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 |
|---|---|---|---|---|
| Small bowel endoscopy CPT 44366 | $723.00 | $1,205.00 | $217.88 – $1,041.88 | 15 |
| Small bowel endoscopy CPT 44369 | $739.20 | $1,232.00 | $217.88 – $1,041.88 | 15 |
| Small bowel endoscopy CPT 44382 | $157.80 | $263.00 | $72.90 – $771.51 | 15 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $581.40 | $969.00 | $188.51 – $1,041.88 | 15 |
| Small bowel endoscopy 44365 CPT 44365 | $550.20 | $917.00 | $179.04 – $1,041.88 | 15 |
| Small bowel endoscopy/biopsy CPT 44361 | $483.00 | $805.00 | $156.78 – $1,041.88 | 15 |
| Small bowel endoscopy br/wa CPT 44380 | $125.40 | $209.00 | $57.93 – $771.51 | 15 |
| Smear gram stain CPT 87205 | $33.00 | $55.00 | $2.78 – $44.00 | 16 |
| Smear nasal eosinophil CPT 89190 | $36.60 | $61.00 | $3.76 – $48.80 | 16 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $44.40 | $74.00 | $3.89 – $59.20 | 16 |
| Smear wet mount CPT 87210 | $44.40 | $74.00 | $3.78 – $59.20 | 16 |
| Sodium 24 hour urine CPT 84300 | $37.80 | $63.00 | $3.29 – $50.40 | 16 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $7.20 | $12.00 | $1.95 – $8.80 | 14 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $10.80 | $18.00 | $1.26 – $5.60 | 14 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $9.60 | $16.00 | $0.65 – $4.80 | 14 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $39.60 | $66.00 | $2.02 – $52.80 | 14 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $197.40 | $329.00 | $71.52 – $263.20 | 14 |
| Sodium serum/plasma/whole blood CPT 84295 | $37.80 | $63.00 | $3.13 – $50.40 | 16 |
| Sp bone agrft morsel add-on CPT 20937 | $231.60 | $386.00 | $47.40 – $1,041.88 | 15 |
| Sp bone agrft struct add-on CPT 20938 | $249.60 | $416.00 | $51.56 – $1,041.88 | 15 |
| Sp bone algrft morsel add-on CPT 20930 | $190.20 | $317.00 | $87.87 – $253.60 | 13 |
| Special supplies phys/qhp CPT 99070 | $319.80 | $533.00 | $69.72 – $426.40 | 13 |
| Specific gravity body fluid CPT 84315 | $12.00 | $20.00 | $2.13 – $16.00 | 15 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $444.00 | $740.00 | $152.00 – $592.00 | 15 |
| Speech Therapy Session (one-on-one) CPT 92507 | $180.60 | $301.00 | $22.79 – $240.80 | 16 |
| Sperm antibody test CPT 89325 | $75.00 | $125.00 | $6.94 – $100.00 | 15 |
| Sphenoid sinus surgery CPT 31051 | $1,141.80 | $1,903.00 | $432.60 – $1,522.40 | 15 |
| Spinal bone allograftstructural 20931 CPT 20931 | $202.80 | $338.00 | $41.58 – $1,041.88 | 15 |
| Spinal bone autograftlocal 20936 CPT 20936 | $234.00 | $390.00 | $108.11 – $312.00 | 12 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $126.00 | $210.00 | $58.21 – $771.51 | 15 |
| Spine X-ray (single view, one level) CPT 72020 | $142.80 | $238.00 | $22.47 – $190.40 | 16 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $465.60 | $776.00 | $147.44 – $723.38 | 15 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $15.00 | $25.00 | $2.25 – $20.00 | 14 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $346.20 | $577.00 | $109.63 – $461.60 | 14 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $1,369.20 | $2,282.00 | $632.57 – $2,357.48 | 14 |
| Sputum specimen collection CPT 89220 | $65.40 | $109.00 | $11.65 – $87.20 | 15 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $354.60 | $591.00 | $103.87 – $472.80 | 15 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $3,393.00 | $5,655.00 | $1,074.45 – $4,524.00 | 14 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $75.60 | $126.00 | $23.94 – $100.80 | 14 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $1,333.20 | $2,222.00 | $422.18 – $1,777.60 | 14 |
| St evaluate speech sound production CPT 92522 | $354.60 | $591.00 | $106.03 – $472.80 | 15 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $418.80 | $698.00 | $44.44 – $558.40 | 16 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,176.60 | $1,961.00 | $141.74 – $1,568.80 | 16 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $307.80 | $513.00 | $19.23 – $143.64 | 16 |
| Strapping of chest CPT 29200 | $225.00 | $375.00 | $14.41 – $105.00 | 16 |
| Strapping of elbow or wrist 29260 CPT 29260 | $220.20 | $367.00 | $32.95 – $102.76 | 16 |
| Strapping of hand or finger CPT 29280 | $220.20 | $367.00 | $37.70 – $108.80 | 15 |
| Strapping of hip CPT 29520 | $59.40 | $99.00 | $12.47 – $83.98 | 16 |
| Strapping of knee CPT 29530 | $307.80 | $513.00 | $19.34 – $143.64 | 16 |
