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 |
|---|---|---|---|---|
| Hemoglobin plasma CPT 83051 | $66.00 | $110.00 | $3.50 – $99.00 | 18 |
| Hemolysins and agglutinins incubated CPT 86941 | $144.60 | $241.00 | $12.11 – $216.90 | 18 |
| Hemophilus influenza antibdy CPT 86684 | $150.60 | $251.00 | $15.84 – $225.90 | 18 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | not published | not published | $305.58 – $3,484.74 | 14 |
| Heparin assay CPT 85520 | $31.80 | $53.00 | $6.53 – $47.70 | 18 |
| Heparin bolus from bag HCPCS J1644 | $4.80 | $6.00 | $0.21 – $0.90 | 12 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $1.40 | $1.75 | $0.02 – $0.90 | 12 |
| Hepatitis a antibody igm CPT 86709 | $27.60 | $46.00 | $11.26 – $41.40 | 18 |
| Hepatitis b core antibody igm CPT 86705 | $28.80 | $48.00 | $11.77 – $43.20 | 18 |
| Hepatitis b core antibody total CPT 86704 | $29.40 | $49.00 | $12.05 – $44.10 | 18 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,300.20 | $2,167.00 | $12.50 – $1,517.40 | 18 |
| Hepatitis b surface antibody CPT 86706 | $25.80 | $43.00 | $10.74 – $38.70 | 18 |
| Hepatitis c antibody CPT 86803 | $102.00 | $170.00 | $14.27 – $153.00 | 18 |
| Hereditary colon ca dsordrs CPT 81435 | $3,394.80 | $5,658.00 | $602.45 – $5,092.20 | 18 |
| Hernia Repair (Inguinal) CPT 49505 | $5,440.80 | $9,068.00 | $396.88 – $8,161.20 | 18 |
| Herpes simplex type 1 antibody igg CPT 86695 | $58.80 | $98.00 | $13.19 – $88.20 | 18 |
| Herpes simplex type 2 antibody igg CPT 86696 | $58.80 | $98.00 | $19.35 – $88.20 | 18 |
| Herpes simplex virus isolation CPT 87255 | $83.40 | $139.00 | $30.05 – $125.10 | 18 |
| Heterophile antibodies screening CPT 86308 | $12.60 | $21.00 | $5.18 – $18.90 | 18 |
| Hexa gene CPT 81255 | $1,335.60 | $2,226.00 | $51.45 – $2,003.40 | 18 |
| Hhv-6 dna quant CPT 87533 | $568.20 | $947.00 | $41.76 – $852.30 | 17 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $136.20 | $227.00 | $37.52 – $325.85 | 18 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $250.20 | $417.00 | $46.36 – $375.30 | 18 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $75.60 | $126.00 | $33.81 – $269.80 | 17 |
| Hip X-ray CPT 73502 | $130.80 | $218.00 | $48.79 – $269.80 | 17 |
| Histamine CPT 83088 | $108.00 | $180.00 | $13.00 – $162.00 | 18 |
| Hla class i high defin qual CPT 86832 | $388.20 | $647.00 | $133.14 – $811.93 | 18 |
| Hla class ii high defin qual CPT 86833 | $388.20 | $647.00 | $121.04 – $817.07 | 18 |
| Hla i & ii typing lr CPT 81370 | $3,155.40 | $5,259.00 | $402.12 – $4,733.10 | 18 |
| Hla i low res one antigen equiv ea CPT 81374 | $790.20 | $1,317.00 | $74.33 – $1,162.80 | 18 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $518.40 | $864.00 | $103.22 – $666.00 | 18 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $0.60 | $1.00 | $0.21 – $0.90 | 12 |
| Ho flex frejka w/cov pre cst HCPCS L1600 | $34.80 | $58.00 | $11.02 – $52.20 | 11 |
| Home sleep test/type 2 porta HCPCS G0398 | $1,159.80 | $1,933.00 | $163.27 – $1,739.70 | 17 |
| Homocysteine CPT 83090 | $41.40 | $69.00 | $17.42 – $62.10 | 18 |
| Homovanillic acid (hva) CPT 83150 | $111.60 | $186.00 | $7.50 – $167.40 | 18 |
| Hpv low-risk types CPT 87623 | $115.80 | $193.00 | $35.09 – $173.70 | 18 |
| Hpv types 16 & 18 only CPT 87625 | $96.00 | $160.00 | $37.82 – $144.00 | 18 |
| H pylori (c-13) breath CPT 83013 | $242.40 | $404.00 | $60.10 – $363.60 | 18 |
| Htt gene detc abnor alleles CPT 81271 | $1,333.80 | $2,223.00 | $137.00 – $2,000.70 | 17 |
| Human epididymis protein 4 (he4) CPT 86305 | $265.20 | $442.00 | $20.81 – $397.80 | 18 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $3.00 | $3.75 | $0.35 – $53.36 | 13 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $12.80 | $16.00 | $5.60 – $15.54 | 12 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | $3.60 | $6.00 | $0.55 – $0.90 | 10 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $28.20 | $43.00 | $12.60 – $22.88 | 13 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $2.00 | $2.50 | $0.03 – $3.24 | 11 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $1,166.40 | $1,458.00 | $0.25 – $0.90 | 10 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $11.40 | $19.00 | $4.20 – $15.30 | 12 |
| Hysterosalpingography s&i CPT 74740 | $369.60 | $616.00 | $85.59 – $740.68 | 17 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $394.88 – $6,272.71 | 14 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $819.84 – $4,040.20 | 12 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $217.84 – $4,040.20 | 14 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $974.00 – $6,272.71 | 12 |
