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 |
|---|---|---|---|---|
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $8.60 | $10.75 | $4.24 – $12.57 | 12 |
| Test stress cardiovascular tracing only CPT 93017 | $509.40 | $849.00 | $39.02 – $954.18 | 18 |
| Tetanus immune globulin inj HCPCS J1670 | $1,339.20 | $1,674.00 | $529.14 – $1,506.60 | 17 |
| Theophylline therapeutic drug level CPT 80198 | $34.80 | $58.00 | $11.00 – $52.20 | 18 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $96.00 | $160.00 | $16.25 – $144.00 | 19 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $75.00 | $125.00 | $10.47 – $112.50 | 19 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $27.00 | $45.00 | $15.24 – $55.92 | 18 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $20.40 | $34.00 | $15.24 – $47.68 | 18 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $73.75 – $4,120.95 | 14 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $22.60 | $28.25 | $1.82 – $12.60 | 13 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $122.40 | $204.00 | $36.58 – $269.80 | 17 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $360.60 | $601.00 | $91.98 – $778.06 | 17 |
| Three-Phase Bone Scan (Nuclear Medicine) CPT 78315 | $540.00 | $900.00 | $207.96 – $1,231.28 | 18 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $6,529.20 | $10,882.00 | $304.02 – $9,793.80 | 18 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $13,197.00 | $21,995.00 | $367.69 – $19,795.50 | 18 |
| Thrombin time CPT 85670 | $52.80 | $88.00 | $5.77 – $79.20 | 18 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $15.60 | $26.00 | $6.47 – $23.40 | 18 |
| Thyroglobulin antibody CPT 86800 | $90.60 | $151.00 | $15.91 – $135.90 | 18 |
| Thyroid imaging CPT 78013 | $420.00 | $700.00 | $191.09 – $1,231.28 | 18 |
| Thyroid (TSH) Test CPT 84443 | $41.40 | $69.00 | $16.80 – $62.10 | 18 |
| Thyroid Ultrasound CPT 76536 | $181.80 | $303.00 | $95.44 – $325.85 | 18 |
| Thyroxine binding globulin (tbg) CPT 84442 | $63.60 | $106.00 | $10.00 – $95.40 | 18 |
| Tigecycline injection HCPCS J3243 | $9.60 | $12.00 | $0.39 – $10.80 | 12 |
| Tilt table study CPT 93660 | $535.80 | $893.00 | $166.34 – $1,625.87 | 17 |
| Tissue culture skin/biopsy CPT 88233 | $346.20 | $577.00 | $24.64 – $519.30 | 18 |
| Tissue exam koh skin/hair/nails CPT 87220 | $10.20 | $17.00 | $3.90 – $15.30 | 18 |
| Tissue transglutaminase iga CPT 86364 | $26.40 | $44.00 | $11.53 – $39.60 | 17 |
| Tixagev and cilgav inj HCPCS M0220 | $1,020.00 | $1,700.00 | $150.50 – $1,530.00 | 12 |
| Tl-201 thallium diag per mci HCPCS A9505 | $117.00 | $195.00 | $34.64 – $175.50 | 11 |
| Tlh uterus 250 g or less CPT 58570 | not published | not published | $818.43 – $13,229.47 | 12 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $921.74 – $13,229.47 | 12 |
| Tobramycin comp unit HCPCS J7685 | $820.00 | $1,025.00 | $1.47 – $922.50 | 11 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $90.40 | $113.00 | $0.81 – $101.70 | 13 |
| Tobramycin peak therapeutic drug level CPT 80200 | $39.60 | $66.00 | $16.13 – $59.40 | 18 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $5,158.20 | $8,597.00 | $5.71 – $18.00 | 17 |
| Toe X-ray (both feet) CPT 73660 | $108.60 | $181.00 | $28.92 – $269.80 | 17 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $123.00 | $205.00 | $43.33 – $139.50 | 13 |
| Tomosynthesis breast screen bilateral CPT 77063 | $45.00 | $75.00 | $43.33 – $67.50 | 13 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $642.83 – $4,120.95 | 12 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $129.60 | $216.00 | $1.09 – $194.40 | 12 |
| Total Hip Replacement CPT 27130 | not published | not published | $1,070.04 – $17,150.78 | 12 |
| Total Knee Replacement CPT 27447 | not published | not published | $1,068.98 – $17,150.78 | 12 |
| Total tau CPT 84394 | $31.80 | $53.00 | $13.25 – $47.70 | 10 |
| Toxoplasma antibody igg CPT 86777 | $35.40 | $59.00 | $14.39 – $53.10 | 18 |
| Toxoplasma antibody igm CPT 86778 | $35.40 | $59.00 | $14.41 – $53.10 | 18 |
| Tpmt gene com vrnts CPT 81335 | $450.00 | $750.00 | $174.81 – $675.00 | 17 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $121.20 | $202.00 | $26.76 – $181.80 | 19 |
| Transferrin CPT 84466 | $31.20 | $52.00 | $12.76 – $46.80 | 18 |
| Transparent film >16<=48 in HCPCS A6258 | $4.20 | $7.00 | $3.84 – $6.30 | 10 |
| Transplant forearm tendon CPT 25310 | not published | not published | $560.00 – $4,122.90 | 14 |
