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 |
|---|---|---|---|---|
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $61.20 | $102.00 | $23.02 – $81.60 | 13 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $63.00 | $105.00 | $1.93 – $84.00 | 13 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $118.80 | $198.00 | $54.89 – $158.40 | 13 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $528.00 | $880.00 | $243.94 – $704.00 | 13 |
| Tc-99m sulfur colloid HCPCS A9541 | $373.80 | $623.00 | $172.70 – $713.83 | 14 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $103.80 | $173.00 | $47.96 – $138.40 | 13 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $207.60 | $346.00 | $30.54 – $276.80 | 16 |
| T cells absolute cd 4 count CPT 86361 | $111.60 | $186.00 | $17.41 – $148.80 | 16 |
| T cells total count CPT 86359 | $331.20 | $552.00 | $24.52 – $441.60 | 16 |
| Telehealth original site facility fee HCPCS Q3014 | $97.80 | $163.00 | $19.13 – $55.20 | 14 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $4,500.60 | $7,501.00 | $172.22 – $6,000.80 | 14 |
| Tenodesis biceps tdn at elbw CPT 24340 | $1,089.60 | $1,816.00 | $497.18 – $1,452.80 | 15 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | $1,179.00 | $1,965.00 | $205.28 – $1,572.00 | 15 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | $551.40 | $919.00 | $117.60 – $1,041.88 | 15 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $486.60 | $811.00 | $87.15 – $2,325.85 | 15 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $40.80 | $68.00 | $7.39 – $54.40 | 14 |
| Testicular imaging w/vasc flow CPT 78761 | $703.80 | $1,173.00 | $134.44 – $938.40 | 16 |
| Test stress cardiovascular tracing only CPT 93017 | $609.00 | $1,015.00 | $39.80 – $812.00 | 16 |
| Test urine urobilinogen CPT 84578 | $29.40 | $49.00 | $2.91 – $39.20 | 16 |
| Tetanus immune globulin inj HCPCS J1670 | $706.20 | $1,177.00 | $326.26 – $941.60 | 14 |
| Theophylline therapeutic drug level CPT 80198 | $97.80 | $163.00 | $9.19 – $130.40 | 16 |
| Therapeutic procd strg endur HCPCS G0237 | $45.00 | $75.00 | $9.26 – $60.00 | 14 |
| Therapy Activity Training (each 15 minutes) CPT 97530 | $81.00 | $135.00 | $13.65 – $108.00 | 16 |
| Therapy Exercise Session (each 15 minutes) CPT 97110 | $76.80 | $128.00 | $8.80 – $102.40 | 16 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $109.20 | $182.00 | $26.43 – $145.60 | 14 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $94.80 | $158.00 | $18.14 – $126.40 | 14 |
| Ther/proph/diag inj ia CPT 96373 | $108.00 | $180.00 | $11.34 – $50.40 | 16 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $12.60 | $21.00 | $1.82 – $16.80 | 14 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | $118.80 | $198.00 | $32.69 – $158.40 | 15 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,092.60 | $1,821.00 | $42.41 – $863.16 | 15 |
| Three-Phase Bone Scan (Nuclear Medicine) CPT 78315 | $1,171.20 | $1,952.00 | $174.69 – $1,561.60 | 16 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $31.80 | $53.00 | $4.21 – $42.40 | 16 |
