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 |
|---|---|---|---|---|
| Skull X-ray (1 to 3 views) CPT 70250 | $262.80 | $438.00 | $27.51 – $372.30 | 20 |
| Skull X-ray (complete) CPT 70260 | $262.80 | $438.00 | $36.01 – $372.30 | 20 |
| Sleep study attended CPT 95807 | $1,830.00 | $3,050.00 | $369.41 – $3,865.00 | 16 |
| Sleep Study (Polysomnography) CPT 95810 | $4,279.20 | $7,132.00 | $354.12 – $5,320.15 | 19 |
| Sleep study unattended CPT 95806 | $984.00 | $1,640.00 | $82.32 – $1,394.00 | 17 |
| Slitting of prepuce CPT 54001 | $4,029.00 | $6,715.00 | $60.96 – $5,707.75 | 19 |
| Sm-153 lexidron ther HCPCS A9604 | $5,947.80 | $9,913.00 | $1,358.08 – $8,426.05 | 15 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $427.80 | $713.00 | $29.48 – $606.05 | 20 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $189.62 – $2,903.52 | 14 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $30.60 | $51.00 | $3.00 – $43.35 | 19 |
| Smear gram stain CPT 87205 | $24.00 | $40.00 | $4.23 – $34.00 | 19 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $33.00 | $55.00 | $4.50 – $46.75 | 19 |
| Smear wet mount CPT 87210 | $32.40 | $54.00 | $5.76 – $45.90 | 19 |
| Sodium 24 hour urine CPT 84300 | $25.20 | $42.00 | $5.01 – $35.70 | 19 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $3.60 | $6.00 | $0.82 – $5.10 | 14 |
| Sodium serum/plasma/whole blood CPT 84295 | $24.60 | $41.00 | $4.76 – $34.85 | 19 |
| Somatosensory testing CPT 95927 | $583.80 | $973.00 | $42.78 – $827.05 | 19 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $2,380.00 – $9,539.00 | 2 |
| Special physics consult CPT 77370 | $892.20 | $1,487.00 | $122.56 – $1,263.95 | 19 |
| Special radiation dosimetry CPT 77331 | $739.80 | $1,233.00 | $22.87 – $1,048.05 | 19 |
| Special radiation treatment CPT 77470 | $2,055.00 | $3,425.00 | $28.16 – $2,911.25 | 19 |
| Special supplies phys/qhp CPT 99070 | $55.20 | $92.00 | $12.60 – $78.20 | 11 |
| Special teletx port plan CPT 77321 | $939.60 | $1,566.00 | $41.27 – $1,331.10 | 19 |
| Specific gravity body fluid CPT 84315 | $17.40 | $29.00 | $1.80 – $24.65 | 17 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $865.20 | $1,442.00 | $195.27 – $1,225.70 | 13 |
| Speech evaluation complex CPT 70371 | $547.80 | $913.00 | $63.43 – $776.05 | 20 |
| Speech Therapy Session (one-on-one) CPT 92507 | $459.00 | $765.00 | $27.56 – $591.00 | 16 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $89.09 – $9,539.00 | 4 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $2,461.20 | $4,102.00 | $93.19 – $3,486.70 | 19 |
| Spine X-ray (single view, one level) CPT 72020 | $188.40 | $314.00 | $18.94 – $266.90 | 20 |
| Spleen imaging CPT 78185 | $1,228.80 | $2,048.00 | $51.09 – $1,740.80 | 19 |
| Splint func pos polyflex ii med HCPCS L3999 | $116.40 | $194.00 | $26.58 – $164.90 | 12 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $5,983.20 | $9,972.00 | $740.15 – $8,476.20 | 17 |
| Split blood or products CPT 86985 | $201.60 | $336.00 | $46.03 – $285.60 | 16 |
| Splt agrft f/s/n/h/f/g/m ea CPT 15121 | $2,538.00 | $4,230.00 | $205.70 – $3,595.50 | 11 |
| Sputum specimen collection CPT 89220 | $1,087.80 | $1,813.00 | $7.03 – $1,541.05 | 18 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $5,445.60 | $9,076.00 | $1,243.41 – $7,714.60 | 15 |
| Srs linear based CPT 77372 | $12,437.40 | $20,729.00 | $802.11 – $17,619.65 | 19 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $435.00 | $725.00 | $98.21 – $616.25 | 13 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $601.20 | $1,002.00 | $79.36 – $851.70 | 13 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $24,161.40 | $40,269.00 | $1,016.56 – $34,228.65 | 17 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $17,281.80 | $28,803.00 | $1,016.56 – $24,482.55 | 17 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $8,640.60 | $14,401.00 | $236.46 – $12,240.85 | 12 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $24,161.40 | $40,269.00 | $1,016.56 – $34,228.65 | 17 |
| St evaluate speech sound production CPT 92522 | $414.00 | $690.00 | $94.15 – $591.00 | 13 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $263.40 | $439.00 | $53.75 – $591.00 | 16 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,228.80 | $2,048.00 | $19.86 – $615.04 | 19 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $520.80 | $868.00 | $25.40 – $737.80 | 19 |
| Strapping of chest CPT 29200 | $378.60 | $631.00 | $44.23 – $536.35 | 19 |
| Strapping of elbow or wrist 29260 CPT 29260 | $204.60 | $341.00 | $39.85 – $289.85 | 19 |