| Transplant hand tendon CPT 26480 | not published | not published | $974.00 – $4,122.90 | 12 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $181.80 | $303.00 | $95.62 – $325.85 | 18 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $181.80 | $303.00 | $97.67 – $325.85 | 18 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $228.60 | $381.00 | $75.03 – $342.90 | 17 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $205.20 | $342.00 | $22.46 – $221.40 | 17 |
| Treat ankle dislocation CPT 27842 | $2,823.60 | $4,706.00 | $148.12 – $4,235.40 | 18 |
| Treat big toe fracture CPT 28505 | not published | not published | $208.12 – $4,122.90 | 14 |
| Treat ectopic pregnancy CPT 59150 | not published | not published | $974.00 – $7,413.68 | 12 |
| Treat ectopic pregnancy CPT 59151 | not published | not published | $974.00 – $7,413.68 | 12 |
| Treat elbow fracture CPT 24620 | $730.20 | $1,217.00 | $175.62 – $2,014.07 | 18 |
| Treat eyelid by injection CPT 68200 | $7,089.60 | $11,816.00 | $68.94 – $10,634.40 | 17 |
| Treat finger fracture each CPT 26742 | $102.00 | $170.00 | $91.88 – $2,014.07 | 18 |
| Treat fracture of radius CPT 25505 | $388.80 | $648.00 | $181.25 – $2,014.07 | 18 |
| Treat heel fracture CPT 28415 | not published | not published | $376.88 – $9,077.48 | 14 |
| Treat hip dislocation CPT 27252 | $982.80 | $1,638.00 | $351.88 – $2,014.07 | 18 |
| Treat humerus fracture CPT 24535 | $388.80 | $648.00 | $257.50 – $2,014.07 | 18 |
| Treat humerus fracture CPT 24565 | $1,484.40 | $2,474.00 | $216.88 – $2,226.60 | 18 |
| Treat knuckle dislocation CPT 26715 | $5,418.60 | $9,031.00 | $280.00 – $8,127.90 | 18 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | not published | not published | $692.75 – $9,077.48 | 12 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | not published | not published | $879.45 – $9,077.48 | 12 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | not published | not published | $619.06 – $9,077.48 | 12 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | not published | not published | $226.88 – $4,040.20 | 14 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $218.40 | $364.00 | $32.12 – $327.60 | 21 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $80.40 | $134.00 | $12.25 – $120.60 | 18 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | not published | not published | $488.18 – $4,040.20 | 12 |
| Treatment of ankle fracture CPT 27792 | not published | not published | $974.00 – $9,077.48 | 12 |
| Treatment of ankle fracture CPT 27814 | not published | not published | $562.50 – $9,077.48 | 14 |
| Treatment of ankle fracture CPT 27822 | not published | not published | $974.00 – $9,077.48 | 12 |
| Treatment of ankle fracture 27786 CPT 27786 | $102.00 | $170.00 | $102.00 – $749.45 | 18 |
| Treatment of miscarriage CPT 59821 | not published | not published | $288.75 – $4,040.20 | 14 |
| Treat metatarsal fracture CPT 28485 | not published | not published | $191.88 – $9,077.48 | 14 |
| Treat thumb fracture CPT 26665 | not published | not published | $864.56 – $4,122.90 | 12 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | $262.80 | $438.00 | $140.90 – $394.20 | 15 |
| Treponema pallidum antibody CPT 86780 | $32.40 | $54.00 | $13.24 – $48.60 | 18 |
| Trg gene rearrangement anal CPT 81342 | $991.80 | $1,653.00 | $201.50 – $1,487.70 | 17 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $12.20 | $15.25 | $0.84 – $12.60 | 13 |
| Trichinella antibody CPT 86784 | $331.80 | $553.00 | $12.56 – $497.70 | 18 |
| Triglycerides CPT 84478 | $13.80 | $23.00 | $5.74 – $20.70 | 18 |
| Trimethobenzamide hcl inj HCPCS J3250 | $93.60 | $117.00 | $42.19 – $105.30 | 12 |
| Trim nail(s) HCPCS G0127 | $109.20 | $182.00 | $6.57 – $182.02 | 17 |
| Trim nondyst nails CPT 11719 | $47.40 | $79.00 | $6.35 – $182.02 | 17 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $686.40 | $1,144.00 | $317.93 – $6,802.93 | 18 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $1,531.20 | $2,552.00 | $191.25 – $3,961.05 | 17 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $1,531.20 | $2,552.00 | $100.29 – $3,961.05 | 17 |
| Troponin quantitative CPT 84484 | $24.00 | $40.00 | $9.87 – $36.00 | 18 |
| Tte w or without contr, cont ecg HCPCS C8930 | $618.60 | $1,031.00 | $567.05 – $2,420.90 | 16 |
| Tte w or without fol w/con,stres HCPCS C8928 | $618.60 | $1,031.00 | $567.05 – $2,420.90 | 16 |
| Tte w or without fol w/cont, com HCPCS C8921 | $873.60 | $1,456.00 | $800.80 – $2,420.90 | 16 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $1,789.20 | $2,982.00 | $965.31 – $2,683.80 | 16 |
| Tubal Ligation (Laparoscopic) CPT 58670 | not published | not published | $784.44 – $7,413.68 | 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.