| Thyroglobulin antibody CPT 86800 | $132.60 | $221.00 | $10.34 – $176.80 | 16 |
| Thyroid (TSH) Test CPT 84443 | $78.60 | $131.00 | $10.92 – $104.80 | 16 |
| Thyroid Ultrasound CPT 76536 | $339.60 | $566.00 | $80.17 – $452.80 | 16 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $1,864.20 | $3,107.00 | $500.35 – $2,116.32 | 14 |
| Thyroxine binding globulin (tbg) CPT 84442 | $103.80 | $173.00 | $9.61 – $138.40 | 16 |
| Tibial arthroscopy/surgery CPT 29855 | $1,560.00 | $2,600.00 | $720.72 – $2,080.00 | 14 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $18,427.80 | $30,713.00 | $188.76 – $24,570.40 | 14 |
| Tissue culture skin/biopsy CPT 88233 | $635.40 | $1,059.00 | $53.00 – $847.20 | 16 |
| Tissue exam koh skin/hair/nails CPT 87220 | $35.40 | $59.00 | $2.78 – $47.20 | 16 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | $14,742.60 | $24,571.00 | $2,956.80 – $19,656.80 | 14 |
| Tixagev and cilgav inj HCPCS M0220 | $1,020.00 | $1,700.00 | $126.42 – $1,360.00 | 16 |
| Tl-201 thallium diag per mci HCPCS A9505 | $181.20 | $302.00 | $37.23 – $241.60 | 13 |
| Tlh w/t/o 250 g or less CPT 58571 | $1,816.80 | $3,028.00 | $839.36 – $2,422.40 | 14 |
| Tlh w/t/o uterus over 250 g CPT 58573 | not published | not published | $1,677.17 – $7,637.28 | 4 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $465.60 | $776.00 | $1.94 – $5.60 | 14 |
| Tobramycin peak therapeutic drug level CPT 80200 | $154.20 | $257.00 | $10.48 – $205.60 | 16 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $6,612.60 | $11,021.00 | $5.71 – $1,763.20 | 14 |
| Toe X-ray (both feet) CPT 73660 | $118.80 | $198.00 | $8.32 – $51.81 | 15 |
| Tomosynthesis breast screen bilateral CPT 77063 | $129.00 | $215.00 | $46.23 – $212.00 | 16 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | $205.20 | $342.00 | $30.21 – $1,041.88 | 16 |
| Tongue mouth neck surgery CPT 41153 | $4,382.40 | $7,304.00 | $2,024.67 – $5,843.20 | 14 |
| Tonsillectomy (age 12+) CPT 42826 | $461.40 | $769.00 | $213.17 – $1,470.59 | 14 |
| Tonsillectomy (child under 12) CPT 42825 | not published | not published | $557.45 – $5,167.85 | 4 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $702.00 | $1,170.00 | $0.91 – $936.00 | 14 |
| Total Hip Replacement CPT 27130 | $3,477.00 | $5,795.00 | $1,606.37 – $4,895.36 | 14 |
| Total hysterectomy CPT 58150 | $1,822.80 | $3,038.00 | $842.13 – $2,430.40 | 14 |
| Total Knee Replacement CPT 27447 | $3,271.80 | $5,453.00 | $1,511.57 – $5,731.96 | 14 |
| Toxoplasma antibody igg CPT 86777 | $100.20 | $167.00 | $9.35 – $133.60 | 16 |
| Tracheostoma revision; simple, without flap rotation CPT 31613 | $845.40 | $1,409.00 | $204.75 – $1,127.20 | 15 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $166.80 | $278.00 | $22.48 – $222.40 | 15 |
| Transcutaneous hgb 88738 CPT 88738 | $25.20 | $42.00 | $3.26 – $33.60 | 16 |
| Transferrin CPT 84466 | $135.60 | $226.00 | $8.29 – $180.80 | 16 |
| Transplant forearm tendon CPT 25310 | $1,335.00 | $2,225.00 | $470.40 – $1,780.00 | 15 |
