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 |
|---|---|---|---|---|
| Foot X-ray CPT 73630 | $122.40 | $204.00 | $35.87 – $269.80 | 17 |
| Foot X-ray (2 views, both feet) CPT 73620 | $50.40 | $84.00 | $29.26 – $269.80 | 17 |
| Forearm X-ray (both sides) CPT 73090 | $108.60 | $181.00 | $30.30 – $269.80 | 17 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $7.20 | $12.00 | $0.10 – $10.80 | 18 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $33.60 | $56.00 | $2.20 – $4.90 | 12 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $72.00 | $120.00 | $37.50 – $217.84 | 17 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $143.40 | $239.00 | $37.50 – $258.29 | 17 |
| Fresh frozen plasma thawing ea un CPT 86927 | $22.20 | $37.00 | $6.61 – $525.08 | 17 |
| Fructosamine glycated protein CPT 82985 | $36.60 | $61.00 | $12.62 – $54.90 | 18 |
| Ftl cgen abnor five anal CPT 81512 | $403.80 | $673.00 | $69.52 – $605.70 | 18 |
| Ftl cgen abnor four anal CPT 81511 | $309.00 | $515.00 | $94.37 – $463.50 | 18 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $136.20 | $227.00 | $59.05 – $325.85 | 18 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $845.00 – $2,324.39 | 12 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $0.42 | $0.52 | $0.02 – $0.22 | 11 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $3.00 | $5.00 | $0.58 – $4.50 | 12 |
| Fusion of big toe joint CPT 28750 | not published | not published | $348.12 – $9,077.48 | 14 |
| Fusion of finger joint CPT 26860 | not published | not published | $681.96 – $4,122.90 | 12 |
| Fusion of foot bones CPT 28730 | not published | not published | $416.25 – $17,150.78 | 14 |
| Fusion of foot bones CPT 28740 | not published | not published | $683.83 – $9,077.48 | 12 |
| Fusion of knuckle CPT 26850 | not published | not published | $328.12 – $9,077.48 | 14 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $16.80 | $28.00 | $1.48 – $25.20 | 11 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $137.40 | $229.00 | $14.71 – $206.10 | 11 |
| Galectin-3 CPT 82777 | $79.80 | $133.00 | $14.24 – $119.70 | 18 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $636.60 | $1,061.00 | $302.57 – $1,231.28 | 18 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $636.60 | $1,061.00 | $413.76 – $1,649.37 | 18 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $974.00 – $7,413.68 | 12 |
| Gammaglobulin iga CPT 82784 | $22.80 | $38.00 | $9.30 – $34.20 | 18 |
| Gammaglobulin ige CPT 82785 | $40.20 | $67.00 | $16.46 – $60.30 | 18 |
| Gamma glutamyltransferase CPT 82977 | $18.00 | $30.00 | $7.20 – $27.00 | 18 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $248.80 | $311.00 | $39.54 – $279.90 | 12 |
| Gardner vag dna quant CPT 87512 | $356.40 | $594.00 | $41.76 – $534.60 | 17 |
| Gastroesophageal reflux test CPT 91034 | $501.00 | $835.00 | $202.96 – $2,193.68 | 18 |
| Gastro/jejuno tube, std HCPCS B4087 | $508.20 | $847.00 | $25.36 – $124.40 | 13 |
| Gated heart multiple CPT 78473 | $2,320.80 | $3,868.00 | $286.64 – $3,481.20 | 18 |
| Gauze >16 <=48 sq in w/bordr HCPCS A6220 | $3.00 | $5.00 | $2.31 – $4.50 | 10 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $375.20 | $469.00 | $3.13 – $27.00 | 19 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $74.40 | $124.00 | $74.40 – $593.42 | 17 |
| Generator barostim neo2 2014 HCPCS C1767 | $27,562.80 | $45,938.00 | $323.38 – $1,531.80 | 13 |
| Generator emblem MRI sicd subq HCPCS C1722 | $28,865.40 | $48,109.00 | $4,148.35 – $29,177.10 | 13 |
| Genetic tstg severe inh cond CPT 81443 | $4,156.20 | $6,927.00 | $2,448.56 – $6,140.74 | 17 |
| Genome sequence analysis CPT 81425 | $4,439.40 | $7,399.00 | $4,069.45 – $12,617.75 | 17 |
| Genome sequence analysis CPT 81426 | $4,439.40 | $7,399.00 | $2,709.95 – $6,796.28 | 17 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $33.00 | $41.25 | $1.66 – $5.40 | 13 |
| Gentamicin peak therapeutic drug level CPT 80170 | $40.20 | $67.00 | $12.00 – $60.30 | 18 |
| G-esoph reflx tst w/electrod CPT 91035 | $671.40 | $1,119.00 | $438.82 – $2,193.68 | 18 |
| Ghs abscess perianal iandd CPT 46050 | $771.60 | $1,286.00 | $94.58 – $1,157.40 | 18 |
| Ghs abscess postoperative iandd complex CPT 10180 | $1,323.60 | $2,206.00 | $192.86 – $3,601.82 | 18 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $39.60 | $66.00 | $17.11 – $59.40 | 17 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $1,532.40 | $2,554.00 | $102.26 – $2,135.70 | 18 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $480.00 | $800.00 | $19.36 – $720.00 | 18 |
| Ghs aspiration bladder - needle CPT 51100 | $625.80 | $1,043.00 | $37.48 – $938.70 | 18 |
