UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
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 |
|---|---|---|---|---|
| 17-ketosteroids CPT 83586 | $88.20 | $147.00 | $8.32 – $117.60 | 16 |
| 24 hr ambulatory b/p monitor CPT 93786 | $63.00 | $105.00 | $26.71 – $84.00 | 14 |
| 3d recon without postprocess indpndt CPT 76376 | $417.60 | $696.00 | $22.83 – $556.80 | 15 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $61.80 | $103.00 | $28.55 – $82.40 | 16 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $156.60 | $261.00 | $32.43 – $143.60 | 14 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,926.80 | $4,878.00 | $44.11 – $3,902.40 | 14 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $119.40 | $199.00 | $7.81 – $159.20 | 16 |
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | $658.20 | $1,097.00 | $191.57 – $877.60 | 16 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | $436.20 | $727.00 | $137.55 – $581.60 | 16 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $969.00 | $1,615.00 | $185.29 – $1,292.00 | 16 |
| Abdominal CT scan (with contrast) CPT 74160 | $754.20 | $1,257.00 | $156.50 – $1,005.60 | 16 |
| Abdominal CT scan (without contrast) CPT 74150 | $590.40 | $984.00 | $135.45 – $787.20 | 16 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,915.20 | $3,192.00 | $423.03 – $2,553.60 | 16 |
| Abdominal MRI (with contrast) CPT 74182 | $1,393.80 | $2,323.00 | $377.41 – $1,858.40 | 16 |
| Abdominal MRI (without contrast) CPT 74181 | $1,335.60 | $2,226.00 | $240.06 – $1,780.80 | 16 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,693.20 | $2,822.00 | $57.93 – $1,041.88 | 16 |
| Abdominal Ultrasound (complete) CPT 76700 | $439.20 | $732.00 | $100.03 – $585.60 | 16 |
| Abdominal Ultrasound (limited) CPT 76705 | $280.80 | $468.00 | $65.62 – $374.40 | 16 |
| Abdominal X-ray (2 views) CPT 74019 | $110.40 | $184.00 | $27.11 – $147.20 | 16 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | $125.40 | $209.00 | $40.66 – $167.20 | 16 |
| Abdominal X-ray (single view) CPT 74018 | $97.20 | $162.00 | $22.20 – $129.60 | 16 |
| Abdominoplasty 15830 CPT 15830 | $2,107.80 | $3,513.00 | $973.80 – $2,810.40 | 14 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $153.00 | $255.00 | $57.26 – $1,041.88 | 15 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $326.40 | $544.00 | $39.90 – $771.51 | 15 |
| Ablation of upper extremity nerves rf CPT 64999 | not published | not published | $48.55 – $48.55 | 1 |
| Abobotulinumtoxina HCPCS J0586 | $19.80 | $33.00 | $8.75 – $26.40 | 14 |
| Abscess imaging whole body CPT 78806 | $1,153.80 | $1,923.00 | $533.06 – $1,538.40 | 13 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $59.40 | $99.00 | $0.05 – $79.20 | 14 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $45.60 | $76.00 | $19.84 – $60.80 | 14 |
| Acetone qualitative CPT 82009 | $46.80 | $78.00 | $2.94 – $62.40 | 16 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $260.40 | $434.00 | $0.39 – $347.20 | 14 |
| Acetylcysteine non-comp unit HCPCS J7608 | $15.00 | $25.00 | $0.83 – $8.65 | 14 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $467.40 | $779.00 | $92.67 – $623.20 | 16 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $52.80 | $88.00 | $16.30 – $70.40 | 14 |
| Acromp/acromionectomy prtl CPT 23130 | $1,094.40 | $1,824.00 | $505.61 – $1,677.17 | 14 |
| Acute hepatitis panel CPT 80074 | $447.00 | $745.00 | $30.96 – $596.00 | 16 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $4.20 | $7.00 | $0.04 – $5.60 | 14 |
| Adalimumab injection HCPCS J0135 | $1,089.60 | $1,816.00 | $503.40 – $1,452.80 | 14 |
| Adapter b 8 channel 10cm HCPCS C1883 | $1,470.00 | $2,450.00 | $465.50 – $1,960.00 | 14 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $51.00 | $85.00 | $0.56 – $68.00 | 14 |
| Adenovirus ag ia CPT 87301 | $111.60 | $186.00 | $7.79 – $148.80 | 15 |
| Adenovirus antibody,serum - quest CPT 86603 | $90.00 | $150.00 | $8.37 – $120.00 | 16 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $1,343.40 | $2,239.00 | $291.38 – $1,791.20 | 15 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $237.60 | $396.00 | $0.26 – $87.20 | 14 |
| Admin ecg contrast agent CPT 93352 | $104.40 | $174.00 | $37.84 – $139.20 | 15 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $193.20 | $322.00 | $29.69 – $257.60 | 16 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $271.80 | $453.00 | $64.76 – $362.40 | 16 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $848.40 | $1,414.00 | $131.04 – $1,131.20 | 16 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $607.80 | $1,013.00 | $96.81 – $810.40 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $150.60 | $251.00 | $32.58 – $200.80 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $292.80 | $488.00 | $52.74 – $390.40 | 16 |
