UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
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 |
|---|---|---|---|---|
| Decalcification CPT 88311 | $272.40 | $454.00 | $12.71 – $142.12 | 12 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $184.80 | $269.00 | $0.77 – $8.55 | 7 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $294.60 | $491.00 | $27.57 – $459.65 | 16 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $321.20 – $2,707.75 | 16 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $2,502.06 – $9,905.66 | 13 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $109.45 – $3,968.58 | 16 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $27.60 | $46.00 | $2.81 – $6.96 | 13 |
| Delayed breast prosthesis 19342 CPT 19342 | not published | not published | $836.96 – $13,268.67 | 13 |
| Delay flap eye/nos/ear/lip CPT 15630 | not published | not published | $317.13 – $2,536.45 | 16 |
| Delivery of placenta 59414 CPT 59414 | $1,687.80 | $2,813.00 | $93.96 – $4,408.81 | 16 |
| Delivery transcath fxtn dvc to endogrft w/s&i CPT 34712 | $5,322.00 | $8,870.00 | $444.68 – $1,670.19 | 3 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $661.80 | $1,103.00 | $13.00 – $273.12 | 16 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $3,027.00 | $5,045.00 | $18.55 – $2,080.57 | 15 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $2,337.60 | $3,896.00 | $25.85 – $545.04 | 15 |
| Dermagraft HCPCS Q4106 | $147.00 | $245.00 | $71.47 – $75.21 | 2 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | $6,715.80 | $11,193.00 | $3,014.16 – $4,345.18 | 3 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $85.60 | $107.00 | $2.23 – $10.09 | 13 |
| Desoxycorticosterone CPT 82633 | $505.80 | $843.00 | $30.62 – $84.20 | 16 |
| Destroy vulva lesion extensive 56515 CPT 56515 | not published | not published | $128.15 – $2,536.45 | 16 |
| Destroy vulva lesion simple 56501 CPT 56501 | not published | not published | $69.85 – $2,536.45 | 16 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $56.51 – $275.52 | 16 |
| Destruction anal lesion(s) CPT 46910 | not published | not published | $118.18 – $2,536.45 | 16 |
| Destruction anal lesion(s) CPT 46924 | not published | not published | $126.50 – $3,802.67 | 16 |
| Destruction benign lesions < 14 lesions CPT 17110 | $714.00 | $1,190.00 | $53.90 – $275.52 | 16 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $729.80 – $3,802.67 | 13 |
| Destruction vag lesions complex 57065 CPT 57065 | not published | not published | $169.88 – $4,408.81 | 16 |
| Device intraute mirena HCPCS J7298 | $3,239.20 | $4,049.00 | $645.67 – $3,779.24 | 2 |
| Device sut capio slim opn HCPCS C2631 | $2,653.20 | $4,422.00 | $533.05 – $533.05 | 1 |
| Device tiss remov myosure reach HCPCS C1782 | $3,130.20 | $5,217.00 | $318.02 – $318.02 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $121.20 | $202.00 | $23.98 – $118.50 | 12 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | $528.00 | $660.00 | $64.99 – $122.32 | 12 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | $1,665.00 | $2,775.00 | $0.99 – $7.38 | 3 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $20.40 | $34.00 | $0.01 – $0.22 | 9 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $12.80 | $16.00 | $0.06 – $0.33 | 10 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,746.00 | $2,910.00 | $39.82 – $312.65 | 13 |
| Dextran 40 infusion HCPCS J7100 | $680.80 | $851.00 | $29.91 – $127.55 | 3 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $143.40 | $239.00 | $0.89 – $4.32 | 7 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $107.20 | $134.00 | $1.67 – $16.20 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $136.80 | $171.00 | $1.14 – $5.25 | 7 |
| Dextrose 5 % IV bolus HCPCS J7070 | $96.00 | $120.00 | $1.97 – $10.51 | 7 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $325.20 | $542.00 | $21.00 – $42.96 | 16 |
| Diabetes (HbA1c) Test CPT 83036 | $125.40 | $209.00 | $7.00 – $20.60 | 16 |
| Diab manage trn ind/group HCPCS G0109 | $93.00 | $155.00 | $13.28 – $55.76 | 10 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $701.79 – $8,090.06 | 13 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $52.72 – $1,634.95 | 12 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $384.60 | $641.00 | $22.00 – $178.73 | 16 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $856.20 | $1,427.00 | $75.90 – $321.79 | 16 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $612.00 | $1,020.00 | $73.61 – $221.29 | 11 |
