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 |
|---|---|---|---|---|
| Lipoprotein blood high res frac & quant CPT 83701 | $361.80 | $603.00 | $24.03 – $542.70 | 18 |
| Lipoprotein blood quant CPT 83704 | $202.80 | $338.00 | $27.03 – $304.20 | 17 |
| Lipoprotein direct measurement hdl CPT 83718 | $19.80 | $33.00 | $7.00 – $29.70 | 18 |
| Lipoprotein direct measurement ldl CPT 83721 | $23.40 | $39.00 | $10.50 – $35.10 | 18 |
| Lip surgery procedure CPT 40799 | $97.80 | $163.00 | $89.65 – $711.57 | 16 |
| Lithium therapeutic drug level CPT 80178 | $16.20 | $27.00 | $6.61 – $24.30 | 18 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $972.60 | $1,621.00 | $140.95 – $1,458.90 | 16 |
| Liver Function Test CPT 80076 | $48.00 | $80.00 | $8.17 – $72.00 | 18 |
| Liver/spleen imag static only CPT 78215 | $516.60 | $861.00 | $86.58 – $1,231.28 | 18 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.60 | $1.00 | $0.60 – $1.55 | 12 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $388.20 | $647.00 | $185.95 – $582.30 | 17 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $11.00 | $13.75 | $0.94 – $11.70 | 13 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $600.60 | $1,001.00 | $129.93 – $900.90 | 17 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $794.40 | $1,324.00 | $215.45 – $1,191.60 | 18 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $669.60 | $1,116.00 | $183.59 – $1,094.32 | 18 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $507.00 | $845.00 | $129.93 – $760.50 | 18 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $975.00 | $1,625.00 | $351.19 – $1,462.50 | 18 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $736.20 | $1,227.00 | $297.75 – $1,104.30 | 18 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $682.20 | $1,137.00 | $209.89 – $1,023.30 | 18 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $158.40 | $264.00 | $40.66 – $325.85 | 18 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $240.00 | $400.00 | $45.77 – $360.00 | 18 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $242.40 | $404.00 | $43.75 – $363.60 | 18 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $122.40 | $204.00 | $32.73 – $269.80 | 17 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $300.00 | $500.00 | $23.75 – $954.18 | 18 |
| Lung function test (mbc/mvv) CPT 94200 | $67.20 | $112.00 | $11.25 – $182.02 | 18 |
| Lung Function Test (Spirometry) CPT 94010 | $150.60 | $251.00 | $18.75 – $479.44 | 18 |
| Lung perfusion imaging CPT 78580 | $516.60 | $861.00 | $98.75 – $1,231.28 | 18 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $377.40 | $629.00 | $181.26 – $566.10 | 17 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $87.60 | $146.00 | $37.32 – $131.40 | 17 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $543.60 | $906.00 | $216.75 – $815.40 | 16 |
| Lymphatics/lymph node imaging CPT 78195 | $622.80 | $1,038.00 | $225.00 – $1,649.37 | 18 |
| Lymphocyte transformation mitogen CPT 86353 | $282.60 | $471.00 | $49.03 – $423.90 | 18 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $113.66 – $2,603.03 | 14 |
| Macroscopic exam arthropod CPT 87168 | $34.20 | $57.00 | $4.27 – $51.30 | 17 |
| Macroscopic exam parasite CPT 87169 | $10.20 | $17.00 | $4.31 – $15.30 | 17 |
| Magnesium CPT 83735 | $16.80 | $28.00 | $6.70 – $24.30 | 18 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $144.60 | $241.00 | $0.48 – $0.90 | 12 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $61.20 | $102.00 | $1.50 – $5.40 | 12 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $94.80 | $158.00 | $43.46 – $142.20 | 17 |
| Marker biop eviva buckle ss HCPCS A4648 | $483.60 | $806.00 | $106.23 – $574.20 | 13 |
| Mastectomy partial CPT 19301 | not published | not published | $517.99 – $4,865.84 | 12 |
| Mastoids complete CPT 70130 | $193.80 | $323.00 | $56.02 – $325.85 | 17 |
| M.avium-intra dna amp prob CPT 87561 | $371.40 | $619.00 | $35.09 – $557.10 | 17 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $90.60 | $151.00 | $14.46 – $135.90 | 18 |
| Mayo aathr protein s free CPT 85306 | $37.20 | $62.00 | $15.32 – $55.80 | 18 |
| Mayo activated protein c resistance assay CPT 85307 | $37.20 | $62.00 | $15.32 – $55.80 | 18 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $197.40 | $329.00 | $38.57 – $296.10 | 17 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $36.00 | $60.00 | $14.78 – $54.00 | 17 |
