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 |
|---|---|---|---|---|
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $2.80 | $3.50 | $0.13 – $6.23 | 16 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $4.40 | $5.50 | $0.57 – $4.50 | 13 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $9.00 | $15.00 | $0.12 – $13.50 | 10 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $0.20 | $0.25 | $0.03 – $0.23 | 10 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $7.00 | $8.75 | $0.26 – $3.60 | 12 |
| Microdissection manual CPT 88381 | $616.80 | $1,028.00 | $85.52 – $925.20 | 11 |
| Microsatellite instability CPT 81301 | $1,389.00 | $2,315.00 | $316.03 – $2,083.50 | 18 |
| Mid and Lower Back (Thoracolumbar Spine) X-ray CPT 72080 | $66.60 | $111.00 | $33.12 – $269.80 | 18 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $1.20 | $1.50 | $0.15 – $0.90 | 13 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $29.80 | $37.25 | $1.45 – $18.00 | 12 |
| Minoxidil, 10 mg HCPCS S0139 | $1.20 | $1.50 | $0.10 – $0.23 | 11 |
| Misoprostol, oral, 200 mcg HCPCS S0191 | $1.00 | $1.25 | $0.69 – $1.12 | 10 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $464.80 | $581.00 | $20.35 – $83.70 | 17 |
| Mlh1 gene CPT 81288 | $1,123.80 | $1,873.00 | $192.32 – $1,685.70 | 17 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $12,370.80 | $20,618.00 | $2,374.62 – $11,248.20 | 13 |
| Mopath procedure level 1 CPT 81400 | $731.40 | $1,219.00 | $63.96 – $904.50 | 17 |
| Mopath procedure level 3 CPT 81402 | $1,288.80 | $2,148.00 | $150.33 – $1,806.30 | 17 |
| Mopath procedure level 5 CPT 81404 | $4,547.40 | $7,579.00 | $274.83 – $1,245.60 | 17 |
| Mopath procedure level 6 CPT 81405 | $4,999.80 | $8,333.00 | $301.35 – $855.00 | 17 |
| Mopath procedure level 7 CPT 81406 | $4,341.60 | $7,236.00 | $85.80 – $709.43 | 17 |
| Mopath procedure level 8 CPT 81407 | $1,687.80 | $2,813.00 | $522.50 – $2,122.36 | 17 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $15.00 | $18.75 | $1.60 – $5.40 | 13 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $60.20 | $75.25 | $9.00 – $16.71 | 12 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $342.00 | $570.00 | $153.91 – $525.08 | 18 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $574.80 | $958.00 | $15.26 – $1,102.25 | 18 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $138.60 | $231.00 | $31.91 – $525.08 | 18 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $378.60 | $631.00 | $161.78 – $567.90 | 18 |
| Mpl gene analysis common variants CPT 81338 | $1,227.60 | $2,046.00 | $150.33 – $1,841.40 | 17 |
| MRA chest wo IV cont HCPCS C8910 | $930.00 | $1,550.00 | $295.34 – $1,395.00 | 16 |
| MRA chest wwo IV cont HCPCS C8911 | $930.00 | $1,550.00 | $436.35 – $1,395.00 | 16 |
| MRA without cont, abd HCPCS C8901 | $923.40 | $1,539.00 | $295.34 – $1,385.10 | 16 |
| MRA without fol w/cont, abd HCPCS C8902 | $923.40 | $1,539.00 | $436.35 – $1,385.10 | 16 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | $924.00 | $1,540.00 | $436.35 – $1,386.00 | 16 |
| MRA without fol w/cont, pelvis HCPCS C8920 | $922.20 | $1,537.00 | $436.35 – $1,383.30 | 16 |
| MRI breast without cont bi CPT 77047 | $1,793.40 | $2,989.00 | $240.97 – $2,690.10 | 18 |
| MRI chest without contrast CPT 71550 | $684.60 | $1,141.00 | $295.34 – $1,026.90 | 18 |
| MRI chest without & w/contrast CPT 71552 | $981.60 | $1,636.00 | $436.35 – $1,472.40 | 18 |
| MRI loex nonjt w IV cont CPT 73719 | $739.80 | $1,233.00 | $289.86 – $1,109.70 | 17 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $685.80 | $1,143.00 | $246.19 – $1,028.70 | 17 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $979.80 | $1,633.00 | $373.09 – $1,469.70 | 17 |
| MRI orbit fac&nck w IV cont CPT 70542 | $697.80 | $1,163.00 | $296.18 – $1,094.32 | 18 |
| MRI tmj CPT 70336 | $2,766.60 | $4,611.00 | $293.87 – $4,149.90 | 18 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $685.80 | $1,143.00 | $295.34 – $1,028.70 | 17 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $982.80 | $1,638.00 | $436.35 – $1,474.20 | 17 |
| MRI without fol w/cont, breast HCPCS C8908 | $1,793.40 | $2,989.00 | $436.35 – $2,690.10 | 16 |
| MRI without fol w/cont, brst, un HCPCS C8905 | $1,422.00 | $2,370.00 | $436.35 – $2,133.00 | 16 |
| Mr safety determination physician/other qhp CPT 76016 | $152.40 | $254.00 | $107.58 – $269.80 | 15 |
| Mr safety implant elec prepj CPT 76018 | $159.00 | $265.00 | $112.15 – $281.26 | 15 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $18.00 | $30.00 | $16.50 – $27.00 | 10 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $42.00 | $70.00 | $29.92 – $75.04 | 15 |
| Mr sfty med physics xm cstmz CPT 76017 | $418.80 | $698.00 | $295.34 – $740.68 | 15 |
