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 |
|---|---|---|---|---|
| Foam drsg <=16 sq in without bdr HCPCS A6209 | $9.00 | $15.00 | $13.27 – $17.26 | 2 |
| Folic acid CPT 82746 | $201.60 | $336.00 | $12.00 – $28.42 | 16 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $1.20 | $1.50 | $0.04 – $0.06 | 4 |
| Follow-up angiography CPT 75898 | $423.60 | $706.00 | $152.89 – $3,740.32 | 12 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $3,905.40 | $6,509.00 | $6.28 – $15.30 | 12 |
| Fondaparinux sodium HCPCS J1652 | $855.00 | $1,425.00 | $0.46 – $31.80 | 10 |
| Foot X-ray CPT 73630 | $325.20 | $542.00 | $19.46 – $118.50 | 13 |
| Foot X-ray (2 views, both feet) CPT 73620 | $297.00 | $495.00 | $17.84 – $118.50 | 13 |
| Forearm X-ray (both sides) CPT 73090 | $235.20 | $392.00 | $19.42 – $118.50 | 13 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $3,162.00 | $5,270.00 | $180.09 – $545.04 | 13 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,269.00 | $2,115.00 | $0.06 – $3.94 | 9 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $419.40 | $699.00 | $4.08 – $13.07 | 3 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $274.45 – $4,782.42 | 16 |
| Frenectomy 41115 CPT 41115 | not published | not published | $351.82 – $2,053.97 | 13 |
| Frenotomy 40806 CPT 40806 | not published | not published | $545.04 – $706.14 | 12 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $247.80 | $413.00 | $33.00 – $91.82 | 15 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $282.60 | $471.00 | $33.00 – $146.41 | 16 |
| Fresh frozen plasma thawing ea un CPT 86927 | $67.20 | $112.00 | $5.17 – $213.04 | 12 |
| Fructosamine glycated protein CPT 82985 | $91.80 | $153.00 | $16.44 – $25.95 | 16 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $786.60 | $1,311.00 | $30.00 – $166.40 | 16 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $729.80 – $2,536.45 | 13 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $729.80 – $2,536.45 | 13 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $729.80 – $2,851.61 | 3 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $836.96 – $2,536.45 | 13 |
| Fundus photography with i&r 92250 CPT 92250 | $138.00 | $230.00 | $24.52 – $161.87 | 12 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $3.60 | $4.50 | $0.01 – $0.27 | 7 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $27.00 | $45.00 | $0.62 – $1.55 | 3 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $1,030.96 – $4,499.05 | 13 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $638.55 – $17,841.43 | 16 |
| Fusion of big toe joint CPT 28750 | not published | not published | $306.35 – $9,905.66 | 16 |
| Fusion of big toe joint CPT 28755 | not published | not published | $234.85 – $9,905.66 | 16 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $670.12 – $2,853.07 | 3 |
| Fusion of finger joint CPT 26860 | not published | not published | $836.96 – $4,499.05 | 13 |
| Fusion of foot bones CPT 28730 | not published | not published | $366.30 – $17,841.43 | 16 |
| Fusion of foot bones CPT 28735 | not published | not published | $425.70 – $17,841.43 | 16 |
| Fusion of foot bones CPT 28740 | not published | not published | $1,030.96 – $9,905.66 | 13 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $240.00 | $400.00 | $59.54 – $137.72 | 3 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $2.40 | $4.00 | $0.17 – $1.79 | 7 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $55.80 | $93.00 | $0.93 – $4.74 | 8 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $70.80 | $118.00 | $9.30 – $40.13 | 8 |
| Galectin-3 CPT 82777 | $87.00 | $145.00 | $14.24 – $47.79 | 16 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $652.20 | $1,087.00 | $208.17 – $546.54 | 16 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $814.20 | $1,357.00 | $208.17 – $700.71 | 16 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $1,414.39 – $8,090.06 | 13 |
| Gamma globulin 1 cc inj HCPCS J1460 | $21.60 | $36.00 | $3.87 – $52.95 | 13 |
| Gammaglobulin iga CPT 82784 | $193.20 | $322.00 | $9.19 – $17.97 | 16 |
| Gammaglobulin ige CPT 82785 | $270.60 | $451.00 | $16.27 – $31.82 | 16 |
| Gamma glutamyltransferase CPT 82977 | $93.60 | $156.00 | $7.12 – $13.98 | 16 |
| Gamunex-c/gammaked HCPCS J1561 | $362.40 | $453.00 | $30.92 – $90.45 | 14 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $386.40 | $483.00 | $24.97 – $122.30 | 7 |
| Gastro/jejuno tube, std HCPCS B4087 | $1,338.60 | $2,231.00 | $62.02 – $63.94 | 2 |
| Gauze >16 <=48 sq in w/bordr HCPCS A6220 | $3.00 | $5.00 | $4.57 – $5.97 | 2 |
