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 |
|---|---|---|---|---|
| Dextran 40 infusion HCPCS J7100 | not published | not published | $39.82 – $66.56 | 4 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $13.99 – $18.95 | 4 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.71 – $1.38 | 4 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $4.62 | $21.00 | $1.18 – $1.92 | 8 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $4.62 | $21.00 | $8.14 – $10.41 | 4 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $13.09 | $59.50 | $1.80 – $2.87 | 8 |
| Dextrose 5 % IV bolus HCPCS J7070 | $4.62 | $21.00 | $2.87 – $4.70 | 8 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $117.00 | $150.00 | $14.13 – $33.60 | 15 |
| Diabetes (HbA1c) Test CPT 83036 | $50.70 | $65.00 | $6.17 – $11.20 | 15 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $7.45 – $38.43 | 14 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $137.37 – $290.45 | 11 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $22.03 – $49.33 | 11 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $22.03 – $49.33 | 11 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $22.03 – $49.33 | 11 |
| Diab manage trn ind/group HCPCS G0109 | $31.98 | $41.00 | $12.67 – $36.00 | 8 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $45.80 – $96.85 | 11 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $22.03 – $49.33 | 11 |
| Diag bronchoscope/catheter CPT 31643 | $103.18 | $469.00 | $136.56 – $2,224.33 | 15 |
| Diag laparo separate proc 49320 CPT 49320 | $205.04 | $932.00 | $26.68 – $7,525.52 | 15 |
| Diagnostic anoscopy CPT 46601 | $57.64 | $262.00 | $76.14 – $514.71 | 12 |
| Diagnostic anoscopy & biopsy CPT 46607 | $76.34 | $347.00 | $101.10 – $1,520.85 | 12 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $301.86 | $387.00 | $21.00 – $166.26 | 15 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $531.96 | $682.00 | $26.96 – $238.50 | 9 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $265.98 | $341.00 | $26.96 – $336.12 | 9 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $454.74 | $583.00 | $40.40 – $250.41 | 12 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $454.74 | $583.00 | $55.81 – $250.41 | 15 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $357.24 | $458.00 | $38.73 – $138.97 | 15 |
| Diagnostic Mammogram (one breast) CPT 77065 | $287.04 | $368.00 | $31.53 – $108.65 | 15 |
| Diagnostic radio unlisted proc CPT 76499 | $283.14 | $363.00 | $53.15 – $113.57 | 10 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $10,006.62 | $12,829.00 | $152.94 – $314.15 | 11 |
| Dialysis one evaluation CPT 90945 | $52.80 | $240.00 | $56.00 – $549.25 | 12 |
| Dialysis repeated eval CPT 90947 | $75.02 | $341.00 | $56.00 – $194.30 | 4 |
| Dialysis training complete CPT 90989 | not published | not published | $339.31 – $653.23 | 4 |
| Dialysis training incompl CPT 90993 | not published | not published | $73.92 – $142.33 | 4 |
| Diathermy eg microwave CPT 97024 | not published | not published | $4.90 – $11.44 | 12 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.07 – $0.10 | 8 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $25.92 | $117.82 | $5.82 – $11.16 | 8 |
| Dicyclomine injection HCPCS J0500 | $64.73 | $294.21 | $11.01 – $19.44 | 8 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.06 – $0.24 | 12 |
| Diffusing capacity CPT 94729 | $5.50 | $25.00 | $6.74 – $50.67 | 8 |
| Digital analysis of eeg CPT 95957 | $61.60 | $280.00 | $80.52 – $160.09 | 8 |
| Digit nerve surgery add-on CPT 64778 | $110.44 | $502.00 | $144.21 – $284.66 | 8 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $4.60 | $20.93 | $3.77 – $11.51 | 8 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $3,610.17 – $7,030.54 | 15 |
| Digoxin total therapeutic drug level CPT 80162 | $70.20 | $90.00 | $8.44 – $17.60 | 15 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | not published | not published | $41.04 – $137.36 | 8 |
| Dilate biliary duct/ampulla CPT 47542 | $82.06 | $373.00 | $107.80 – $211.39 | 11 |
| Dilate esophagus CPT 43453 | $53.02 | $241.00 | $61.95 – $2,446.86 | 15 |
| Dilate esophagus 1/mult pass CPT 43450 | $48.84 | $222.00 | $61.95 – $1,209.32 | 15 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $7,934.16 | $10,172.00 | $269.47 – $535.34 | 4 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $7,934.16 | $10,172.00 | $134.73 – $267.67 | 4 |
