UPMC Carlisle
361 Alexander Spring Road, Carlisle, PA · UPMC · · NPI 1689107328
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 |
|---|---|---|---|---|
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $3,004.80 | $5,008.00 | $10.90 – $2,128.40 | 17 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $641.40 | $1,069.00 | $11.95 – $884.00 | 17 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $9.00 | $15.00 | $0.05 – $12.75 | 14 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $3,588.60 | $5,981.00 | $572.47 – $5,083.85 | 17 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,228.80 | $2,048.00 | $77.29 – $1,740.80 | 19 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $4,242.60 | $7,071.00 | $426.38 – $6,010.35 | 19 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $4,812.60 | $8,021.00 | $835.74 – $6,817.85 | 19 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $3,217.80 | $5,363.00 | $82.73 – $4,558.55 | 19 |
| Rpl tun-cvad w subq port CPT 36582 | $8,004.00 | $13,340.00 | $348.25 – $11,339.00 | 19 |
| Rpl tun-cvad w subq pump CPT 36583 | $8,004.00 | $13,340.00 | $351.07 – $11,339.00 | 19 |
| Rpl tun cvc wo subq port CPT 36581 | $4,201.80 | $7,003.00 | $236.08 – $5,952.55 | 19 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | not published | not published | $1,050.80 – $16,693.00 | 4 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $811.95 – $9,550.51 | 12 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $786.32 – $8,930.03 | 12 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $603.84 – $9,550.51 | 12 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | not published | not published | $1,273.41 – $16,693.00 | 4 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | not published | not published | $908.60 – $7,586.32 | 4 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | not published | not published | $881.94 – $16,693.00 | 4 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $673.80 – $9,550.51 | 12 |
| Rsv assay w/optic CPT 87807 | $73.80 | $123.00 | $12.31 – $104.55 | 19 |
| Rubella antibody igg CPT 86762 | $80.40 | $134.00 | $14.25 – $113.90 | 19 |
| Rubeola antibody igg CPT 86765 | $72.00 | $120.00 | $11.80 – $102.00 | 19 |
| Russell viper venom diluted CPT 85613 | $48.60 | $81.00 | $9.48 – $68.85 | 19 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $1,441.80 | $2,403.00 | $35.92 – $2,042.55 | 17 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $262.80 | $438.00 | $21.61 – $372.30 | 20 |
| Salivary gland imaging CPT 78230 | $1,228.80 | $2,048.00 | $51.09 – $1,740.80 | 19 |
| Salivary glnd img serial img CPT 78231 | $1,228.80 | $2,048.00 | $45.85 – $1,740.80 | 19 |
| Sarscov coronavirus ag ia CPT 87426 | $84.60 | $141.00 | $17.76 – $119.85 | 19 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $819.60 | $1,366.00 | $118.73 – $1,161.10 | 19 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $394.20 | $657.00 | $90.01 – $558.45 | 19 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $379.80 | $633.00 | $86.72 – $554.17 | 19 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $394.20 | $657.00 | $90.01 – $558.45 | 19 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $394.20 | $657.00 | $90.01 – $558.45 | 19 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $394.20 | $657.00 | $90.01 – $801.00 | 16 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $2,643.60 | $4,406.00 | $603.62 – $3,745.10 | 18 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $885.82 – $4,966.18 | 12 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $189.60 | $316.00 | $14.57 – $268.60 | 16 |
| Screen cerv/vag thin layer HCPCS G0123 | $145.20 | $242.00 | $11.14 – $205.70 | 16 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $479.69 – $2,182.77 | 11 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $479.69 – $2,241.85 | 11 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $100.20 | $167.00 | $17.87 – $141.95 | 18 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $60.00 | $100.00 | $13.70 – $85.00 | 18 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $108.00 | $180.00 | $19.00 – $153.00 | 18 |
| Screening Mammogram CPT 77067 | $257.40 | $429.00 | $58.77 – $506.81 | 15 |
| Screening prostate cancer PSA HCPCS G0103 | $97.80 | $163.00 | $10.62 – $138.55 | 16 |
| Screen pap by tech w md supv HCPCS P3000 | $55.20 | $92.00 | $10.00 – $78.20 | 17 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $394.20 | $657.00 | $57.64 – $558.45 | 20 |
| Sc ther infusion reset pump CPT 96371 | $148.20 | $247.00 | $33.84 – $209.95 | 19 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $12,577.80 | $20,963.00 | $265.12 – $17,818.55 | 12 |
