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 |
|---|---|---|---|---|
| Injection for bladder x-ray CPT 51600 | $1,708.98 | $2,191.00 | $33.60 – $68.66 | 11 |
| Injection for hip x-ray CPT 27095 | $50.16 | $228.00 | $50.40 – $1,187.28 | 11 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $1,040.52 | $1,334.00 | $10.00 – $78.81 | 11 |
| Injection for spleen x-ray CPT 38200 | $79.42 | $361.00 | $77.18 – $204.95 | 8 |
| Injection for tear sac x-ray CPT 68850 | $31.46 | $143.00 | $41.81 – $81.06 | 11 |
| Injection for ureter x-ray CPT 50684 | $1,197.30 | $1,535.00 | $41.36 – $80.39 | 11 |
| Injection for ureter x-ray CPT 50690 | $1,479.66 | $1,897.00 | $45.15 – $109.98 | 11 |
| Injection, fosphenytoin sodi HCPCS S0078 | not published | not published | $26.50 – $48.17 | 4 |
| Injection, fulvestrant HCPCS J9395 | not published | not published | $5.07 – $9.87 | 15 |
| Injection glatiramer acetate HCPCS J1595 | not published | not published | $50.85 – $174.83 | 12 |
| Injection, glucarpidase HCPCS C9293 | not published | not published | $419.98 – $461.98 | 2 |
| Injection, inclisiran, 1 mg HCPCS J1306 | not published | not published | $8.97 – $17.48 | 15 |
| Injection into brain canal CPT 61026 | $69.96 | $318.00 | $88.49 – $1,187.28 | 15 |
| Injection into brain canal CPT 61055 | $71.28 | $324.00 | $94.59 – $380.75 | 15 |
| Injection into hemorrhoid(s) CPT 46500 | $112.86 | $513.00 | $14.97 – $1,175.98 | 15 |
| Injection into spinal artery CPT 62294 | $598.62 | $2,721.00 | $84.71 – $1,537.49 | 14 |
| Injection into vocal cord CPT 31513 | $80.74 | $367.00 | $106.65 – $500.87 | 15 |
| Injection intraop add-on CPT 48400 | $65.56 | $298.00 | $84.66 – $168.57 | 7 |
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $0.73 – $1.10 | 12 |
| Injection jaw joint x-ray CPT 21116 | $378.30 | $485.00 | $23.97 – $70.41 | 11 |
| Injection jugular CPT 36299 | not published | $0.01 | not published | 0 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.06 – $1.76 | 8 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $4.16 – $8.11 | 15 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $11.73 – $91.80 | 11 |
| Injection of sinus tract CPT 20500 | $55.88 | $254.00 | $7.32 – $1,910.65 | 15 |
| Injection,onabotulinumtoxina HCPCS J0585 | not published | not published | $4.72 – $9.20 | 15 |
| Injection, pentamidine iseth HCPCS S0080 | not published | not published | $97.70 – $127.50 | 4 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.22 – $1.83 | 12 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $1.74 – $2.73 | 3 |
| Injection px peyronie ds CPT 54200 | $54.56 | $248.00 | $7.16 – $313.71 | 12 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $19.58 | $89.00 | $25.96 – $518.31 | 12 |
| Injection, renflexis HCPCS Q5104 | not published | not published | $18.20 – $35.45 | 15 |
| Injection, ruconest HCPCS J0596 | not published | not published | $26.69 – $51.98 | 15 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $75.24 | $342.00 | $294.03 – $893.26 | 11 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,620.84 | $2,078.00 | $51.47 – $893.26 | 15 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,620.84 | $2,078.00 | $22.05 – $893.26 | 15 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,083.38 | $2,671.00 | $90.78 – $1,148.35 | 15 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,562.34 | $2,003.00 | $48.20 – $94.20 | 11 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,083.38 | $2,671.00 | $85.83 – $1,148.35 | 15 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,562.34 | $2,003.00 | $41.37 – $80.84 | 11 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,083.38 | $2,671.00 | $73.77 – $1,148.35 | 15 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,025.66 | $2,597.00 | $87.57 – $893.26 | 15 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $61.16 | $278.00 | $80.97 – $893.26 | 15 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $117.68 – $229.17 | 15 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $691.08 | $886.00 | $18.50 – $380.75 | 15 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $863.46 | $1,107.00 | $6.41 – $380.75 | 15 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $863.46 | $1,107.00 | $6.41 – $380.75 | 15 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $108.42 | $139.00 | $7.86 – $17.47 | 4 |
