 – $557.37 | 15 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $561.60 | $875.00 | $8.00 – $491.50 | 15 |
| Clsd tx pelvic ring fx CPT 27197 | $81.84 | $372.00 | $19.00 – $309.41 | 15 |
| Clsd tx pelvic ring fx CPT 27198 | $196.24 | $892.00 | $144.80 – $1,187.28 | 15 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $3,745.56 | $4,802.00 | $28.07 – $2,064.31 | 15 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $561.60 | $720.00 | $16.07 – $310.83 | 15 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $561.60 | $722.00 | $20.84 – $403.10 | 15 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $3,745.56 | $4,802.00 | $21.78 – $2,064.31 | 15 |
| Clsd tx/scapular fx without manip 23570 CPT 23570 | $156.20 | $710.00 | $20.51 – $397.19 | 15 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $3,745.56 | $4,802.00 | $6.37 – $2,064.31 | 15 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $3,745.56 | $4,802.00 | $6.55 – $2,064.31 | 15 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $257.40 | $1,170.00 | $6.37 – $2,064.31 | 15 |
| Clsd tx/talotarsal dislocat/anes 28575 CPT 28575 | $215.60 | $980.00 | $1.50 – $4,185.10 | 15 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $561.60 | $720.00 | $16.44 – $309.41 | 15 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $561.60 | $720.00 | $7.77 – $309.41 | 15 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $561.60 | $855.00 | $24.81 – $480.94 | 15 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $3,745.56 | $4,802.00 | $36.70 – $2,064.31 | 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.