| Diagnostic Mammogram (one breast) CPT 77065 | $478.80 | $798.00 | $57.72 – $174.53 | 11 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $160.23 – $2,450.86 | 10 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $37.20 | $62.00 | $1.97 – $14.90 | 7 |
| Dicyclomine injection HCPCS J0500 | $496.00 | $620.00 | $3.35 – $67.98 | 7 |
| Diffusing capacity CPT 94729 | $298.80 | $498.00 | $36.25 – $148.64 | 11 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $78.40 | $98.00 | $3.12 – $25.62 | 7 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,528.80 | $14,411.00 | $1,285.38 – $5,581.69 | 13 |
| Digoxin total therapeutic drug level CPT 80162 | $181.80 | $303.00 | $11.00 – $25.67 | 16 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $574.40 | $718.00 | $15.56 – $115.27 | 7 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $64.90 – $1,300.05 | 16 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $2,145.00 | $3,575.00 | $351.03 – $505.54 | 2 |
| Dilate ic vasospasm init CPT 61640 | $6,317.40 | $10,529.00 | $998.42 – $1,439.28 | 2 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $22.00 – $216.96 | 16 |
| Dilation of salivary duct CPT 42660 | not published | not published | $38.50 – $706.14 | 16 |
| Dilation of urethra CPT 53665 | not published | not published | $22.00 – $2,840.52 | 16 |
| Dilator fascial 10fx20cm HCPCS C2627 | $415.20 | $692.00 | $104.22 – $104.22 | 1 |
| Dilat xst trc ndurlgc px CPT 50436 | $2,365.80 | $3,943.00 | $94.52 – $4,782.42 | 13 |
| Dimenhydrinate injection HCPCS J1240 | $14.40 | $18.00 | $1.32 – $24.37 | 7 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $9.60 | $16.00 | $0.02 – $3.46 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $84.80 | $106.00 | $0.48 – $2.18 | 10 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $24.60 | $41.00 | $9.93 – $64.02 | 11 |
| Disability dlco CPT 94727 | $173.40 | $289.00 | $34.35 – $205.40 | 16 |
| Disaccharidases CPT 82657 | $304.80 | $508.00 | $21.91 – $47.94 | 13 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $2,226.17 – $7,495.67 | 13 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,381.13 – $8,202.79 | 13 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $1,597.80 | $2,663.00 | $195.30 – $723.16 | 3 |
| Dna antibody native/double stranded CPT 86225 | $192.00 | $320.00 | $13.58 – $26.56 | 16 |
| Dna gardnerella CPT 87510 | $268.20 | $447.00 | $16.04 – $51.51 | 16 |
| Dna trichomonas CPT 87660 | $278.40 | $464.00 | $19.82 – $53.81 | 16 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $337.20 | $562.00 | $4.47 – $26.81 | 7 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $5,133.60 | $8,556.00 | $0.40 – $2.72 | 7 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $81.60 | $136.00 | $0.53 – $2.10 | 7 |
| Doppler echo complete CPT 93320 | $495.00 | $825.00 | $66.58 – $203.12 | 11 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $537.00 | $895.00 | $189.67 – $541.32 | 3 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $291.00 | $485.00 | $100.70 – $382.89 | 16 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $201.60 | $336.00 | $53.67 – $333.51 | 16 |
| Dornase alfa non-comp unit HCPCS J7639 | $197.60 | $247.00 | $11.25 – $141.78 | 9 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $574.20 | $957.00 | $100.25 – $263.21 | 13 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $554.40 | $693.00 | $1.91 – $8.93 | 7 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,819.20 | $3,032.00 | $68.49 – $182.49 | 13 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $1.40 | $1.75 | $0.07 – $0.11 | 4 |
| Dpyd gene common variants CPT 81232 | $1,535.40 | $2,559.00 | $110.86 – $188.79 | 13 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $541.20 | $902.00 | $29.15 – $975.61 | 16 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $2,312.40 | $3,854.00 | $38.50 – $975.61 | 16 |
| Drainage external ear simple 69000 CPT 69000 | $1,248.00 | $2,080.00 | $47.30 – $975.61 | 16 |
| Drainage mouth roof lesion CPT 42000 | $4,356.00 | $7,260.00 | $22.00 – $729.80 | 16 |
| Drainage of arm bursa 23931 CPT 23931 | $4,234.20 | $7,057.00 | $43.45 – $2,246.66 | 16 |
| Drainage of kidney lesion CPT 50390 | $2,310.60 | $3,851.00 | $100.70 – $975.61 | 16 |
| Drainage of mouth lesion CPT 41008 | $3,332.40 | $5,554.00 | $25.85 – $4,496.91 | 16 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $25.85 – $706.14 | 16 |
| Drainage of mouth lesion CPT 41017 | $3,332.40 | $5,554.00 | $25.85 – $4,496.91 | 16 |
| Drainage of nose lesion int 30000 CPT 30000 | $9,740.40 | $16,234.00 | $56.10 – $1,631.43 | 16 |
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.