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 |
|---|---|---|---|---|
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $22,299.60 | $37,166.00 | $336.73 – $42,162.05 | 17 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $22,299.60 | $37,166.00 | $311.00 – $33,449.40 | 17 |
| Rmvl icd pulse gen only CPT 33241 | $1,741.20 | $2,902.00 | $179.23 – $4,579.97 | 17 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $1,487.40 | $2,479.00 | $131.04 – $2,231.10 | 17 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | not published | not published | $77.10 – $189.36 | 3 |
| Rmvl perm pm pulse gen CPT 33233 | $1,779.00 | $2,965.00 | $523.58 – $10,729.38 | 17 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $9,066.60 | $15,111.00 | $312.10 – $24,543.02 | 17 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $7,300.80 | $12,168.00 | $282.39 – $10,951.20 | 17 |
| Rmvl sq defib electrode CPT 33272 | not published | not published | $288.77 – $11,151.55 | 12 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $89.60 | $112.00 | $30.78 – $100.80 | 17 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $22.20 | $27.75 | $11.01 – $27.61 | 15 |
| Romiplostim injection HCPCS J2796 | $244.80 | $408.00 | $87.57 – $367.20 | 12 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $7,147.80 | $11,913.00 | $9.64 – $50.40 | 17 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $18.60 | $31.00 | $0.05 – $0.90 | 12 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $666.60 | $1,111.00 | $436.01 – $1,955.67 | 17 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $666.60 | $1,111.00 | $81.42 – $1,955.67 | 18 |
| Rpl tun cvc wo subq port CPT 36581 | $1,719.60 | $2,866.00 | $232.36 – $3,961.05 | 18 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | not published | not published | $749.45 – $980.21 | 3 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $642.35 – $7,928.80 | 11 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $621.76 – $7,413.68 | 11 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $477.74 – $7,928.80 | 11 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $6,856.20 | $11,427.00 | $285.09 – $10,284.30 | 17 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $396.46 – $7,413.68 | 11 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $533.09 – $7,928.80 | 11 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $398.12 – $7,928.80 | 14 |
| Rubella antibody igg CPT 86762 | $35.40 | $59.00 | $13.82 – $53.10 | 18 |
| Rubeola antibody igg CPT 86765 | $23.40 | $39.00 | $11.80 – $35.10 | 18 |
| Russell viper venom diluted CPT 85613 | $23.40 | $39.00 | $9.58 – $35.10 | 18 |
| Rx metab gen seq alys pnl 6 CPT 81418 | $2,427.00 | $4,045.00 | $917.08 – $3,640.50 | 15 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $4,757.40 | $7,929.00 | $31.52 – $99.90 | 17 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $145.80 | $243.00 | $31.62 – $325.85 | 18 |
| Salmonella antibody CPT 86768 | $144.60 | $241.00 | $13.19 – $216.90 | 17 |
| Sarscov coronavirus ag ia CPT 87426 | $34.80 | $58.00 | $34.80 – $88.60 | 17 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $825.00 | $1,375.00 | $152.44 – $1,237.50 | 18 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $211.80 | $353.00 | $104.81 – $325.85 | 18 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $222.60 | $371.00 | $114.80 – $333.90 | 18 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $222.60 | $371.00 | $114.80 – $333.90 | 18 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $222.60 | $371.00 | $98.12 – $333.90 | 18 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $477.00 – $4,122.90 | 12 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $99.00 | $165.00 | $23.31 – $117.00 | 17 |
| Screen cerv/vag thin layer HCPCS G0123 | $61.20 | $102.00 | $17.83 – $91.80 | 17 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $1,440.00 | $2,400.00 | $159.27 – $2,160.00 | 17 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $1,590.00 | $2,650.00 | $159.04 – $2,385.00 | 17 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $63.00 | $105.00 | $19.00 – $94.50 | 18 |
| Screening Mammogram CPT 77067 | $205.20 | $342.00 | $116.60 – $307.80 | 13 |
| Screening prostate cancer PSA HCPCS G0103 | $96.00 | $160.00 | $16.99 – $144.00 | 17 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $4,946.40 | $8,244.00 | $1.52 – $7.20 | 13 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $181.80 | $303.00 | $90.64 – $325.85 | 18 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $2,592.00 | $4,320.00 | $200.39 – $3,888.00 | 12 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $96.00 | $160.00 | $23.61 – $144.00 | 18 |