| Mthfr gene analy common variants CPT 81291 | $108.00 | $180.00 | $65.34 – $163.87 | 17 |
| Mucopolysaccharides CPT 83864 | $307.80 | $513.00 | $18.00 – $461.70 | 18 |
| Mumps antibody igg CPT 86735 | $37.80 | $63.00 | $13.05 – $56.70 | 17 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $9.60 | $12.00 | $0.16 – $0.90 | 11 |
| Mycophenolic acid HCPCS J7518 | $7.00 | $8.75 | $0.34 – $7.20 | 11 |
| Mycoplasma antibody igm CPT 86738 | $32.40 | $54.00 | $13.24 – $48.60 | 18 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $890.40 | $1,484.00 | $175.40 – $1,335.60 | 17 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | not published | not published | $77.10 – $1,003.92 | 14 |
| Myelography via inj w/s&i cervical CPT 62302 | $581.40 | $969.00 | $77.10 – $994.27 | 18 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $581.40 | $969.00 | $77.10 – $994.27 | 18 |
| Myelography via inj w/s&i thoracic CPT 62303 | $1,024.20 | $1,707.00 | $77.10 – $1,536.30 | 18 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $28.20 | $47.00 | $11.53 – $39.60 | 17 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $10.80 | $18.00 | $0.60 – $3.70 | 12 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $1.80 | $3.00 | $0.08 – $2.70 | 10 |
| Naltrexone, depot form HCPCS J2315 | $4,812.60 | $8,021.00 | $3.21 – $1,622.23 | 21 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | not published | not published | $273.17 – $711.57 | 10 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | not published | not published | $845.00 – $2,191.27 | 12 |
| Nasal/sinus endo surg w/concha bullosa resct 31240 CPT 31240 | not published | not published | $698.73 – $2,191.27 | 12 |
| Nasal/sinus endo w/ethmoidectomy part 31254 CPT 31254 | not published | not published | $974.00 – $8,796.33 | 12 |
| Nasal/sinus endo w/front sinus expl 31276 CPT 31276 | not published | not published | $974.00 – $8,796.33 | 12 |
| Natriuretic peptide CPT 83880 | $83.40 | $139.00 | $36.05 – $125.10 | 18 |
| Natural killer cells total count CPT 86357 | $93.00 | $155.00 | $37.73 – $139.50 | 18 |
| Nebulizer Breathing Treatment CPT 94640 | $100.20 | $167.00 | $10.80 – $623.24 | 17 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | $109.80 | $183.00 | $21.88 – $269.80 | 18 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | $794.40 | $1,324.00 | $215.79 – $1,191.60 | 18 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $669.60 | $1,116.00 | $183.59 – $1,094.32 | 18 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $507.00 | $845.00 | $129.93 – $760.50 | 18 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $975.00 | $1,625.00 | $352.23 – $1,462.50 | 18 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $736.20 | $1,227.00 | $303.31 – $1,104.30 | 18 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $682.20 | $1,137.00 | $209.54 – $1,023.30 | 18 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | $251.40 | $419.00 | $33.12 – $377.10 | 18 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | $229.80 | $383.00 | $50.77 – $344.70 | 18 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | $242.40 | $404.00 | $61.67 – $363.60 | 18 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $981.60 | $1,636.00 | $377.80 – $1,472.40 | 18 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $737.40 | $1,229.00 | $269.26 – $1,106.10 | 18 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $682.20 | $1,137.00 | $236.23 – $1,023.30 | 18 |
| Neck Soft Tissue CT Scan (with and without contrast) CPT 70492 | $795.00 | $1,325.00 | $192.50 – $1,192.50 | 18 |
| Neck Soft Tissue CT Scan (with contrast) CPT 70491 | $642.00 | $1,070.00 | $171.88 – $963.00 | 18 |
| Neck Soft Tissue CT Scan (without contrast) CPT 70490 | $507.60 | $846.00 | $129.93 – $761.40 | 18 |
| Neg pres wound ther drsg set HCPCS A6550 | $91.20 | $152.00 | $19.85 – $128.70 | 10 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $46.20 | $57.75 | $0.80 – $15.30 | 12 |
| New Patient Office Visit (level 2) CPT 99202 | $129.60 | $216.00 | $31.71 – $2,193.68 | 17 |
| New Patient Office Visit (level 3) CPT 99203 | $129.60 | $216.00 | $43.29 – $194.40 | 16 |
| New Patient Office Visit (level 4) CPT 99204 | $165.60 | $276.00 | $61.00 – $248.40 | 16 |
| New Patient Office Visit (level 5) CPT 99205 | $217.80 | $363.00 | $61.00 – $321.30 | 16 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $2.40 | $3.00 | $0.07 – $2.70 | 10 |
| Nintedanib 150 mg capsule HCPCS J8999 | $0.60 | $0.75 | $0.06 – $0.23 | 11 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $4.00 | $5.00 | $1.49 – $4.50 | 10 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $82.80 | $138.00 | $29.07 – $124.20 | 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.