| Hysterotomy abdominal 59100 CPT 59100 | $3,761.40 | $6,269.00 | $836.26 – $6,212.39 | 17 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $90.60 | $151.00 | $83.05 – $135.90 | 11 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $165.00 | $275.00 | $25.43 – $247.50 | 12 |
| Icatibant injection HCPCS J1744 | $1,249.60 | $1,562.00 | $130.39 – $1,405.80 | 17 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $33,717.60 | $56,196.00 | $5,200.00 – $35,674.20 | 12 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $42,449.40 | $70,749.00 | $9,762.77 – $46,244.70 | 13 |
| Icd crtp serena MRI HCPCS C2621 | $35,393.40 | $58,989.00 | $3,469.40 – $16,434.00 | 12 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $2,850.60 | $4,751.00 | $110.62 – $4,275.90 | 18 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $2,992.80 | $4,988.00 | $622.00 – $4,489.20 | 17 |
| Idursulfase injection HCPCS J1743 | $7,538.40 | $9,423.00 | $533.91 – $8,480.70 | 17 |
| Igh@ var region somatic mutation analy CPT 81263 | $1,313.40 | $2,189.00 | $294.52 – $1,970.10 | 18 |
| Igk rearrangeabn clonal pop CPT 81264 | $919.80 | $1,533.00 | $162.57 – $1,379.70 | 18 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $72.00 | $120.00 | $51.11 – $108.00 | 12 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $128.40 | $214.00 | $88.49 – $1,102.25 | 18 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $189.60 | $316.00 | $12.02 – $525.08 | 18 |
| Iliac/fem angio cath insert HCPCS G0278 | $5,502.00 | $9,170.00 | $11.83 – $8,253.00 | 12 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $106.20 | $177.00 | $33.63 – $159.30 | 11 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $114.60 | $191.00 | $9.12 – $43.20 | 11 |
| Immune complex assay CPT 86332 | $165.00 | $275.00 | $24.37 – $247.50 | 18 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $192.00 | $240.00 | $39.17 – $155.70 | 20 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $51.00 | $85.00 | $20.81 – $76.50 | 18 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $51.00 | $85.00 | $20.81 – $76.50 | 18 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $52.80 | $88.00 | $8.00 – $79.20 | 18 |
| Immunodiffusion nes CPT 86329 | $226.20 | $377.00 | $14.05 – $339.30 | 18 |
| Immunofixation electrophoresis serum CPT 86334 | $54.60 | $91.00 | $22.34 – $81.90 | 18 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $102.00 | $170.00 | $19.64 – $153.00 | 12 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $125.40 | $209.00 | $8.78 – $525.08 | 18 |
| Immunology procedure CPT 86849 | $43.20 | $72.00 | $18.00 – $64.80 | 10 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $5,874.00 | $9,790.00 | $134.71 – $638.10 | 13 |
| Implant neuroelectrodes CPT 64561 | not published | not published | $136.02 – $8,680.29 | 15 |
| Implant ureth bulk agent HCPCS L8606 | $919.80 | $1,533.00 | $133.43 – $1,379.70 | 11 |
| Impl neurostim electr perc CPT 63650 | $4,007.40 | $6,679.00 | $466.19 – $8,680.29 | 21 |
| Imported lipodox inj HCPCS Q2049 | $1,459.80 | $2,433.00 | $528.86 – $2,189.70 | 15 |
| In-111 autol wbc diag per dose HCPCS A9570 | $4,486.80 | $7,478.00 | $1,031.39 – $6,730.20 | 16 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $139.20 | $232.00 | $127.60 – $1,937.70 | 16 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $638.40 | $1,064.00 | $585.20 – $1,793.88 | 16 |
| Incise perq finger tendon 26060 CPT 26060 | not published | not published | $80.00 – $2,033.63 | 14 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $843.60 | $1,406.00 | $29.38 – $2,904.64 | 18 |
| Incision of breast lesion CPT 19020 | $1,223.40 | $2,039.00 | $91.25 – $2,039.03 | 18 |
| Incision of foot tendon 28234 CPT 28234 | $3,037.20 | $5,062.00 | $140.62 – $4,555.80 | 18 |
| Incision of metatarsal CPT 28306 | not published | not published | $384.38 – $9,077.48 | 14 |
| Incision of metatarsal CPT 28308 | not published | not published | $642.83 – $4,122.90 | 12 |
| Incision of tendon sheath CPT 25000 | not published | not published | $275.62 – $2,033.63 | 14 |
| Incision of urethra CPT 53020 | not published | not published | $56.25 – $2,603.03 | 14 |
| Incision tendon sheath CPT 26055 | not published | not published | $250.00 – $2,033.63 | 14 |
| Incisn of toe tndn CPT 28010 | $1,864.80 | $3,108.00 | $163.75 – $2,904.64 | 18 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $592.53 – $4,040.20 | 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.