| Gel cap app device for trach HCPCS L8515 | $1,097.40 | $1,829.00 | $90.88 – $92.36 | 2 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $804.60 | $1,341.00 | $1.98 – $24.00 | 12 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $45.00 | $75.00 | $131.75 – $255.55 | 13 |
| Generator barostim neo2 2014 HCPCS C1767 | $88,474.20 | $147,457.00 | $9,564.36 – $9,564.36 | 1 |
| Generator emblem MRI sicd subq HCPCS C1722 | $97,435.80 | $162,393.00 | $16,618.10 – $16,618.10 | 1 |
| Genetic tstg severe inh cond CPT 81443 | $14,904.00 | $24,840.00 | $1,495.39 – $2,644.44 | 13 |
| Genome sequence analysis CPT 81425 | $4,439.40 | $7,399.00 | $3,072.67 – $5,433.70 | 13 |
| Genome sequence analysis CPT 81426 | $4,439.40 | $7,399.00 | $1,655.04 – $2,926.75 | 13 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $56.40 | $70.50 | $1.39 – $7.33 | 10 |
| Gentamicin peak therapeutic drug level CPT 80170 | $253.80 | $423.00 | $12.00 – $31.67 | 16 |
| G-esoph reflx tst w/electrod CPT 91035 | $740.40 | $1,234.00 | $278.95 – $802.67 | 14 |
| Ghs abscess perianal iandd CPT 46050 | $2,335.80 | $3,893.00 | $83.23 – $1,264.19 | 16 |
| Ghs abscess postoperative iandd complex CPT 10180 | $3,099.00 | $5,165.00 | $169.72 – $3,968.58 | 16 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $121.20 | $202.00 | $16.91 – $43.68 | 13 |
| Ghs bladder cath - complex-foley CPT 51703 | $2,310.60 | $3,851.00 | $82.07 – $285.96 | 16 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,133.40 | $1,889.00 | $38.50 – $960.26 | 16 |
| Ghs central line insert < age 5, failed CPT 36555 | $3,239.40 | $5,399.00 | $129.62 – $4,364.40 | 16 |
| Ghs change cysto/gastrost CPT 43762 | $2,313.60 | $3,856.00 | $34.21 – $337.24 | 16 |
| Ghs chemo IV push, ea addtl CPT 96411 | $158.40 | $264.00 | $58.18 – $108.14 | 15 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $532.20 | $887.00 | $34.68 – $90.15 | 16 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $407.40 | $679.00 | $40.15 – $340.92 | 16 |
| Ghs closed reduction ankle dislocation CPT 27840 | $2,310.60 | $3,851.00 | $98.45 – $611.04 | 16 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $2,337.60 | $3,896.00 | $545.04 – $2,219.16 | 13 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $2,335.80 | $3,893.00 | $256.85 – $2,219.16 | 16 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $3,021.60 | $5,036.00 | $263.94 – $616.23 | 13 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $2,313.60 | $3,856.00 | $545.04 – $2,219.16 | 13 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $3,098.40 | $5,164.00 | $729.80 – $2,219.16 | 13 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $2,310.60 | $3,851.00 | $172.70 – $819.30 | 16 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $407.40 | $679.00 | $42.90 – $372.59 | 16 |
| Ghs community re-entry 15 minutes CPT 97537 | $141.60 | $236.00 | $25.48 – $100.11 | 4 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | not published | not published | $127.83 – $553.32 | 13 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $349.20 | $582.00 | $55.76 – $178.73 | 13 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $405.00 | $675.00 | $29.15 – $553.32 | 16 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $566.40 | $944.00 | $28.60 – $178.73 | 16 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $234.60 | $391.00 | $15.03 – $42.19 | 16 |
| Ghs dislocation elbow closed treatment CPT 24600 | $2,334.00 | $3,890.00 | $112.75 – $607.36 | 16 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | not published | not published | $85.38 – $1,300.05 | 16 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $588.60 | $981.00 | $92.94 – $368.26 | 12 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,505.40 | $2,509.00 | $101.39 – $960.26 | 16 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $615.00 | $1,025.00 | $172.16 – $375.76 | 15 |
| Ghs excision ingrown nail CPT 11765 | $382.20 | $637.00 | $55.00 – $554.00 | 16 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $2,061.00 | $3,435.00 | $174.87 – $414.50 | 13 |
| Ghs fb removal - incisional CPT 10121 | $3,097.80 | $5,163.00 | $71.50 – $2,246.66 | 16 |
| Ghs fb removal - non-incisional CPT 20520 | $801.60 | $1,336.00 | $68.75 – $2,246.66 | 16 |
| Ghs fish cytogen CPT 88271 | $420.60 | $701.00 | $21.16 – $32.01 | 13 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $420.60 | $701.00 | $50.59 – $105.65 | 13 |
| Ghs flow volume loop CPT 94375 | $169.80 | $283.00 | $30.71 – $375.76 | 16 |
| Ghs gastric intub aspiration lavage CPT 43753 | $213.60 | $356.00 | $18.16 – $431.79 | 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.