| Ghs bladder cath - complex-foley CPT 51703 | $66.00 | $110.00 | $61.48 – $196.91 | 18 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $856.80 | $1,428.00 | $43.75 – $1,285.20 | 18 |
| Ghs central line insert < age 5, failed CPT 36555 | $698.40 | $1,164.00 | $147.30 – $3,961.05 | 18 |
| Ghs change cysto/gastrost CPT 43762 | $348.60 | $581.00 | $30.90 – $749.45 | 18 |
| Ghs chemo IV push, ea addtl CPT 96411 | $108.60 | $181.00 | $48.53 – $218.09 | 16 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $516.60 | $861.00 | $35.09 – $774.90 | 18 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $102.00 | $170.00 | $45.62 – $749.45 | 18 |
| Ghs closed reduction ankle dislocation CPT 27840 | $388.80 | $648.00 | $111.88 – $749.45 | 18 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $388.80 | $648.00 | $356.40 – $2,014.07 | 17 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,254.00 | $2,090.00 | $291.88 – $2,014.07 | 18 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | not published | not published | $305.00 – $2,324.39 | 14 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $1,254.00 | $2,090.00 | $622.00 – $2,014.07 | 17 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $1,254.00 | $2,090.00 | $804.94 – $2,014.07 | 17 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $3,065.40 | $5,109.00 | $196.25 – $4,598.10 | 18 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $102.00 | $170.00 | $48.75 – $749.45 | 18 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $59.40 | $99.00 | $50.31 – $2,904.64 | 17 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $59.40 | $99.00 | $33.12 – $2,904.64 | 18 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $59.40 | $99.00 | $32.50 – $2,904.64 | 18 |
| Ghs cricothyroidotomy CPT 31605 | $476.40 | $794.00 | $210.86 – $845.00 | 18 |
| Ghs cutdown placement under 1 yr CPT 36420 | $97.20 | $162.00 | $39.13 – $394.97 | 18 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $272.40 | $454.00 | $15.21 – $408.60 | 18 |
| Ghs dislocation elbow closed treatment CPT 24600 | $102.00 | $170.00 | $102.00 – $749.45 | 18 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $493.80 | $823.00 | $27.41 – $740.70 | 17 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,357.80 | $2,263.00 | $108.28 – $2,036.70 | 18 |
| Ghs excision ingrown nail CPT 11765 | $52.20 | $87.00 | $52.20 – $2,904.64 | 18 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $137.40 | $229.00 | $87.57 – $2,904.64 | 17 |
| Ghs fb removal - incisional CPT 10121 | $1,129.80 | $1,883.00 | $81.25 – $2,904.64 | 18 |
| Ghs fb removal - non-incisional CPT 20520 | not published | not published | $78.12 – $2,904.64 | 14 |
| Ghs fish cytogen CPT 88271 | $52.80 | $88.00 | $21.42 – $79.20 | 17 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $98.40 | $164.00 | $51.19 – $147.60 | 17 |
| Ghs flow volume loop CPT 94375 | $260.40 | $434.00 | $39.34 – $954.18 | 18 |
| Ghs histoplasma antigen CPT 87385 | $29.40 | $49.00 | $13.21 – $44.10 | 17 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | $457.20 | $762.00 | $88.98 – $685.80 | 18 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $1,441.20 | $2,402.00 | $48.12 – $2,578.00 | 18 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,463.40 | $2,439.00 | $135.62 – $2,195.10 | 18 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $89.40 | $149.00 | $45.00 – $2,904.64 | 18 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $118.80 | $198.00 | $51.25 – $2,904.64 | 18 |
| Ghs init tx 1st degree burn CPT 16000 | $56.40 | $94.00 | $22.50 – $2,904.64 | 18 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $1,122.60 | $1,871.00 | $91.88 – $1,683.90 | 18 |
| Ghs insertion of needle - bone CPT 36680 | $90.60 | $151.00 | $49.15 – $1,222.75 | 18 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $83.40 | $139.00 | $83.40 – $1,033.67 | 18 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $217.80 | $363.00 | $115.00 – $1,033.67 | 18 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $3,872.40 | $6,454.00 | $115.00 – $5,808.60 | 18 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $289.20 | $482.00 | $227.32 – $749.45 | 17 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $91.80 | $153.00 | $19.64 – $141.37 | 17 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $1,020.00 | $1,700.00 | $425.00 – $1,530.00 | 12 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $1,020.00 | $1,700.00 | $425.00 – $1,530.00 | 12 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $1,020.00 | $1,700.00 | $425.00 – $1,530.00 | 13 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $2,286.00 | $3,810.00 | $278.87 – $3,429.00 | 17 |
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.