| Strapping of toes 29550 CPT 29550 | $307.80 | $513.00 | $12.21 – $143.64 | 16 |
| Strep a ag ia CPT 87430 | $43.20 | $72.00 | $6.62 – $57.60 | 16 |
| Strep b dna amp probe CPT 87653 | $124.20 | $207.00 | $22.81 – $165.60 | 16 |
| Stress test pulmonary CPT 94618 | $40.20 | $67.00 | $18.57 – $53.60 | 16 |
| Stress tte complete CPT 93351 | $916.80 | $1,528.00 | $194.82 – $1,222.40 | 16 |
| Subtalar arthro w/deb CPT 29906 | $1,253.40 | $2,089.00 | $579.07 – $1,671.20 | 14 |
| Subtalar arthro w/exc CPT 29905 | $1,069.80 | $1,783.00 | $494.25 – $1,426.40 | 14 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $24.00 | $40.00 | $0.92 – $32.00 | 14 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $5,718.60 | $9,531.00 | $1,760.54 – $7,192.80 | 14 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $253.20 | $422.00 | $55.86 – $337.60 | 14 |
| Support clav 29.6-40.5in med HCPCS L3650 | $108.00 | $180.00 | $34.20 – $144.00 | 15 |
| Surg dx exam anorectal CPT 45990 | $150.00 | $250.00 | $30.77 – $1,041.88 | 15 |
| Surgical pathology level 1 gross examination only CPT 88300 | $52.80 | $88.00 | $5.75 – $70.40 | 16 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $110.40 | $184.00 | $11.85 – $147.20 | 16 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $132.60 | $221.00 | $17.36 – $176.80 | 16 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $169.20 | $282.00 | $35.70 – $225.60 | 16 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $572.40 | $954.00 | $47.77 – $763.20 | 16 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $811.20 | $1,352.00 | $53.00 – $1,081.60 | 16 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $720.00 | $1,200.00 | $158.03 – $960.00 | 15 |
| Susceptibility mic per plate CPT 87186 | $61.20 | $102.00 | $5.62 – $81.60 | 16 |
| Swallowing Evaluation (Bedside) CPT 92610 | $418.80 | $698.00 | $40.84 – $558.40 | 16 |
| Swallowing Therapy Session CPT 92526 | $272.40 | $454.00 | $82.99 – $363.20 | 15 |
| Sweat collection by iontophoresis CPT 89230 | $90.00 | $150.00 | $1.47 – $120.00 | 15 |
| Synch audio-only est high 40 CPT 98015 | $149.40 | $249.00 | $69.02 – $199.20 | 12 |
| Synch audio-only est low 20 CPT 98013 | $69.00 | $115.00 | $31.88 – $92.00 | 12 |
| Synch audio-only est mod 30 CPT 98014 | $102.00 | $170.00 | $47.12 – $136.00 | 12 |
| Synch audio-only est sf 10 CPT 98012 | $37.80 | $63.00 | $17.46 – $50.40 | 12 |
| Synch audio-only new high 60 CPT 98011 | $183.60 | $306.00 | $84.82 – $244.80 | 12 |
| Synch audio-only new low 30 CPT 98009 | $89.40 | $149.00 | $41.30 – $119.20 | 12 |
| Synch audio-only new mod 45 CPT 98010 | $140.40 | $234.00 | $64.86 – $187.20 | 12 |
| Synch audio-only new sf 15 CPT 98008 | $51.60 | $86.00 | $23.84 – $68.80 | 12 |
| Synvisc or synvisc-one HCPCS J7325 | $29.40 | $49.00 | $7.95 – $39.20 | 14 |
| System pacing micra av HCPCS C1786 | $3,982.20 | $6,637.00 | $1,261.03 – $5,309.60 | 14 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $6,752.40 | $11,254.00 | $2,138.26 – $9,003.20 | 14 |
| T3 (triiodothyronine) free CPT 84481 | $177.60 | $296.00 | $11.01 – $236.80 | 16 |
| T3 (triiodothyronine) total CPT 84480 | $102.60 | $171.00 | $8.40 – $136.80 | 16 |
| T4 (thyroxine) free CPT 84439 | $64.20 | $107.00 | $5.86 – $85.60 | 16 |
| T4 (thyroxine) total CPT 84436 | $49.80 | $83.00 | $4.47 – $66.40 | 16 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $4.20 | $7.00 | $0.17 – $5.60 | 14 |
| Tacrolimus therapeutic drug level CPT 80197 | $175.80 | $293.00 | $8.92 – $234.40 | 16 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $3,475.80 | $5,793.00 | $14.31 – $4,634.40 | 14 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | $160.80 | $268.00 | $25.77 – $214.40 | 16 |
| Target gsa panel hmtlmph neop CPT 81450 | $3,256.20 | $5,427.00 | $53.00 – $4,341.60 | 16 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $280.80 | $468.00 | $40.29 – $374.40 | 16 |
| Tc-99m exametazime diag HCPCS A9521 | $1,335.00 | $2,225.00 | $616.77 – $1,780.00 | 13 |
| Tc-99m labeled rbc HCPCS A9560 | $271.20 | $452.00 | $106.48 – $361.60 | 13 |
| Tc-99m maa HCPCS A9540 | $61.20 | $102.00 | $28.27 – $81.60 | 13 |
| Tc-99m mebrofenin HCPCS A9537 | $250.80 | $418.00 | $63.06 – $334.40 | 13 |
| Tc-99m medronate HCPCS A9503 | $159.00 | $265.00 | $14.82 – $212.00 | 13 |
| Tc-99m mertiatide HCPCS A9562 | $587.40 | $979.00 | $271.38 – $783.20 | 13 |
| Tc-99m pentetate dtpa HCPCS A9539 | $61.20 | $102.00 | $28.27 – $81.60 | 13 |
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.