| Strapping of hand or finger CPT 29280 | $204.60 | $341.00 | $31.25 – $289.85 | 17 |
| Strapping of hip CPT 29520 | $411.60 | $686.00 | $41.90 – $583.10 | 19 |
| Strapping of knee CPT 29530 | $411.60 | $686.00 | $32.38 – $583.10 | 19 |
| Strapping of toes 29550 CPT 29550 | $204.60 | $341.00 | $25.40 – $289.85 | 19 |
| Streptozocin injection HCPCS J9320 | $209.40 | $349.00 | $47.81 – $502.27 | 12 |
| Stress test pulmonary CPT 94618 | $399.00 | $665.00 | $11.34 – $565.25 | 19 |
| Str markers specimen anal CPT 81265 | $505.20 | $842.00 | $115.35 – $715.70 | 17 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $4.80 | $8.00 | $0.14 – $1.16 | 12 |
| Sugars single quant CPT 84378 | $58.80 | $98.00 | $8.15 – $83.30 | 19 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $2,896.20 | $4,827.00 | $65.08 – $403.75 | 11 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $0.60 | $1.00 | $0.05 – $0.85 | 14 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $105.60 | $176.00 | $24.11 – $149.60 | 13 |
| Surgical pathology level 1 gross examination only CPT 88300 | $54.60 | $91.00 | $1.97 – $77.35 | 19 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $54.60 | $91.00 | $6.55 – $77.35 | 19 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $116.40 | $194.00 | $8.52 – $164.90 | 19 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $116.40 | $194.00 | $11.79 – $164.12 | 19 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $664.80 | $1,108.00 | $15.06 – $941.80 | 19 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,472.40 | $2,454.00 | $22.93 – $2,085.90 | 19 |
| Susceptibility agar dilution per agent CPT 87181 | $25.80 | $43.00 | $4.70 – $36.55 | 19 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $25.80 | $43.00 | $4.70 – $36.55 | 19 |
| Susceptibility mic per plate CPT 87186 | $48.60 | $81.00 | $7.03 – $68.85 | 19 |
| Svc venogram s&i CPT 75827 | $1,344.60 | $2,241.00 | $29.48 – $2,377.68 | 20 |
| Swallowing Evaluation (Bedside) CPT 92610 | $532.80 | $888.00 | $49.40 – $754.80 | 16 |
| Swallowing Therapy Session CPT 92526 | $384.60 | $641.00 | $46.31 – $387.00 | 13 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $24.60 | $41.00 | $4.36 – $34.85 | 19 |
| System sealant biosentry tract HCPCS C2613 | $680.40 | $1,134.00 | $155.36 – $963.90 | 11 |
| T3 (triiodothyronine) free CPT 84481 | $86.40 | $144.00 | $16.77 – $122.40 | 19 |
| T3 (triiodothyronine) total CPT 84480 | $72.00 | $120.00 | $8.00 – $102.00 | 19 |
| T4 (thyroxine) free CPT 84439 | $45.60 | $76.00 | $8.00 – $64.60 | 19 |
| T4 (thyroxine) total CPT 84436 | $34.20 | $57.00 | $6.80 – $48.45 | 19 |
| Tacrol astagraf ex rel oral HCPCS J7508 | $16.80 | $28.00 | $0.27 – $2.78 | 15 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $15.60 | $26.00 | $0.69 – $4.25 | 14 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $21.00 | $35.00 | $0.17 – $2.55 | 15 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $148.20 | $247.00 | $33.84 – $421.04 | 17 |
| Tacrolimus therapeutic drug level CPT 80197 | $98.40 | $164.00 | $13.59 – $139.40 | 19 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $796.80 | $1,328.00 | $14.17 – $1,128.80 | 17 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $188.40 | $314.00 | $21.61 – $266.90 | 20 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | $6,216.00 | $10,360.00 | $70.97 – $440.30 | 17 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | $9,000.00 | $15,000.00 | $205.50 – $2,503.42 | 17 |
| Tavr perq femoral CPT 33361 | $10,503.00 | $17,505.00 | $1,475.28 – $14,879.25 | 12 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $357.60 | $596.00 | $0.28 – $211.65 | 17 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $556.80 | $928.00 | $69.78 – $788.80 | 19 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $345.00 | $575.00 | $8.40 – $488.75 | 19 |
| Tc-99m diag per dose HCPCS A4641 | $77.40 | $129.00 | $17.67 – $109.65 | 11 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $7,144.80 | $11,908.00 | $572.18 – $10,121.80 | 15 |
| Tc-99m fanolesomab diag HCPCS A9566 | $6,315.00 | $10,525.00 | $1,441.92 – $8,946.25 | 11 |
| Tc-99m labeled rbc HCPCS A9560 | $590.40 | $984.00 | $134.33 – $836.40 | 11 |
| Tc-99m maa HCPCS A9540 | $576.00 | $960.00 | $43.15 – $816.00 | 11 |
| Tc-99m mebrofenin HCPCS A9537 | $94.80 | $158.00 | $21.65 – $134.30 | 11 |
| Tc-99m medronate HCPCS A9503 | $54.60 | $91.00 | $12.47 – $77.35 | 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.