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 |
|---|---|---|---|---|
| Drain thigh/knee lesion 27301 CPT 27301 | $317.90 | $1,445.00 | $41.68 – $3,691.65 | 15 |
| Drain thyroid/tongue cyst CPT 60000 | $98.12 | $446.00 | $12.99 – $1,910.65 | 15 |
| Drain to peritoneal cavity CPT 49062 | $477.40 | $2,170.00 | $55.86 – $1,228.26 | 4 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $464.88 | $596.00 | $9.00 – $256.30 | 15 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $464.88 | $596.00 | $21.00 – $256.30 | 15 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $935.22 | $1,199.00 | $26.00 – $515.34 | 15 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $27.50 | $125.00 | $36.09 – $1,187.28 | 15 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $44.84 – $69.50 | 8 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | $3,532.62 | $4,529.00 | $80.65 – $1,457.83 | 7 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $2,525.64 | $3,238.00 | $247.35 – $498.65 | 7 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $54,707.31 – $115,671.81 | 11 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | $55.22 | $251.00 | $65.92 – $140.84 | 10 |
| Drm agrft t/a/l ea addl CPT 15131 | $55.22 | $251.00 | $67.83 – $140.84 | 10 |
| Drng appendix abscess open 44900 CPT 44900 | $485.98 | $2,209.00 | $50.48 – $1,251.54 | 7 |
| Drng hand tendon sheath 26020 CPT 26020 | $349.14 | $1,587.00 | $9.64 – $4,185.10 | 15 |
| Drng of eyelid abscess 67700 CPT 67700 | $699.66 | $897.00 | $9.45 – $385.58 | 15 |
| Drng of finger abscess comp 26011 CPT 26011 | $3,791.58 | $4,861.00 | $15.19 – $2,089.89 | 15 |
| Drng of hydrocele 55000 CPT 55000 | $52.14 | $237.00 | $36.75 – $907.53 | 15 |
| Drng of mouth lesion 40801 CPT 40801 | $1,191.84 | $1,528.00 | $16.27 – $656.86 | 15 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | $195.14 | $887.00 | $31.06 – $4,101.16 | 15 |
| Drng of palm multi bursas 26030 CPT 26030 | $308.88 | $1,404.00 | $15.00 – $4,185.10 | 15 |
| Drng of palm single bursa 26025 CPT 26025 | $262.46 | $1,193.00 | $9.64 – $4,185.10 | 15 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | $265.54 | $1,207.00 | $31.47 – $1,520.85 | 15 |
| Drng of salivary cyst 42409 CPT 42409 | $7,588.62 | $9,729.00 | $17.21 – $4,183.11 | 15 |
| Drng of scrotum abscess 55100 CPT 55100 | $104.28 | $474.00 | $13.75 – $2,089.89 | 15 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | $682.88 | $3,104.00 | $56.18 – $1,743.51 | 7 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | $622.38 | $2,829.00 | $72.72 – $1,598.07 | 7 |
| Drng ovary abscess perqt 58822 CPT 58822 | $441.10 | $2,005.00 | $70.11 – $1,145.32 | 7 |
| Drng peritoneal abscess open 49020 CPT 49020 | $984.50 | $4,475.00 | $43.60 – $2,538.23 | 7 |
| Drng salivary gland simple 42300 CPT 42300 | $3,466.32 | $4,444.00 | $12.84 – $1,910.65 | 15 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $1,191.84 | $1,528.00 | $11.06 – $656.86 | 15 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.58 – $2.41 | 8 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $8.19 | $37.21 | $5.06 – $13.37 | 8 |
| Drop lock knee HCPCS L2182 | not published | not published | $57.72 – $122.05 | 11 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $18.48 – $39.08 | 11 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | not published | not published | $69.82 – $69.82 | 1 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $11.68 – $17.52 | 8 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $11.04 – $16.56 | 8 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $2.34 – $13.34 | 8 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | not published | not published | $10.27 – $33.00 | 2 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $7.87 – $16.66 | 11 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $151.27 – $217.47 | 4 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $24.38 – $38.56 | 4 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $50.72 – $76.07 | 8 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $205.70 – $295.71 | 4 |
| Drug admin & hemodynmic meas CPT 93463 | $59.40 | $270.00 | $78.70 – $153.54 | 4 |
| Drug assay caffeine CPT 80155 | $25.52 | $116.00 | $15.44 – $42.04 | 15 |
| Drug assay posaconazole CPT 80187 | $142.74 | $183.00 | $17.90 – $34.70 | 15 |
| Drug assay rufinamide CPT 80210 | $142.74 | $183.00 | $17.90 – $29.55 | 12 |
| Drug assay vedolizumab CPT 80280 | $202.80 | $260.00 | $25.45 – $42.04 | 12 |
