Teeth cleaning, adult cost in Rochester, NY — inpatient
In Rochester, NY, 4 hospitals list a cash price for routine teeth cleaning (prophylaxis), adult or teen as an inpatient: from $66.95 to $82.40, with a median of $66.95. The lowest listed price is at Clifton Springs Hospital And Clinic and 2 other hospitals. Across New York, the median is $152.50 at 22 hospitals.
Cash prices at 4 facilities across 3 cities for code D1110, as an inpatient (admitted to hospital) . Collected Sep 23, 2026; the hospital files themselves were last updated between Apr 1, 2026 and Apr 1, 2026.
Where each hospital's price falls
Each dot is one hospital's cash price on a scale from the lowest to the highest in Rochester, NY.
Hospitals, cheapest first
| Hospital | Cash price | List price | Insurers pay | Off list | File date |
|---|---|---|---|---|---|
| Clifton Springs Hospital And Clinic lowest Clifton Springs, NY · (315) 462-9561 HC PROPHYLAXIS ADULT | $66.95 | $103.00 | — | 35% | Apr 1, 2026 source file |
| Rochester General Hospital lowest Rochester, NY · (585) 922-4000 HC PROPHYLAXIS ADULT | $66.95 | $103.00 | — | 35% | Apr 1, 2026 source file |
| Newark-Wayne Community Hospital lowest Newark, NY · (315) 332-2022 HC PROPHYLAXIS ADULT | $66.95 | $103.00 | — | 35% | Apr 1, 2026 source file |
| The Unity Hospital of Rochester Rochester, NY · (585) 723-7000 HC PROPHYLAXIS ADULT | $82.40 | $103.00 | — | 20% | Apr 1, 2026 source file |
Inpatient: lowest $66.95, median $66.95, highest $82.40 — a 1.2× difference within the same market.
As an outpatient, the same code is billed by 6 facilities here, median $74.68 — that is the price to compare if you are not being admitted.
What it is
This is a routine preventive teeth cleaning that removes plaque, tartar and stains from the teeth, usually done once or twice a year. It is for people with healthy gums or mild gum inflammation.
What the price covers
The fee covers the cleaning and polishing. The dental exam, X-rays and fluoride treatment are billed under their own codes.