| Transplant hand tendon CPT 26480 | $1,284.60 | $2,141.00 | $593.49 – $1,712.80 | 14 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | $337.20 | $562.00 | $80.33 – $449.60 | 16 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | $326.40 | $544.00 | $91.97 – $435.20 | 16 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $4,137.00 | $6,895.00 | $75.03 – $5,516.00 | 14 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | $482.40 | $804.00 | $18.99 – $643.20 | 14 |
| Treat ankle dislocation CPT 27842 | $1,580.40 | $2,634.00 | $124.42 – $1,216.00 | 16 |
| Treat ankle fracture CPT 28445 | $1,699.80 | $2,833.00 | $282.45 – $2,266.40 | 15 |
| Treat big toe fracture CPT 28505 | $858.00 | $1,430.00 | $174.82 – $1,192.92 | 15 |
| Treat clavicle dislocation 23545 CPT 23545 | $1,266.00 | $2,110.00 | $123.90 – $771.51 | 16 |
| Treat ectopic pregnancy CPT 59151 | not published | not published | $1,480.67 – $5,167.06 | 4 |
| Treat elbow dislocation CPT 24605 | $1,693.20 | $2,822.00 | $165.38 – $1,147.20 | 16 |
| Treat elbow fracture CPT 24586 | $2,013.60 | $3,356.00 | $682.50 – $2,831.42 | 15 |
| Treat finger fracture each CPT 26727 | $903.60 | $1,506.00 | $235.20 – $2,325.85 | 15 |
| Treat foot dislocation CPT 28605 | $463.20 | $772.00 | $77.17 – $771.51 | 15 |
| Treat fracture of radius CPT 25505 | $1,581.00 | $2,635.00 | $152.25 – $1,123.20 | 16 |
| Treat fracture of ulna CPT 25535 | $478.20 | $797.00 | $95.08 – $814.74 | 16 |
| Treat hand dislocation CPT 26675 | $1,693.20 | $2,822.00 | $77.17 – $1,041.88 | 16 |
| Treat hand dislocation CPT 26685 | $764.40 | $1,274.00 | $353.15 – $1,192.92 | 14 |
| Treat hip dislocation CPT 27252 | $1,391.40 | $2,319.00 | $295.57 – $1,855.20 | 15 |
| Treat humerus fracture CPT 24515 | $1,695.00 | $2,825.00 | $411.60 – $2,260.00 | 15 |
| Treat humerus fracture CPT 24516 | $1,675.80 | $2,793.00 | $774.22 – $2,234.40 | 14 |
| Treat humerus fracture CPT 24535 | $1,950.60 | $3,251.00 | $216.30 – $1,436.00 | 16 |
| Treat humerus fracture CPT 24545 | $1,524.00 | $2,540.00 | $444.68 – $2,041.83 | 15 |
| Treat humerus fracture CPT 24565 | $750.00 | $1,250.00 | $182.18 – $1,041.88 | 15 |
| Treat humerus fracture CPT 24575 | $1,536.60 | $2,561.00 | $415.80 – $2,048.80 | 15 |
| Treat humerus fracture CPT 24579 | $1,515.60 | $2,526.00 | $415.80 – $2,020.80 | 15 |
| Treat kneecap dislocation CPT 27562 | $1,520.40 | $2,534.00 | $141.22 – $956.00 | 16 |
| Treat kneecap dislocation CPT 27566 | $1,388.40 | $2,314.00 | $470.40 – $2,139.11 | 15 |
| Treat kneecap fracture CPT 27524 | $1,468.80 | $2,448.00 | $426.30 – $1,958.40 | 15 |
| Treat knee dislocation CPT 27552 | $1,099.20 | $1,832.00 | $164.85 – $1,465.60 | 15 |
| Treat knee fracture CPT 27535 | $1,735.20 | $2,892.00 | $801.66 – $2,313.60 | 14 |
| Treat knee fracture 27530 CPT 27530 | $1,266.00 | $2,110.00 | $91.75 – $771.51 | 16 |
| Treat knuckle dislocation CPT 26705 | $1,693.20 | $2,822.00 | $77.17 – $1,041.88 | 16 |
| Treat knuckle dislocation CPT 26715 | $1,023.00 | $1,705.00 | $235.20 – $1,470.59 | 15 |
| Treat lower jaw fracture 21462 CPT 21462 | $1,787.40 | $2,979.00 | $583.80 – $2,414.04 | 15 |
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.