| Dilate ic vasospasm init CPT 61640 | $226.16 | $1,028.00 | $383.59 – $762.16 | 4 |
| Dilate tear duct opening CPT 68801 | $47.96 | $218.00 | $6.48 – $514.71 | 12 |
| Dilate urethra stricture CPT 53600 | $39.38 | $179.00 | $21.00 – $313.71 | 15 |
| Dilate urethra stricture CPT 53601 | $33.00 | $150.00 | $21.00 – $166.26 | 15 |
| Dilate urethra stricture CPT 53605 | $39.16 | $178.00 | $21.00 – $4,448.70 | 15 |
| Dilate urethra stricture CPT 53621 | $44.00 | $200.00 | $21.00 – $313.71 | 15 |
| Dilation/female urethra/initial 53660 CPT 53660 | $25.52 | $116.00 | $21.00 – $201.81 | 15 |
| Dilation of anal sphincter CPT 45905 | $105.60 | $480.00 | $13.88 – $1,520.85 | 15 |
| Dilation of cervical canal 57800 CPT 57800 | $29.70 | $135.00 | $39.25 – $4,101.16 | 15 |
| Dilation of rectal stricture 45910 CPT 45910 | $119.90 | $545.00 | $15.74 – $1,520.85 | 15 |
| Dilation of salivary duct CPT 42660 | $48.84 | $222.00 | $36.75 – $656.86 | 15 |
| Dilation of urethra CPT 53661 | $24.64 | $112.00 | $21.00 – $166.26 | 15 |
| Dilation of urethra CPT 53665 | $22.88 | $104.00 | $21.00 – $2,642.30 | 15 |
| Dilation of vagina CPT 57400 | $80.52 | $366.00 | $38.85 – $4,101.16 | 15 |
| Dilation salivary duct 42650 CPT 42650 | $36.74 | $167.00 | $36.75 – $1,910.65 | 15 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $1,562.34 | $2,003.00 | $21.00 – $860.94 | 15 |
| Dilat xst trc ndurlgc px CPT 50436 | $8,070.66 | $10,347.00 | $119.84 – $4,448.70 | 15 |
| Dilat xst trc new access rcs CPT 50437 | $8,070.66 | $10,347.00 | $198.79 – $4,448.70 | 15 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $8.79 | $39.94 | $0.03 – $0.05 | 5 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $54.55 – $75.83 | 4 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.30 – $11.31 | 8 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $539.79 – $1,051.20 | 15 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $0.03 | 4 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $2.32 | $10.54 | $0.73 – $2.10 | 9 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $15.00 – $95.60 | 9 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.60 – $5.47 | 8 |
| Direct advanced life support CPT 99288 | not published | not published | $88.00 – $88.00 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $23.30 – $50.63 | 12 |
| Disability dlco CPT 94727 | $7.26 | $33.00 | $9.71 – $201.81 | 15 |
| Disaccharidases CPT 82657 | $14.52 | $66.00 | $11.48 – $24.17 | 12 |
| Disarticulation sho sec clsr CPT 23921 | $295.90 | $1,345.00 | $38.94 – $2,359.45 | 15 |
| Disarticulation shoulder CPT 23920 | $698.28 | $3,174.00 | $91.41 – $1,791.89 | 7 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | $905.30 | $4,115.00 | $130.15 – $2,325.76 | 7 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | $127.60 | $580.00 | $30.82 – $329.02 | 7 |
| Discography cerv/thor spine CPT 72285 | $6,282.90 | $8,055.00 | $25.20 – $2,518.80 | 15 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $53.51 – $113.14 | 11 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $104.00 – $268.59 | 11 |
| Dise eval slp do brth flx dx CPT 42975 | $59.84 | $272.00 | $79.01 – $2,224.33 | 12 |
| Dissect brain w/scope CPT 62161 | $952.38 | $4,329.00 | $135.01 – $2,455.08 | 7 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | $63.36 | $288.00 | $79.60 – $93.58 | 3 |
| Dissolve clot heart vessel CPT 92975 | $226.82 | $1,031.00 | $295.03 – $586.61 | 7 |
| Dist revas ligation hemo CPT 36838 | $691.02 | $3,141.00 | $62.65 – $6,972.61 | 15 |
| Div aberrant vsl w/reanast CPT 33803 | $701.36 | $3,188.00 | $63.82 – $1,811.62 | 7 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | $490.16 | $2,228.00 | $58.15 – $7,630.39 | 14 |
| Division of fallopian tube 58605 CPT 58605 | $208.12 | $946.00 | $33.15 – $540.65 | 7 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $13.88 – $23.41 | 4 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $178.20 | $810.00 | $41.69 – $460.52 | 7 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $184.14 – $840.00 | 15 |
| Dmpk gene charac alleles CPT 81239 | $181.28 | $824.00 | $181.39 – $299.56 | 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.