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Short Term Acute Care HospitalVoluntary Non-Profit - Private

Clifton Springs Hospital And Clinic

Rochester Regional Health System · Clifton Springs, NY

2 Coulter Road, Clifton Springs, NY 14432(315) 462-9561

2 of 5

CMS star rating

203

Beds

2,429

Inpatient discharges a year

$134.4M

Net patient revenue a year

30

In-network payers

Photo 1: Doug Kerr from Albany, NY, United States, CC BY-SA 2.0, via Wikimedia Commons · Photo 2: Public domain (USGS NAIP, CONUS), via USGS National Map / USDA NAIP

About this hospital

Clifton Springs Hospital And Clinic is a 203-bed voluntary non-profit - private hospital in Clifton Springs, NY, affiliated with Rochester Regional Health System. Below you'll find publicly disclosed negotiated rates and facility details, including 30 in-network payers and 182 disclosed rate categories.

  • Disproportionate share hospital
  • 340B participant
CCN
330265
NPI
1366505463
Website
rochesterregional.org
Health system
Rochester Regional Health System
Teaching
No Medicare-funded residents
County
Ontario County
Metro area
Rochester, NY MSA
Medicare contractor
Jurisdiction K, National Government Services (13001)
In Medicare since
1966
Last CMS survey
2023

Prices for common services

The 24 services Clifton Springs Hospital And Clinic most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.

Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.

Ear, nose and throat

Correction of the nasal septum

CPT 30520

$1,759 - $6,261

from 3 insurers · median $4,801

Aetna$1,759
Insurer A*$4,801
Insurer B*$6,261
Medicare $3,573Nearby hospitals $6,87230% below nearby hospitals

68 Medicare claims in Level 4 ENT Procedures (CMS 2024)

Medicine & Surgery · Inpatient

Major lower-extremity joint replacement without MCC

MS-DRG 470

$8,314 - $22,003

from 4 insurers · median $19,612

Aetna$20,865
Insurer A*$8,314
Insurer B*est.$18,360
Insurer C*$22,003
Medicare $11,306Nearby hospitals $22,14911% below nearby hospitals

12 Medicare discharges for this DRG in CMS hospital data

Medicine & Surgery · Inpatient

Spinal fusion except cervical without MCC

MS-DRG 460

$38,432 - $40,855

from 2 insurers · median $39,643

Aetna$38,432
Insurer A*$40,855
Medicare $27,950Nearby hospitals $42,4887% below nearby hospitals

Hospital reports orthopedic surgery services to CMS

Medicine & Surgery · Inpatient

Cervical spinal fusion without CC or MCC

MS-DRG 473

$26,139 - $28,483

from 2 insurers · median $27,311

Aetna$26,139
Insurer A*$28,483
Medicare $16,162Nearby hospitals $29,0566% below nearby hospitals

Hospital reports orthopedic surgery services to CMS

How the insurers pay at Clifton Springs Hospital And Clinic

Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.

InsurerServicesMedian % of MedicareAbove nearbyBelow nearby
Insurer A*14
185%
35
Insurer B*24
146%
021
Insurer C*22
61%
019
Insurer D*1
-
00

How we chose these services: 3 appear in this hospital's own Medicare claims, 12 are common here based on CMS Medicare volume, and 9 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Clifton Springs Hospital And Clinic, or start a free trial.

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthCenteneEMI Health

More about this hospital

  • Quality

    2 of 5 stars

    • 168 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.24%)
    See quality ratings

  • Doctors and services

    Accredited by DNV

    • No Medicare-funded residents
    • 31 services
    • 376 affiliated clinicians
    See doctors and services

  • Finances

    $134.4M net patient revenue

    • Operating margin on patient care -5.6%
    • $4.2M unreimbursed and uncompensated care
    • $11.4M net income
    See finances

  • Ownership and leadership

    Private (not for profit)

    • Dustin M Riccio, chief executive
    • 340B drug pricing program participant
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Clifton Springs Hospital And Clinic in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
16-0743966Clifton Springs Hospital And Clinic52Aetna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Aspirus Health Plan, Asuris Northwest Health and 47 more1366505463 Clifton Springs Sanitarium Co1518021310 Clifton Springs Sanitarium Co1891850152 Clifton Springs Sanitarium Coand 11 more

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

2 Coulter Road, Clifton Springs, NY 14432

(315) 462-9561

Get directions

Frequently asked questions

About Clifton Springs Hospital And Clinic's rates and hospital price transparency.

How much does an MRI cost at Clifton Springs Hospital And Clinic?

For MRI brain before and after contrast (CPT 70553), published negotiated rates at Clifton Springs Hospital And Clinic range from $301 to $552 across 3 insurers. Blue Cross Blue Shield's rate is $505. The median at nearby comparable hospitals is $556. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a CT scan cost at Clifton Springs Hospital And Clinic?

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Clifton Springs Hospital And Clinic range from $314 to $552 across 2 insurers. UnitedHealthcare's rate is $552. The median at nearby comparable hospitals is $1,779. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Clifton Springs Hospital And Clinic?

For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Clifton Springs Hospital And Clinic range from $907 to $2,383 across 3 insurers. Blue Cross Blue Shield's rate is $2,383. The median at nearby comparable hospitals is $2,749. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a mammogram cost at Clifton Springs Hospital And Clinic?

For Screening mammography, bilateral (CPT 77067), published negotiated rates at Clifton Springs Hospital And Clinic range from $98 to $119 across 3 insurers. Blue Cross Blue Shield's rate is $98. The median at nearby comparable hospitals is $274. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does hip or knee replacement cost at Clifton Springs Hospital And Clinic?

For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Clifton Springs Hospital And Clinic range from $8,314 to $22,003 across 4 insurers. Aetna's rate is $20,865. The median at nearby comparable hospitals is $22,149. What a patient pays depends on their plan's deductible, coinsurance and network status.

What is Clifton Springs Hospital And Clinic's CMS star rating?

Clifton Springs Hospital And Clinic has a CMS overall hospital star rating of 2 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 73% of US hospitals.

Is Clifton Springs Hospital And Clinic a teaching hospital?

CMS reports no Medicare-funded interns or residents at Clifton Springs Hospital And Clinic for fiscal year 2027.

Does Medicare penalize Clifton Springs Hospital And Clinic for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Clifton Springs Hospital And Clinic's base inpatient payments by an estimated 0.24% in fiscal year 2027 for more readmissions than expected.

What are the most common Medicare inpatient stays at Clifton Springs Hospital And Clinic?

In 2024, the most common were heart failure and shock with mcc (24 discharges), septicemia or severe sepsis without mv >96 hours with mcc (21 discharges), alcohol, drug abuse or dependence with rehabilitation therapy (19 discharges).

What is Clifton Springs Hospital And Clinic's case mix index?

Clifton Springs Hospital And Clinic's Medicare case mix index is 1.42 for fiscal year 2027, higher than 19% of hospitals paid under the inpatient prospective payment system.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

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Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
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  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
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Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.

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  • Missing, duplicate and outdated charge lines identified
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