UPMC Chautauqua
207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $250.20 | $417.00 | $17.50 – $375.30 | 18 |
| 17-hydroxypregnenolone CPT 84143 | $269.40 | $449.00 | $22.81 – $404.10 | 18 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $1,747.80 | $2,913.00 | $965.31 – $2,621.70 | 16 |
| 2nd order venous cath CPT 36012 | $8,958.00 | $14,930.00 | $77.10 – $13,437.00 | 13 |
| 3-d radiotherapy plan CPT 77295 | $2,010.00 | $3,350.00 | $427.58 – $3,015.00 | 13 |
| 3d recon without postprocess indpndt CPT 76376 | $82.80 | $138.00 | $22.21 – $124.20 | 11 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $4.80 | $6.00 | $2.10 – $5.40 | 11 |
| 5% dextrose with potassium HCPCS S5012 | $49.00 | $61.25 | $4.62 – $55.12 | 11 |
| 5' nucleotidase - sendout CPT 83915 | $243.00 | $405.00 | $11.15 – $364.50 | 18 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $130.80 | $218.00 | $6.15 – $196.20 | 12 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $110.40 | $138.00 | $36.17 – $124.20 | 20 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $30.60 | $51.00 | $12.01 – $45.90 | 18 |
| Abd/low ext cath 1st CPT 36245 | $80.40 | $134.00 | $73.70 – $194.15 | 12 |
| Abd/low ext cath 2nd CPT 36246 | $80.40 | $134.00 | $73.70 – $207.65 | 12 |
| Abd/low ext cath 3rd CPT 36247 | $80.40 | $134.00 | $73.70 – $246.02 | 12 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $294.60 | $491.00 | $105.64 – $441.90 | 18 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $795.00 | $1,325.00 | $217.51 – $1,192.50 | 18 |
| Abdominal CT scan (with contrast) CPT 74160 | $669.60 | $1,116.00 | $186.31 – $1,004.40 | 18 |
| Abdominal CT scan (without contrast) CPT 74150 | $507.00 | $845.00 | $129.93 – $760.50 | 18 |
| Abdominal MRI (with and without contrast) CPT 74183 | $978.60 | $1,631.00 | $373.87 – $1,467.90 | 18 |
| Abdominal MRI (with contrast) CPT 74182 | $739.80 | $1,233.00 | $334.11 – $1,109.70 | 18 |
| Abdominal MRI (without contrast) CPT 74181 | $684.00 | $1,140.00 | $215.14 – $1,026.00 | 18 |
| Abdominal paracentesis w/image guidance CPT 49083 | $373.80 | $623.00 | $88.60 – $1,179.90 | 18 |
| Abdominal Ultrasound (complete) CPT 76700 | $181.80 | $303.00 | $119.09 – $325.85 | 18 |
| Abdominal Ultrasound (limited) CPT 76705 | $181.80 | $303.00 | $78.12 – $325.85 | 18 |
| Abdominal X-ray (2 views) CPT 74019 | $181.80 | $303.00 | $32.27 – $325.85 | 18 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $134.40 | $224.00 | $48.40 – $325.85 | 18 |
| Abdominal X-ray (single view) CPT 74018 | $122.40 | $204.00 | $26.43 – $269.80 | 18 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $355.80 | $593.00 | $61.18 – $1,179.90 | 18 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $47.50 – $1,882.25 | 14 |
| Ablation cryo abd perit om CPT 49999 | $84.60 | $141.00 | $77.55 – $2,872.87 | 16 |
| Ablation of upper extremity nerves rf CPT 64999 | $159.60 | $266.00 | $146.30 – $904.52 | 16 |
| Abobotulinumtoxina HCPCS J0586 | $64.60 | $80.75 | $8.49 – $72.00 | 17 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,914.60 | $3,191.00 | $161.92 – $2,871.90 | 18 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $1.20 | $1.50 | $0.06 – $0.90 | 12 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $115.20 | $144.00 | $19.84 – $129.60 | 12 |
| Acetylcholine receptor modulating antibody CPT 86043 | $31.20 | $52.00 | $9.64 – $46.80 | 16 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $258.00 | $430.00 | $0.39 – $5.40 | 12 |
| Acetylcysteine non-comp unit HCPCS J7608 | $42.20 | $52.75 | $0.67 – $24.98 | 11 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $189.00 | $315.00 | $110.33 – $394.89 | 18 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $20.40 | $34.00 | $5.58 – $36.48 | 18 |
| Acoustic immitance testing CPT 92570 | $90.60 | $151.00 | $29.31 – $479.44 | 18 |
| Acute hepatitis panel CPT 80074 | $117.00 | $195.00 | $47.63 – $175.50 | 18 |
| Acyclovir 400 mg tablet HCPCS J8499 | $13.20 | $22.00 | $5.50 – $19.80 | 10 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $370.80 | $618.00 | $0.04 – $0.90 | 12 |
| #acylcarnitineprfl CPT 82017 | $284.40 | $474.00 | $16.87 – $426.60 | 17 |
| Adapter b 8 channel 10cm HCPCS C1883 | $536.40 | $894.00 | $29.70 – $804.60 | 13 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $155.40 | $259.00 | $0.43 – $9.00 | 12 |