| Semen analysis presence/motility CPT 89321 | $21.00 | $35.00 | $12.05 – $31.50 | 17 |
| Serpina1 gene CPT 81332 | $345.60 | $576.00 | $43.65 – $488.70 | 18 |
| Set radiation therapy field CPT 77280 | $487.80 | $813.00 | $75.00 – $731.70 | 13 |
| Set radiation therapy field CPT 77290 | $910.20 | $1,517.00 | $151.88 – $1,365.30 | 13 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $78.75 – $2,904.64 | 14 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $766.49 – $9,077.48 | 12 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $961.46 – $9,077.48 | 14 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $638.56 – $4,122.90 | 14 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $650.58 – $4,122.90 | 14 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $679.38 – $4,122.90 | 14 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $42.60 | $71.00 | $13.36 – $89.57 | 21 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $133.80 | $223.00 | $29.64 – $269.80 | 18 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,365.00 – $9,077.48 | 12 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $122.40 | $204.00 | $24.77 – $325.85 | 17 |
| Shoulder MRI (with and without contrast) CPT 73223 | $979.20 | $1,632.00 | $430.70 – $1,468.80 | 17 |
| Shoulder MRI (with contrast) CPT 73222 | $739.80 | $1,233.00 | $347.81 – $2,420.90 | 17 |
| Shoulder MRI (without contrast) CPT 73221 | $685.80 | $1,143.00 | $221.48 – $1,028.70 | 17 |
| Shoulder X-ray CPT 73030 | $133.80 | $223.00 | $35.89 – $269.80 | 17 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $102.60 | $171.00 | $22.31 – $269.80 | 17 |
| Sickling rbc CPT 85660 | $13.20 | $22.00 | $3.00 – $19.80 | 18 |
| Sigmoidoscopy and biopsy CPT 45331 | $402.00 | $670.00 | $59.50 – $1,147.37 | 18 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $749.40 | $1,249.00 | $95.67 – $1,147.37 | 18 |
| Sigmoidoscopy for bleeding CPT 45334 | $993.60 | $1,656.00 | $97.91 – $1,490.40 | 18 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $749.40 | $1,249.00 | $54.88 – $1,147.37 | 18 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $749.40 | $1,249.00 | $62.50 – $1,483.84 | 18 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $993.60 | $1,656.00 | $100.10 – $1,490.40 | 18 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $993.60 | $1,656.00 | $103.35 – $2,904.64 | 18 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $993.60 | $1,656.00 | $77.99 – $1,490.40 | 18 |
| Sig w/tndsc balloon dilation CPT 45340 | $993.60 | $1,656.00 | $64.91 – $1,490.40 | 18 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $492.00 | $615.00 | $116.28 – $553.50 | 12 |
| Sinus CT scan (with and without contrast) CPT 70488 | $795.00 | $1,325.00 | $201.71 – $1,192.50 | 18 |
| Sinus CT scan (with contrast) CPT 70487 | $652.20 | $1,087.00 | $165.20 – $978.30 | 18 |
| Sinus CT scan (without contrast) CPT 70486 | $507.60 | $846.00 | $129.93 – $761.40 | 18 |
| Sinus/juglr venogram s&i CPT 75860 | $734.40 | $1,224.00 | $31.25 – $9,644.58 | 18 |
| Sinus X-ray (complete) CPT 70220 | $181.80 | $303.00 | $39.42 – $272.70 | 18 |
| Sinus X-ray (limited) CPT 70210 | $50.40 | $84.00 | $30.39 – $269.80 | 18 |
| Sirolimus, oral HCPCS J7520 | $11.00 | $13.75 | $0.87 – $11.70 | 12 |
| Skin Biopsy CPT 11102 | $326.40 | $544.00 | $31.36 – $2,904.64 | 18 |
| Skull X-ray (1 to 3 views) CPT 70250 | $155.40 | $259.00 | $37.28 – $325.85 | 18 |
| Skull X-ray (complete) CPT 70260 | $200.40 | $334.00 | $46.81 – $325.85 | 18 |
| Skyla, 13.5 mg HCPCS J7301 | $1,345.80 | $2,243.00 | $972.39 – $2,018.70 | 11 |
| Sleep Study (Polysomnography) CPT 95810 | $1,188.00 | $1,980.00 | $281.92 – $3,117.50 | 18 |
| Sleep study unattended CPT 95806 | $213.60 | $356.00 | $94.77 – $479.44 | 17 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $144.60 | $241.00 | $6.85 – $19.80 | 10 |
| Sling suprapubic suburetheral HCPCS C1771 | $3,118.20 | $5,197.00 | $91.43 – $4,677.30 | 13 |
| Slitting of prepuce CPT 54001 | not published | not published | $60.00 – $2,603.03 | 14 |
| Slp pure tone screening CPT 92551 | $58.80 | $98.00 | $10.00 – $88.20 | 12 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $291.00 | $485.00 | $46.88 – $545.49 | 18 |
| Small bowel endoscopy CPT 44360 | $1,738.20 | $2,897.00 | $119.39 – $2,607.30 | 18 |
| Small bowel endoscopy CPT 44382 | not published | not published | $60.67 – $1,191.35 | 14 |
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.