| Mayo alpha 1 antitrypsin CPT 82103 | $32.40 | $54.00 | $13.44 – $48.60 | 18 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $229.20 | $382.00 | $11.00 – $343.80 | 18 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,227.60 | $2,046.00 | $121.63 – $726.30 | 17 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,606.20 | $2,677.00 | $91.66 – $726.30 | 18 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $2,403.60 | $4,006.00 | $109.60 – $1,095.30 | 18 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $13,585.20 | $22,642.00 | $1,160.00 – $20,377.80 | 17 |
| Mayo androstenedione CPT 82157 | $106.20 | $177.00 | $25.00 – $159.30 | 18 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $36.00 | $60.00 | $14.60 – $54.00 | 18 |
| Mayo antithrombin iii antigen CPT 85301 | $145.80 | $243.00 | $10.81 – $218.70 | 18 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $36.60 | $61.00 | $15.05 – $54.90 | 18 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $85.80 | $143.00 | $28.07 – $128.70 | 18 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $24.60 | $41.00 | $10.18 – $36.90 | 18 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $31.20 | $52.00 | $12.90 – $46.80 | 18 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $34.20 | $57.00 | $13.19 – $51.30 | 18 |
| Mayo brcmg brucella antibody igm CPT 86622 | $21.60 | $36.00 | $8.93 – $32.40 | 18 |
| Mayo c1 esterase inhibitor CPT 83883 | $33.00 | $55.00 | $13.60 – $49.50 | 17 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $231.00 | $385.00 | $16.87 – $346.50 | 17 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $198.60 | $331.00 | $26.78 – $297.90 | 18 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $1,576.80 | $2,628.00 | $122.22 – $2,365.20 | 18 |
| Mayo ceruloplasmin CPT 82390 | $25.80 | $43.00 | $10.00 – $38.70 | 18 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $121.20 | $202.00 | $14.12 – $181.80 | 17 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $54.60 | $91.00 | $12.88 – $81.90 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $32.40 | $54.00 | $9.88 – $48.60 | 18 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $54.60 | $91.00 | $12.68 – $81.90 | 18 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $380.40 | $634.00 | $64.89 – $570.60 | 18 |
| Mayo chromium CPT 82495 | $30.60 | $51.00 | $6.00 – $50.86 | 18 |
| Mayo coccidioides antibody CPT 86635 | $45.00 | $75.00 | $11.47 – $67.50 | 18 |
| Mayo cocou cortisone urine CPT 82542 | $44.40 | $74.00 | $19.27 – $66.60 | 18 |
| Mayo cortisol free CPT 82530 | $79.80 | $133.00 | $16.71 – $119.70 | 18 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $123.00 | $205.00 | $11.16 – $184.50 | 17 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $180.00 | $300.00 | $12.12 – $270.00 | 18 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $75.60 | $126.00 | $13.25 – $113.40 | 18 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $89.40 | $149.00 | $21.00 – $134.10 | 18 |
| Mayo dihydrotestosterone CPT 82642 | $105.00 | $175.00 | $29.28 – $157.50 | 17 |
| Mayo efpo chloride stool CPT 82438 | $12.00 | $20.00 | $3.00 – $18.00 | 18 |
| Mayo estriol CPT 82677 | $142.20 | $237.00 | $17.50 – $213.30 | 18 |
| Mayo estrone CPT 82679 | $117.00 | $195.00 | $13.00 – $175.50 | 18 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $48.60 | $81.00 | $13.00 – $72.90 | 18 |
| Mayo everolimus therapeutic drug level CPT 80169 | $67.20 | $112.00 | $13.73 – $100.80 | 18 |
| Mayo factor ii CPT 85210 | $52.80 | $88.00 | $4.00 – $79.20 | 18 |
| Mayo factor vii CPT 85230 | $43.80 | $73.00 | $5.00 – $65.70 | 18 |
| Mayo factor viii vw factor antigen CPT 85246 | $56.40 | $94.00 | $22.94 – $84.60 | 18 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $56.40 | $94.00 | $22.94 – $84.60 | 18 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $56.40 | $94.00 | $22.94 – $84.60 | 18 |
| Mayo factor x CPT 85260 | $83.40 | $139.00 | $12.00 – $125.10 | 18 |
| Mayo factor xi CPT 85270 | $219.60 | $366.00 | $12.00 – $329.40 | 18 |
| Mayo fat/lipids feces quantitative CPT 82710 | $265.80 | $443.00 | $4.02 – $398.70 | 18 |
| Mayo fbl culture fungi blood CPT 87103 | $21.60 | $36.00 | $12.46 – $51.31 | 18 |
| Mayo ffspg allergen clam igg CPT 86001 | $39.60 | $66.00 | $5.78 – $59.40 | 18 |
| Mayo fibrinogen antigen CPT 85385 | $128.40 | $214.00 | $9.91 – $192.60 | 18 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $67.20 | $112.00 | $14.47 – $100.80 | 18 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $8,483.40 | $14,139.00 | $237.50 – $855.00 | 10 |
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.