| Drug assay voriconazole CPT 80285 | $142.74 | $183.00 | $17.90 – $34.70 | 15 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $12.30 – $20.32 | 12 |
| Drug of abuse screen urine CPT 80305 | $66.30 | $85.00 | $8.32 – $19.15 | 15 |
| Drug screening tapentadol CPT 80372 | not published | not published | $19.33 – $23.41 | 4 |
| Drug screen quant tiagabine CPT 80199 | $18.04 | $82.00 | $17.90 – $31.52 | 15 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $13.88 – $23.41 | 4 |
| Drug test def 15-21 classes HCPCS G0482 | $1,046.76 | $1,342.00 | $131.16 – $216.63 | 14 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $63.95 – $124.73 | 14 |
| Drug test def 22+ classes HCPCS G0483 | $1,300.26 | $1,667.00 | $162.97 – $275.49 | 14 |
| Drug test def 8-14 classes HCPCS G0481 | $824.46 | $1,057.00 | $98.39 – $170.68 | 14 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $41.01 – $102.16 | 14 |
| Drug test prsmv instrmnt CPT 80306 | $11.44 | $52.00 | $11.31 – $25.54 | 15 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $326.82 | $419.00 | $41.01 – $102.16 | 15 |
| Drvvt confirm - quest CPT 85597 | $95.16 | $122.00 | $7.51 – $39.74 | 15 |
| Dry needling (97799) CPT 97799 | $0.22 | $1.00 | not published | 0 |
| Dstrj extensive retinopathy CPT 67227 | $154.22 | $701.00 | $20.61 – $4,864.07 | 15 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $90.42 | $411.00 | $11.93 – $2,518.80 | 12 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | $124.74 | $567.00 | $15.00 – $515.34 | 15 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | $105.16 | $478.00 | $6.93 – $515.34 | 15 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | $122.98 | $559.00 | $3.00 – $789.56 | 15 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | $167.86 | $763.00 | $3.47 – $789.56 | 15 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $331.15 – $707.62 | 11 |
| Ductogram sgl duct CPT 77053 | $10.56 | $48.00 | $14.09 – $311.79 | 15 |
| Duodenal exclusion CPT 48547 | $1,106.60 | $5,030.00 | $129.30 – $2,851.66 | 7 |
| Duodenal motility study CPT 91022 | $43.78 | $199.00 | $58.96 – $684.40 | 15 |
| Duplex scan bilateral study 93985 CPT 93985 | $707.46 | $907.00 | $30.22 – $311.79 | 15 |
| Duplex scan unilateral study 93986 CPT 93986 | $311.22 | $399.00 | $18.82 – $151.52 | 15 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $14.08 | $64.00 | $12.58 – $137.16 | 15 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $457.86 | $587.00 | $19.15 – $201.81 | 15 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $707.46 | $907.00 | $23.33 – $311.79 | 15 |
| Duragen 1x1 5ea/bx HCPCS C9354 | not published | not published | $19.38 – $21.32 | 3 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $61.94 – $120.63 | 15 |
| Dxa bone density axl vrt fx CPT 77085 | $342.42 | $439.00 | $11.65 – $137.16 | 12 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $52.48 – $201.81 | 14 |
| Dx aly aud oi snd prcsr each CPT 92623 | not published | not published | $13.92 – $27.78 | 10 |
| Dx bronchoscope/brush 31623 CPT 31623 | $80.30 | $365.00 | $106.30 – $2,224.33 | 15 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $81.40 | $370.00 | $107.58 – $2,224.33 | 15 |
| Dx bronchoscope/wash 31622 CPT 31622 | $80.52 | $366.00 | $106.47 – $2,224.33 | 15 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $10.09 – $514.71 | 15 |
| Dx duod intub w/asp spec 43756 CPT 43756 | $30.80 | $140.00 | $41.37 – $1,209.32 | 15 |
| Dx duod intub w/asp specs CPT 43757 | $47.08 | $214.00 | $62.27 – $1,209.32 | 15 |
| Dx gastr intub w/asp spec CPT 43754 | $23.54 | $107.00 | $26.13 – $1,187.28 | 15 |
| Dx gastr intub w/asp specs CPT 43755 | $36.74 | $167.00 | $47.93 – $1,187.28 | 15 |
| Dx intraop epcar Ultrasound chd i&r CPT 76989 | not published | not published | $0.02 – $56.23 | 7 |
| Dx intraop epicar car Ultrasound chd CPT 76987 | not published | not published | $0.01 – $150.59 | 7 |
| Dx intraop thoracic aorta Ultrasound CPT 76984 | not published | not published | $0.02 – $49.21 | 7 |
| Dx laryngoscopy newborn CPT 31520 | $96.58 | $439.00 | $127.03 – $500.87 | 15 |
| Dx laryngoscopy w/oper scope CPT 31526 | $97.02 | $441.00 | $123.90 – $2,224.33 | 15 |
| Dx ntrop epcr Ultrasound chd img acq CPT 76988 | not published | not published | $0.01 – $95.88 | 7 |
| Dynamic cavernosometry CPT 54231 | $71.50 | $325.00 | $94.11 – $313.71 | 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.