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 |
|---|---|---|---|---|
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $67.02 – $100.52 | 8 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $1,216.02 | $1,559.00 | $39.43 – $77.17 | 11 |
| Pvb thoracic cont infusion CPT 64463 | $1,620.84 | $2,078.00 | $66.47 – $893.26 | 14 |
| Pvb thoracic single inj site CPT 64461 | $1,620.84 | $2,078.00 | $63.57 – $893.26 | 15 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $416.81 – $881.28 | 11 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $9,873.54 – $20,876.36 | 11 |
| Pyelotomy complicated CPT 50135 | $700.04 | $3,182.00 | $248.80 – $248.80 | 1 |
| Pyelotomy w/drg pyelostomy CPT 50125 | $605.88 | $2,754.00 | $63.87 – $1,560.73 | 7 |
| Pyelotomy w/exploration CPT 50120 | $585.86 | $2,663.00 | $61.73 – $1,508.42 | 7 |
| Pyelotomy w/removal calculus CPT 50130 | $636.68 | $2,894.00 | $67.06 – $1,639.03 | 7 |
| Pyloroplasty 43800 CPT 43800 | $575.74 | $2,617.00 | $67.40 – $1,483.79 | 7 |
| Pyridoxine hcl 100 mg HCPCS J3415 | not published | not published | $12.07 – $20.59 | 8 |
| Pyruvate CPT 84210 | $9.68 | $44.00 | $6.90 – $15.78 | 15 |
| Pyruvate kinase CPT 84220 | $6.16 | $28.00 | $6.00 – $12.80 | 15 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $209.60 – $443.18 | 11 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | $5.94 | $27.00 | $4.77 – $166.26 | 12 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $23.76 | $108.00 | $31.65 – $694.29 | 15 |
| Quant diff pulm perf w/imaging CPT 78597 | $20.68 | $94.00 | $27.48 – $518.31 | 15 |
| Quest t3 uptake CPT 84479 | $34.32 | $44.00 | $4.08 – $14.32 | 15 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $339.34 – $717.49 | 11 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $3.10 – $475.33 | 12 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $398.26 | $1,810.26 | $10.50 – $506.88 | 15 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $172.28 – $399.36 | 15 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $1,497.09 | $6,804.94 | $10.50 – $375.45 | 16 |
| Rabies vaccine id CPT 90676 | not published | not published | $86.10 – $288.27 | 11 |
| Racepinephrine hcl soln nebu 2.25% (base equivalent) HCPCS J7699 | not published | not published | $0.70 – $0.70 | 1 |
| Radial keratotomy CPT 65771 | not published | not published | $512.10 – $1,156.91 | 4 |
| Radiation handling CPT 77790 | not published | not published | $5.85 – $29.20 | 8 |
| Radiation physics consult CPT 77336 | not published | not published | $50.03 – $171.26 | 15 |
| Radiation therapy dose plan CPT 77300 | $20.46 | $93.00 | $15.75 – $171.26 | 15 |
| Radiation therapy management CPT 77431 | $67.32 | $306.00 | $76.13 – $171.10 | 7 |
| Radiation treatment aid(s) CPT 77332 | $14.74 | $67.00 | $12.56 – $171.26 | 15 |
| Radiation treatment aid(s) CPT 77333 | $24.64 | $112.00 | $25.46 – $171.26 | 15 |
| Radiation treatment aid(s) CPT 77334 | $37.62 | $171.00 | $38.33 – $472.18 | 15 |
| Radiation treatment delivery CPT 77401 | not published | not published | $32.25 – $141.24 | 15 |
| Radiation treatment delivery CPT 77402 | not published | not published | $32.25 – $192.87 | 15 |
| Radiation treatment delivery CPT 77412 | not published | not published | $66.00 – $350.63 | 15 |
| Radiation tx management x5 CPT 77427 | $119.46 | $543.00 | $144.50 – $303.55 | 8 |
| Radical abdominal hysterectomy 58210 CPT 58210 | $1,126.18 | $5,119.00 | $178.16 – $2,913.61 | 7 |
| Radical rescj tumor clavicle CPT 23200 | $932.36 | $4,238.00 | $121.91 – $2,393.28 | 7 |
| Radical rescj tumor prox hum CPT 23220 | $1,197.24 | $5,442.00 | $156.39 – $3,073.04 | 7 |
| Radical rescj tumor scapula CPT 23210 | $1,093.18 | $4,969.00 | $142.87 – $2,807.14 | 7 |
| Radical resection of elbow CPT 24149 | $734.80 | $3,340.00 | $96.46 – $9,214.43 | 15 |
| Radical resection sternum 21630 CPT 21630 | $812.02 | $3,691.00 | $106.46 – $2,083.08 | 7 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | $646.80 | $2,940.00 | $76.30 – $3,691.65 | 15 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | $892.54 | $4,057.00 | $116.07 – $3,691.65 | 15 |
| Radiesse injection HCPCS Q2026 | not published | not published | $242.26 – $363.43 | 10 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $3,200.78 – $6,767.66 | 11 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $491.34 – $1,038.89 | 11 |
| Radiology port images(s) CPT 77417 | not published | not published | $11.31 – $22.90 | 8 |