| Administration immunization each additional vaccine CPT 90472 | $17.40 | $29.00 | $0.56 – $16.34 | 14 |
| Administration vaccine hepatitis b HCPCS G0010 | $16.20 | $27.00 | $7.48 – $21.60 | 14 |
| Administration vaccine influenza virus HCPCS G0008 | $86.40 | $144.00 | $9.70 – $28.00 | 15 |
| Administration vaccine pneumococcal HCPCS G0009 | $86.40 | $144.00 | $9.70 – $28.00 | 15 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $15,894.60 | $26,491.00 | $42.16 – $13,245.60 | 14 |
| Adrenalin epinephrine inject HCPCS J0171 | $381.60 | $636.00 | $0.55 – $1.60 | 14 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $19,490.40 | $32,484.00 | $230.15 – $3,712.00 | 14 |
| Air conduction bilat CPT 92552 | $12.00 | $20.00 | $5.54 – $38.14 | 16 |
| Albumin body fluid quantitative each specimen CPT 82042 | $39.60 | $66.00 | $2.41 – $52.80 | 15 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $61.80 | $103.00 | $21.34 – $61.60 | 15 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $63.00 | $105.00 | $29.11 – $84.00 | 15 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $82.20 | $137.00 | $3.76 – $109.60 | 16 |
| Albumin serum plasma or whole blood CPT 82040 | $39.60 | $66.00 | $3.22 – $52.80 | 16 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $289.80 | $483.00 | $133.89 – $2,429.89 | 14 |
| Alkaline phosphatase CPT 84075 | $40.80 | $68.00 | $3.37 – $54.40 | 16 |
| Allergen egg white ige CPT 86003 | $1,347.00 | $2,245.00 | $3.39 – $1,796.00 | 16 |
| Allergy injections; 2 or more 95117 CPT 95117 | $41.40 | $69.00 | $10.44 – $55.20 | 15 |
| Allergy injection; single 95115 CPT 95115 | $36.60 | $61.00 | $9.03 – $48.80 | 15 |
| Allgrft implnt knee w/scope CPT 29867 | $2,334.60 | $3,891.00 | $1,078.59 – $3,112.80 | 14 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $7,558.80 | $12,598.00 | $78.17 – $10,078.40 | 14 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $6,451.80 | $10,753.00 | $916.70 – $2,645.60 | 15 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $4,333.80 | $7,223.00 | $1,372.37 – $5,778.40 | 14 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $676.20 | $1,127.00 | $151.16 – $901.60 | 15 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $2,400.60 | $4,001.00 | $101.87 – $3,200.80 | 14 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $2,536.20 | $4,227.00 | $803.13 – $3,381.60 | 14 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $1.20 | $2.00 | $0.55 – $5.46 | 14 |
| Alpha-fetoprotein tumor marker CPT 82105 | $115.20 | $192.00 | $10.90 – $153.60 | 16 |
| Alprostadil for injection HCPCS J0270 | $249.00 | $415.00 | $11.71 – $283.20 | 14 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $5,517.60 | $9,196.00 | $37.70 – $108.80 | 14 |
| Alt/sgpt CPT 84460 | $40.80 | $68.00 | $3.44 – $54.40 | 16 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $151.20 | $252.00 | $42.23 – $201.60 | 15 |
| Ambl bp mntr w/sw a/r CPT 93788 | $18.60 | $31.00 | $5.76 – $24.80 | 14 |
| Amifostine HCPCS J0207 | $667.20 | $1,112.00 | $308.25 – $889.60 | 14 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $15.00 | $25.00 | $0.63 – $20.00 | 14 |
| Amino acid screen, urine CPT 82128 | $133.80 | $223.00 | $8.40 – $178.40 | 16 |
| Aminolevulinic acid delta CPT 82135 | $112.20 | $187.00 | $10.69 – $149.60 | 16 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $16.80 | $28.00 | $5.96 – $22.40 | 14 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $57.60 | $96.00 | $2.61 – $57.60 | 14 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $15.60 | $26.00 | $0.43 – $20.80 | 14 |
| Ammonia CPT 82140 | $100.80 | $168.00 | $5.25 – $134.40 | 16 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $1,377.60 | $2,296.00 | $306.60 – $1,836.80 | 15 |
| Amphetamine confirm urine -sendout CPT 80324 | $61.80 | $103.00 | $9.85 – $82.40 | 15 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $21.00 | $35.00 | $0.55 – $7.20 | 14 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $18.00 | $30.00 | $1.39 – $12.80 | 14 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $532.20 | $887.00 | $53.00 – $709.60 | 14 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $852.60 | $1,421.00 | $240.97 – $1,136.80 | 15 |
| Amputate lower leg at knee CPT 27598 | $1,287.60 | $2,146.00 | $594.87 – $2,004.78 | 14 |
| Amputation follow-up surgery CPT 25931 | $1,336.80 | $2,228.00 | $617.60 – $1,782.40 | 14 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | $1,218.60 | $2,031.00 | $562.99 – $1,748.86 | 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.