| Injection, ticarcillin disod HCPCS S0040 | not published | not published | $13.33 – $20.88 | 3 |
| Injection torsemide 10 mg/ml HCPCS J3265 | not published | not published | $1.91 – $4.66 | 3 |
| Injection treatment of eye CPT 66020 | $79.64 | $362.00 | $10.66 – $2,941.83 | 15 |
| Injection treatment of eye CPT 66030 | $67.32 | $306.00 | $9.04 – $2,941.83 | 15 |
| Injection treatment of nerve CPT 64605 | $264.44 | $1,202.00 | $34.07 – $2,518.80 | 15 |
| Injection treatment of nerve CPT 64610 | $298.10 | $1,355.00 | $38.62 – $2,518.80 | 15 |
| Injection treatment of nerve CPT 64681 | $136.40 | $620.00 | $17.84 – $1,148.35 | 15 |
| Injection treatment of nose CPT 30200 | $37.18 | $169.00 | $48.78 – $656.86 | 12 |
| Inject sacroiliac joint CPT 27096 | $2,149.68 | $2,756.00 | $11.16 – $131.61 | 11 |
| Inject/treat eye socket CPT 67500 | $39.82 | $181.00 | $43.45 – $385.58 | 15 |
| Inject/treat eye socket CPT 67505 | $43.78 | $199.00 | $45.36 – $385.58 | 15 |
| Inject/treat eye socket CPT 67515 | $28.38 | $129.00 | $38.04 – $385.58 | 15 |
| Inj, eculizumab-aagh, 2 mg HCPCS Q5151 | not published | not published | $22.78 – $34.17 | 11 |
| Inj, eculizumab-aeeb, 2 mg HCPCS Q5152 | not published | not published | $30.14 – $45.22 | 11 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $24.51 – $47.74 | 15 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $15.34 – $29.88 | 15 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $277.30 – $540.02 | 15 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $41.73 – $81.27 | 15 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $60.94 | $277.00 | $81.08 – $893.26 | 15 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $48.40 | $220.00 | $64.56 – $1,148.35 | 15 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $2.38 – $3.11 | 3 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.22 – $1.83 | 8 |
| Inj, erzofri, 1 mg HCPCS J2428 | not published | not published | $12.46 – $18.69 | 11 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | not published | not published | $4.01 – $5.29 | 4 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $159.99 – $215.06 | 4 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $137.87 – $268.50 | 15 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $12.62 – $24.58 | 15 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $1,694,431.20 – $2,541,880.00 | 11 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $7.20 – $14.02 | 15 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $25.05 – $48.79 | 15 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $21.89 – $80.98 | 4 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $13.77 – $26.82 | 15 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $102.03 – $198.70 | 15 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.03 – $0.04 | 4 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $0.88 – $1.71 | 15 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $5.40 – $10.51 | 15 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $2.08 – $4.06 | 15 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $241.51 – $315.17 | 4 |
| Inj follitropin beta 75 iu HCPCS S0128 | not published | not published | $217.50 – $283.84 | 4 |
| Inj for ext venography CPT 36005 | $699.66 | $897.00 | $37.71 – $74.53 | 11 |
| Inj for mammo ductogram CPT 19030 | $46.42 | $211.00 | $7.11 – $417.00 | 12 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.44 – $1.60 | 15 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $440.58 – $857.99 | 15 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $3.32 – $4.38 | 4 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $2.41 – $12.26 | 15 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $20.40 – $50.37 | 12 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $3.21 – $4.82 | 8 |
| Inj, ganciclovir (exela) HCPCS J1574 | not published | not published | $51.00 – $67.21 | 4 |
| Inj ganirelix acetat 250 mcg HCPCS S0132 | not published | not published | $141.00 – $240.12 | 4 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $4.99 – $12.19 | 8 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $85.15 – $165.82 | 15 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $2,013.10 – $3,920.36 | 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.