| Radiotherapy dose plan imrt CPT 77301 | $262.02 | $1,191.00 | $344.82 – $1,764.87 | 15 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $124.82 – $187.24 | 12 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $22.88 | $104.00 | $30.18 – $1,683.89 | 15 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $28.60 | $130.00 | $38.21 – $1,683.89 | 15 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $2,673.06 | $3,427.00 | $69.20 – $1,683.89 | 15 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $30.80 | $140.00 | $41.01 – $1,683.89 | 15 |
| Radphm lcl tumor plr sgl day CPT 78800 | $18.92 | $86.00 | $24.99 – $518.31 | 15 |
| Radphm quant measure sgl area add-on CPT 78835 | $2,004.60 | $2,570.00 | $17.20 – $95.63 | 8 |
| Rad rescj tum dstl/shft hum CPT 24150 | $956.34 | $4,347.00 | $125.08 – $9,214.43 | 15 |
| Rad rescj tum shoulder<5 cm CPT 23077 | $701.36 | $3,188.00 | $57.23 – $3,691.65 | 15 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | $822.36 | $3,738.00 | $107.22 – $3,691.65 | 15 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | $636.24 | $2,892.00 | $57.23 – $3,691.65 | 15 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | $440.66 | $2,003.00 | $57.48 – $3,691.65 | 15 |
| Rad resect abd tumor 5 cm/> CPT 22905 | $825.66 | $3,753.00 | $96.57 – $3,691.65 | 15 |
| Rad resect hand tumor < 3 cm CPT 26117 | $466.62 | $2,121.00 | $60.99 – $3,691.65 | 15 |
| Rad resect hand tumor 3 cm/> CPT 26118 | $656.04 | $2,982.00 | $85.47 – $3,691.65 | 15 |
| Rad resection tum radial h/n CPT 24152 | $833.14 | $3,787.00 | $107.25 – $9,214.43 | 14 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | $590.26 | $2,683.00 | $77.73 – $3,691.65 | 15 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $54.10 – $105.35 | 15 |
| Range of motion measurements CPT 95852 | $3.52 | $16.00 | $4.39 – $9.17 | 11 |
| Ranibizumab injection HCPCS J2778 | $81.84 | $372.00 | $66.20 – $128.92 | 15 |
| Rapid desensitization CPT 95180 | $62.92 | $286.00 | $8.93 – $514.71 | 15 |
| Rapid Strep Test CPT 87880 | $87.36 | $112.00 | $6.30 – $18.02 | 15 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $273.55 – $532.72 | 15 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $163.63 – $318.65 | 15 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $384.42 – $679.58 | 3 |
| Rbc count only automated CPT 85041 | $15.60 | $20.00 | $1.91 – $6.43 | 15 |
| Rbc deglycerolized each unit HCPCS P9039 | not published | not published | $330.00 – $843.23 | 10 |
| Rbc depletion of harvest CPT 38212 | $30.58 | $139.00 | $38.33 – $563.90 | 12 |
| Rbc irradiated each unit HCPCS P9038 | not published | not published | $19.23 – $192.47 | 11 |
| Rbc mechanical fragility CPT 85547 | $5.72 | $26.00 | $5.46 – $15.86 | 15 |
| Rbc o2 co2 reduced HCPCS P9027 | not published | not published | $294.03 – $628.29 | 10 |
| Rbc osmotic fragility CPT 85555 | $4.84 | $22.00 | $3.00 – $8.14 | 15 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $24.43 – $514.71 | 12 |
| Rcm img acquisj&i&r 1st les CPT 96931 | not published | not published | $137.58 – $262.23 | 4 |
| Rcm img acquisj&i&r ea addl CPT 96934 | not published | not published | $95.70 – $182.68 | 4 |
| Rcm img acquisj only 1st les CPT 96932 | not published | not published | $100.96 – $193.89 | 4 |
| Rcm img acquisj only ea addl CPT 96935 | not published | not published | $61.47 – $118.07 | 4 |
| Rcm i&r only 1st lesion CPT 96933 | not published | not published | $35.34 – $68.34 | 4 |
| Rcm i&r only ea addl lesion CPT 96936 | not published | not published | $33.40 – $64.62 | 4 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | $1,358.06 | $6,173.00 | $178.28 – $7,630.39 | 15 |
| Rcnstj forehead w/autograft CPT 21180 | $1,045.88 | $4,754.00 | $137.12 – $2,685.69 | 7 |
| Rcnstj forehead with grafts CPT 21179 | $936.32 | $4,256.00 | $122.84 – $2,405.31 | 7 |
| Rcnstj mdfc lefort i 1 w/grf CPT 21145 | $952.16 | $4,328.00 | $125.92 – $2,445.27 | 7 |
| Rcnstj mdfc lefort i 2 w/grf CPT 21146 | $994.18 | $4,519.00 | $131.49 – $2,553.31 | 7 |
| Rcnstj mdfc lefort iii w/i CPT 21155 | $1,326.38 | $6,029.00 | $175.65 – $3,433.18 | 7 |
| Rcnstj mdfc lefort iii without i CPT 21154 | $1,195.48 | $5,434.00 | $158.37 – $3,093.83 | 7 |
| Rcnstj mdfc lefrtii w/b1 grf CPT 21151 | $1,110.12 | $5,046.00 | $147.12 – $2,874.08 | 7 |
| Rcnst mdfc lfrtiii advm w/i CPT 21160 | $1,725.02 | $7,841.00 | $210.00 – $4,462.63 | 7 |
| Rcnst mdfc lfrtiii advm wo i CPT 21159 | $1,590.38 | $7,229.00 | $210.00 – $4,114.15 | 7 |
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.