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 |
|---|---|---|---|---|
| Njx aa&/strd lmbr plex nfs CPT 64449 | not published | not published | $60.69 – $1,131.28 | 12 |
| Njx aa&/strd nrv nrvtg si jt CPT 64451 | $633.60 | $1,056.00 | $77.10 – $950.40 | 17 |
| Njx interlaminar lmbr/sac CPT 62326 | $2,830.80 | $4,718.00 | $92.92 – $4,246.20 | 18 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $1,726.20 | $2,877.00 | $77.10 – $2,589.30 | 17 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $900.00 | $1,500.00 | $127.50 – $1,350.00 | 18 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $696.00 | $1,160.00 | $80.00 – $1,231.28 | 18 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $1,260.60 | $2,101.00 | $142.50 – $1,890.90 | 18 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $574.80 | $958.00 | $297.73 – $1,649.37 | 18 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $451.80 | $753.00 | $223.39 – $1,231.28 | 18 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $274.80 | $458.00 | $135.91 – $686.79 | 18 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | $147.00 | $245.00 | $23.75 – $269.80 | 18 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $686.40 | $1,144.00 | $286.00 – $1,029.60 | 13 |
| Nuclear rx IV admin CPT 79101 | $900.00 | $1,500.00 | $143.66 – $1,350.00 | 18 |
| Nuclear Stress Test (Heart) CPT 78452 | $804.60 | $1,341.00 | $426.00 – $4,000.25 | 18 |
| Nudt15 gene common variants CPT 81306 | $450.00 | $750.00 | $291.36 – $730.70 | 17 |
| Nushield 1 square cm HCPCS Q4160 | $1,915.20 | $3,192.00 | $101.84 – $482.40 | 13 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $166.80 | $278.00 | $66.27 – $250.20 | 17 |
| Observation direct referral from physician office for admission HCPCS G0379 | $50.40 | $84.00 | $50.40 – $2,207.16 | 18 |
| Observation per hour HCPCS G0378 | $21.60 | $36.00 | $21.60 – $2,207.16 | 14 |
| Obstetric panel inc HIV tstg CPT 80081 | $372.60 | $621.00 | $74.86 – $558.90 | 18 |
| Obstetrics panel CPT 80055 | $93.00 | $155.00 | $12.00 – $139.50 | 18 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $94.80 | $158.00 | $94.80 – $325.85 | 18 |
| Occupational Therapy Evaluation (high complexity) CPT 97167 | $108.60 | $181.00 | $47.06 – $181.29 | 18 |
| Occupational Therapy Evaluation (low complexity) CPT 97165 | $90.60 | $151.00 | $47.06 – $135.90 | 18 |
| Occupational Therapy Evaluation (moderate complexity) CPT 97166 | $99.00 | $165.00 | $47.06 – $148.50 | 18 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $196.80 | $246.00 | $58.97 – $221.40 | 17 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $210.00 | $350.00 | $0.61 – $4.50 | 13 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $573.60 | $717.00 | $158.04 – $4,443.72 | 21 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $7.20 | $9.00 | $0.87 – $23.81 | 11 |
| Olanzapine long-acting inj HCPCS J2358 | $2,323.80 | $3,873.00 | $2.87 – $3,485.70 | 17 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $165.60 | $207.00 | $37.92 – $186.30 | 17 |
| Oncoprotein dcp CPT 83951 | $870.00 | $1,450.00 | $64.41 – $1,305.00 | 18 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $3.60 | $4.50 | $0.16 – $1.80 | 12 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $35.40 | $59.00 | $0.01 – $53.10 | 11 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $26.60 | $33.25 | $0.08 – $29.70 | 13 |
| Open bx/exc inguinofem nodes CPT 38531 | not published | not published | $373.00 – $4,865.84 | 11 |
| Opn impltj nea sacral nerve CPT 64581 | not published | not published | $203.10 – $8,680.29 | 12 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $974.00 – $9,077.48 | 12 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $974.00 – $9,077.48 | 12 |
| Oral aprepitant HCPCS J8501 | $102.00 | $170.00 | $2.73 – $46.44 | 12 |
| Oral everolimus HCPCS J7527 | $1,140.00 | $1,900.00 | $1.37 – $1,710.00 | 11 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $994.99 – $4,655.61 | 12 |
| Organic acids total quant ea spec CPT 83918 | $366.60 | $611.00 | $22.75 – $549.90 | 18 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $68.12 – $2,904.64 | 14 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $63.20 | $79.00 | $4.01 – $71.10 | 12 |
| Oscillation chest wall mechanical per session CPT 94669 | $507.60 | $846.00 | $19.84 – $761.40 | 20 |
| Osmolality blood CPT 83930 | $16.20 | $27.00 | $3.00 – $24.30 | 18 |
| Osmolality urine CPT 83935 | $16.80 | $28.00 | $3.00 – $25.20 | 18 |
| Oth resp proc, group HCPCS G0239 | $75.60 | $126.00 | $10.99 – $119.27 | 19 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $93.00 | $155.00 | $25.12 – $139.50 | 12 |