| Sedimentation rate erythrocyte automated CPT 85652 | $13.80 | $23.00 | $2.67 – $19.55 | 19 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $168.60 | $281.00 | $22.19 – $387.00 | 13 |
| Semen analysis presence/motility CPT 89321 | $86.40 | $144.00 | $6.63 – $122.40 | 17 |
| Serpina1 gene CPT 81332 | $252.00 | $420.00 | $43.21 – $357.00 | 19 |
| Set radiation therapy field CPT 77280 | $655.20 | $1,092.00 | $47.81 – $928.20 | 19 |
| Set radiation therapy field CPT 77285 | $1,029.00 | $1,715.00 | $66.81 – $1,457.75 | 19 |
| Set radiation therapy field CPT 77290 | $1,273.20 | $2,122.00 | $94.97 – $1,803.70 | 19 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $3.60 | $6.00 | $0.14 – $0.85 | 13 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $10.20 | $17.00 | $0.14 – $1.36 | 13 |
| Sex chromatin identification CPT 88130 | $43.20 | $72.00 | $9.86 – $61.20 | 17 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $520.80 | $868.00 | $40.64 – $875.08 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $520.80 | $868.00 | $48.26 – $875.08 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $819.00 | $1,365.00 | $63.50 – $1,160.25 | 19 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $1,341.60 | $2,236.00 | $80.01 – $1,900.60 | 19 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $520.80 | $868.00 | $35.56 – $875.08 | 19 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $520.80 | $868.00 | $44.45 – $875.08 | 19 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $575.40 | $959.00 | $52.07 – $875.08 | 19 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $520.80 | $868.00 | $31.75 – $875.08 | 19 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $465.00 | $775.00 | $40.64 – $875.08 | 19 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $660.00 | $1,100.00 | $48.26 – $935.00 | 19 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $1,016.56 – $10,934.13 | 12 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $976.85 – $10,934.13 | 14 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $648.78 – $4,966.18 | 14 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $1,001.12 – $10,934.13 | 14 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $690.25 – $4,966.18 | 14 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $171.60 | $286.00 | $16.13 – $243.10 | 19 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $188.40 | $314.00 | $24.89 – $266.90 | 20 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,016.56 – $10,934.13 | 12 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $262.80 | $438.00 | $21.61 – $589.04 | 17 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,713.80 | $4,523.00 | $618.88 – $3,844.55 | 18 |
| Shoulder MRI (with contrast) CPT 73222 | $2,713.80 | $4,523.00 | $403.15 – $3,844.55 | 18 |
| Shoulder MRI (without contrast) CPT 73221 | $1,656.00 | $2,760.00 | $352.39 – $2,346.00 | 18 |
| Shoulder X-ray CPT 73030 | $188.40 | $314.00 | $21.61 – $419.44 | 17 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $188.40 | $314.00 | $19.01 – $419.44 | 17 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $262.80 | $438.00 | $36.93 – $372.30 | 20 |
| Sialography s&i CPT 70390 | $547.80 | $913.00 | $27.51 – $776.05 | 20 |
| Sialolithotomy 42330 CPT 42330 | $3,971.40 | $6,619.00 | $81.28 – $5,626.15 | 19 |
| Sickling rbc CPT 85660 | $28.80 | $48.00 | $3.00 – $40.80 | 19 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $80.86 – $1,395.46 | 14 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $154.88 – $1,804.69 | 14 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $81.60 | $136.00 | $16.99 – $187.67 | 14 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,294.80 | $2,158.00 | $131.00 – $1,834.30 | 21 |
| Sinus CT scan (with contrast) CPT 70487 | $1,294.80 | $2,158.00 | $104.80 – $1,834.30 | 21 |
| Sinus CT scan (without contrast) CPT 70486 | $796.80 | $1,328.00 | $100.71 – $1,128.80 | 21 |
| Sinus/juglr venogram s&i CPT 75860 | $5,906.40 | $9,844.00 | $19.65 – $8,367.40 | 20 |
| Sinus X-ray (complete) CPT 70220 | $188.40 | $314.00 | $29.48 – $266.90 | 20 |
| Sinus X-ray (limited) CPT 70210 | $188.40 | $314.00 | $21.61 – $266.90 | 20 |
| Sipuleucel-t - su HCPCS Q2043 | $150.00 | $250.00 | $34.25 – $88,435.71 | 17 |
| Sirolimus, oral HCPCS J7520 | $20.40 | $34.00 | $0.55 – $3.76 | 15 |
| Skin Biopsy CPT 11102 | $575.40 | $959.00 | $40.93 – $1,016.56 | 19 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $3,200.40 | $5,334.00 | $132.64 – $4,533.90 | 11 |
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.