| Adenovirus antibody,serum - quest CPT 86603 | $343.80 | $573.00 | $12.87 – $515.70 | 18 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $400.00 | $500.00 | $0.24 – $4.27 | 13 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $205.20 | $342.00 | $27.71 – $307.80 | 16 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $225.00 | $375.00 | $58.20 – $337.50 | 16 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $266.40 | $444.00 | $121.97 – $1,016.38 | 17 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $183.00 | $305.00 | $84.59 – $1,016.38 | 17 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $85.20 | $142.00 | $24.92 – $218.09 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $124.20 | $207.00 | $45.74 – $218.09 | 16 |
| Administration immunization each additional vaccine CPT 90472 | $12.00 | $20.00 | $10.40 – $18.00 | 11 |
| Administration vaccine hepatitis b HCPCS G0010 | $12.00 | $20.00 | $11.00 – $141.37 | 17 |
| Administration vaccine influenza virus HCPCS G0008 | $12.00 | $20.00 | $12.00 – $58.06 | 21 |
| Administration vaccine pneumococcal HCPCS G0009 | $12.00 | $20.00 | $12.00 – $58.06 | 21 |
| Adrenalin epinephrine inject HCPCS J0171 | $176.40 | $294.00 | $0.72 – $2.70 | 12 |
| Aep hearing status deter i&r CPT 92651 | $200.40 | $334.00 | $87.60 – $954.18 | 18 |
| Aep neurodiagnostic i&r CPT 92653 | $373.80 | $623.00 | $84.39 – $954.18 | 18 |
| Aep thrshld est mlt freq i&r CPT 92652 | $373.80 | $623.00 | $115.15 – $954.18 | 18 |
| _afb id by dna probe rflx ast CPT 87149 | $142.20 | $237.00 | $20.05 – $213.30 | 18 |
| #afb mycobacteria suscep. #1 CPT 87190 | $85.20 | $142.00 | $7.00 – $127.80 | 18 |
| Air conduction bilat CPT 92552 | $58.80 | $98.00 | $10.00 – $394.97 | 18 |
| Albumin body fluid quantitative each specimen CPT 82042 | $18.00 | $30.00 | $7.78 – $25.20 | 17 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $408.60 | $681.00 | $51.20 – $305.10 | 12 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $266.40 | $333.00 | $51.20 – $299.70 | 17 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $13.80 | $23.00 | $5.78 – $20.70 | 18 |
| Albumin serum plasma or whole blood CPT 82040 | $18.00 | $30.00 | $3.65 – $27.00 | 18 |
| Albuterol ipratrop non-comp HCPCS J7620 | $1.60 | $2.00 | $0.09 – $1.80 | 11 |
| Albuterol non-comp con HCPCS J7611 | $0.80 | $1.00 | $0.18 – $0.90 | 11 |
| Albuterol non-comp unit HCPCS J7613 | $0.80 | $1.00 | $0.06 – $0.90 | 11 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | $70.20 | $117.00 | $14.64 – $93.60 | 10 |
| Alkaline phosphatase CPT 84075 | $12.60 | $21.00 | $5.18 – $18.90 | 18 |
| Allergen alpha lactalbumin ige CPT 86008 | $12.60 | $21.00 | $12.60 – $44.97 | 18 |
| Allergen egg white ige CPT 86003 | $12.60 | $21.00 | $5.22 – $18.90 | 18 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $9,274.20 | $15,457.00 | $144.48 – $13,911.30 | 13 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $36.00 | $45.00 | $4.50 – $40.50 | 17 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $1,424.40 | $2,374.00 | $33.05 – $2,136.60 | 18 |
| Alpha-fetoprotein amniotic CPT 82106 | $183.00 | $305.00 | $17.00 – $274.50 | 18 |
| Alpha-fetoprotein tumor marker CPT 82105 | $103.80 | $173.00 | $16.77 – $155.70 | 18 |
| Alprostadil for injection HCPCS J0270 | $166.80 | $278.00 | $0.55 – $10.05 | 12 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $348.80 | $436.00 | $73.78 – $252.00 | 21 |
| Alt/sgpt CPT 84460 | $18.00 | $30.00 | $5.30 – $27.00 | 18 |
| Aluminum - quest CPT 82108 | $187.20 | $312.00 | $25.48 – $264.60 | 18 |
| Ambl bp mntr w/sw a/r CPT 93788 | $79.80 | $133.00 | $5.57 – $394.97 | 17 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $41.80 | $52.25 | $0.63 – $8.10 | 13 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $13.60 | $17.00 | $1.71 – $15.30 | 10 |
| Aminolevulinic acid delta CPT 82135 | $121.20 | $202.00 | $12.00 – $181.80 | 18 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $19.60 | $24.50 | $3.60 – $10.34 | 12 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $144.00 | $240.00 | $0.40 – $0.90 | 12 |
| Ammonia CPT 82140 | $36.00 | $60.00 | $5.00 – $54.00 | 18 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $5,440.80 | $9,068.00 | $365.00 – $8,161.20 | 18 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $138.40 | $173.00 | $38.71 – $155.70 | 12 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $108.80 | $136.00 | $21.48 – $122.40 | 17 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $13.80 | $17.25 | $0.55 – $3.60 | 12 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $26.60 | $33.25 | $1.39 – $29.70 | 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.