| Ot re-evaluation patient/family CPT 97168 | $67.20 | $112.00 | $28.30 – $108.78 | 19 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $225.60 | $376.00 | $16.59 – $338.40 | 19 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $780.44 – $6,272.71 | 12 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $54.60 | $91.00 | $0.79 – $9.90 | 12 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $15.60 | $26.00 | $0.05 – $2.70 | 12 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $17.40 | $29.00 | $0.87 – $9.00 | 12 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $1.00 | $1.25 | $0.11 – $0.90 | 12 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $44.40 | $74.00 | $10.54 – $66.60 | 17 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $54.40 | $68.00 | $13.06 – $2,284.14 | 18 |
| Palonosetron hcl HCPCS J2469 | $179.40 | $299.00 | $0.36 – $269.10 | 12 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $49.00 | $61.25 | $9.64 – $54.90 | 12 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $200.40 | $334.00 | $137.43 – $433.94 | 17 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $22.60 | $28.25 | $2.01 – $25.20 | 10 |
| Papaverin hcl injection HCPCS J2440 | $60.40 | $75.50 | $5.50 – $38.25 | 12 |
| Parathormone (pth) intact CPT 83970 | $102.00 | $170.00 | $41.28 – $153.00 | 18 |
| Parathyroid planar imaging CPT 78070 | $408.60 | $681.00 | $76.80 – $1,231.28 | 18 |
| Parathyroid planar img w/tomo spect CPT 78071 | $282.00 | $470.00 | $282.00 – $1,231.28 | 18 |
| Parenteral 50% dextrose solu HCPCS B4164 | $133.60 | $167.00 | $17.96 – $150.30 | 10 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $56.40 | $94.00 | $13.43 – $2,904.64 | 18 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $148.12 – $4,040.20 | 14 |
| Partial exc bone humerus CPT 24140 | not published | not published | $343.75 – $4,122.90 | 14 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $328.12 – $4,122.90 | 14 |
| Partial removal finger bone CPT 26236 | $1,105.80 | $1,843.00 | $343.75 – $2,014.07 | 18 |
| Partial removal of foot bone CPT 28288 | not published | not published | $308.12 – $4,122.90 | 14 |
| Partial removal of thyroid CPT 60220 | not published | not published | $730.75 – $7,413.68 | 12 |
| Partial removal of toe CPT 28160 | not published | not published | $601.84 – $4,122.90 | 12 |
| Partial removal of ulna CPT 25150 | not published | not published | $845.00 – $4,122.90 | 12 |
| Partial removal of ulna CPT 25240 | not published | not published | $883.19 – $4,122.90 | 12 |
| Partial thyroid excision CPT 60210 | not published | not published | $845.00 – $7,413.68 | 12 |
| Part removal of metatarsal CPT 28110 | not published | not published | $333.07 – $4,122.90 | 14 |
| Path clin consltj mod 21-40 CPT 80504 | $447.60 | $746.00 | $49.35 – $671.40 | 16 |
| Path clin consltj sf 5-20 CPT 80503 | $198.60 | $331.00 | $23.11 – $297.90 | 16 |
| Pcv21 vaccine im CPT 90684 | $252.80 | $316.00 | $12.50 – $284.40 | 11 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $1,111.20 | $1,852.00 | $89.34 – $1,666.80 | 17 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $872.40 | $1,454.00 | $106.33 – $1,308.60 | 17 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $645.60 | $1,076.00 | $184.91 – $968.40 | 16 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $795.00 | $1,325.00 | $198.81 – $1,192.50 | 18 |
| Pelvic CT scan (with contrast) CPT 72193 | $669.60 | $1,116.00 | $175.11 – $1,004.40 | 18 |
| Pelvic CT scan (without contrast) CPT 72192 | $507.00 | $845.00 | $129.93 – $760.50 | 18 |
| Pelvic MRI (with and without contrast) CPT 72197 | $978.60 | $1,631.00 | $373.18 – $1,467.90 | 18 |
| Pelvic MRI (with contrast) CPT 72196 | $739.20 | $1,232.00 | $296.98 – $1,108.80 | 18 |
| Pelvic MRI (without contrast) CPT 72195 | $684.60 | $1,141.00 | $253.58 – $1,026.90 | 18 |
| Pelvic Ultrasound (complete) CPT 76856 | $181.80 | $303.00 | $95.62 – $325.85 | 18 |
| Pelvic Ultrasound (limited) CPT 76857 | $122.40 | $204.00 | $40.00 – $325.85 | 18 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $117.00 | $195.00 | $21.88 – $325.85 | 18 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $159.60 | $266.00 | $38.31 – $325.85 | 18 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $147.00 | $245.00 | $53.67 – $220.50 | 17 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $199.20 | $249.00 | $4.36 – $146.70 | 17 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $543.00 | $905.00 | $16.46 – $75.26 | 17 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $19.20 | $28.00 | $0.76 – $2.70 | 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.