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 |
|---|---|---|---|---|
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $274.80 | $458.00 | $17.00 – $35.78 | 16 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,032.80 | $3,388.00 | $463.24 – $792.36 | 13 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $64.20 | $107.00 | $19.09 – $70.93 | 3 |
| Graft axiofill 1000mg HCPCS J3590 | $16,126.80 | $26,878.00 | $1,111.50 – $1,111.50 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $264.60 | $441.00 | $33.89 – $42.48 | 2 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $33,418.20 | $55,697.00 | $60.21 – $74.42 | 2 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $25,816.80 | $43,028.00 | $596.69 – $596.69 | 1 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $27,435.60 | $45,726.00 | $636.47 – $636.47 | 1 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $328.80 | $548.00 | $36.53 – $235.18 | 3 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $417.60 | $696.00 | $85.17 – $87.60 | 2 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $8,992.20 | $14,987.00 | $17.06 – $85.14 | 3 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $17,093.40 | $28,489.00 | $209.32 – $209.32 | 1 |
| Granisetron hcl injection HCPCS J1626 | $1,654.80 | $2,758.00 | $0.12 – $1.04 | 7 |
| Great toe with reduction 28495 CPT 28495 | $4,066.80 | $6,778.00 | $83.05 – $729.80 | 16 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $322.39 – $5,076.39 | 13 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $102.20 – $610.30 | 3 |
| Gstr rstcv px shrt roux-en-y CPT 43846 | not published | not published | $2,515.63 – $4,493.84 | 3 |
| G-tube reposition CPT 43761 | $3,123.00 | $5,205.00 | $103.87 – $729.80 | 16 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,451.40 | $2,419.00 | $137.81 – $1,036.64 | 16 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $41,988.60 | $69,981.00 | $538.40 – $538.40 | 1 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $6,678.00 | $11,130.00 | $61.14 – $61.14 | 1 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,106.40 | $1,844.00 | $55.24 – $55.24 | 1 |
| Gw stiffened micro access kit HCPCS C1894 | $3,858.60 | $6,431.00 | $47.90 – $47.90 | 1 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $715.17 – $5,309.76 | 13 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $115.20 | $144.00 | $2.78 – $25.35 | 10 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $80.00 | $100.00 | $0.51 – $3.86 | 10 |
| Hand-held pefr meter a4614 HCPCS A4614 | $231.60 | $386.00 | $31.60 – $48.63 | 2 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $67.80 | $113.00 | $23.13 – $100.11 | 11 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $492.80 – $4,499.05 | 16 |
| Hand X-ray CPT 73130 | $250.20 | $417.00 | $20.23 – $118.50 | 13 |
| Hand X-ray (2 views, both hands) CPT 73120 | $192.60 | $321.00 | $19.42 – $166.40 | 13 |
| Haptoglobin quantitative CPT 83010 | $178.20 | $297.00 | $12.00 – $24.31 | 16 |
| Hbot, full body chamber, 30m HCPCS G0277 | $1,031.40 | $1,719.00 | $29.67 – $163.87 | 14 |
| Hcg qualitative CPT 84703 | $134.40 | $224.00 | $7.43 – $14.52 | 16 |
| Hcg quantitative CPT 84702 | $298.80 | $498.00 | $14.88 – $25.93 | 16 |
| Hc hearing aid chck binaurl CPT 92593 | $198.00 | $330.00 | $13.20 – $70.65 | 9 |
| Hc hearing aid chck monarl CPT 92592 | $165.00 | $275.00 | $9.90 – $60.39 | 9 |
| Hc hearing aid exam both ears CPT 92591 | $246.00 | $410.00 | $19.80 – $117.23 | 9 |
| Hc hearing aid exam one ear CPT 92590 | $221.40 | $369.00 | $19.80 – $96.69 | 9 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $673.80 | $1,123.00 | $40.70 – $260.30 | 2 |
| Hc nm fusion spect CT unlisted CPT 78999 | $771.60 | $1,286.00 | $121.81 – $546.54 | 12 |
| Hc nm kidney imaging with flow CPT 78701 | $917.40 | $1,529.00 | $85.54 – $546.54 | 16 |
| Head CT scan (with and without contrast) CPT 70470 | $3,598.20 | $5,997.00 | $146.43 – $823.15 | 16 |
| Head CT scan (with contrast) CPT 70460 | $3,127.20 | $5,212.00 | $130.53 – $675.38 | 16 |
| Head CT scan (without contrast) CPT 70450 | $3,127.20 | $5,212.00 | $98.61 – $568.49 | 16 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $238.80 | $398.00 | $18.61 – $118.50 | 13 |
| Helicobacter pylori antibody igm CPT 86677 | $207.60 | $346.00 | $16.65 – $28.77 | 16 |
| Hematocrit CPT 85014 | $76.20 | $127.00 | $2.35 – $4.55 | 16 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $87.20 | $109.00 | $13.87 – $36.91 | 13 |
| Hemodialysis one evaluation CPT 90935 | $6,177.60 | $10,296.00 | $152.56 – $831.51 | 12 |
| Hemoglobin CPT 85018 | $55.20 | $92.00 | $2.35 – $4.55 | 16 |
| Hemoglobin fetal qualitative CPT 83033 | $64.80 | $108.00 | $6.53 – $14.50 | 16 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $68.40 | $114.00 | $3.00 – $11.86 | 16 |
| Hemoglobin plasma CPT 83051 | $68.40 | $114.00 | $3.50 – $11.69 | 16 |
| Hemoglobin urine CPT 83069 | $156.60 | $261.00 | $3.90 – $7.62 | 13 |
| Hemolysins and agglutinins incubated CPT 86941 | $144.60 | $241.00 | $11.96 – $26.26 | 16 |
| Hemophilus influenza antibdy CPT 86684 | $237.00 | $395.00 | $15.65 – $42.19 | 16 |
| Heparin assay CPT 85520 | $89.40 | $149.00 | $6.53 – $14.50 | 16 |
| Heparin bolus from bag HCPCS J1644 | $15.20 | $19.00 | $0.13 – $0.74 | 7 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $4.60 | $5.75 | $0.01 – $0.23 | 7 |
| Hepatitis a antibody igm CPT 86709 | $192.00 | $320.00 | $11.13 – $28.90 | 16 |
| Hepatitis b core antibody igm CPT 86705 | $63.60 | $106.00 | $11.64 – $30.24 | 16 |
| Hepatitis b core antibody total CPT 86704 | $211.80 | $353.00 | $11.91 – $30.97 | 16 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,348.80 | $1,686.00 | $11.00 – $171.63 | 15 |
| Hepatitis b surface antibody CPT 86706 | $193.20 | $322.00 | $10.62 – $27.58 | 16 |
| Hepatitis c antibody CPT 86803 | $138.00 | $230.00 | $14.10 – $36.67 | 16 |
| Hepatitis d quantification CPT 87523 | $719.40 | $1,199.00 | $16.00 – $46.27 | 12 |
| Hereditary colon ca dsordrs CPT 81435 | $3,394.80 | $5,658.00 | $556.77 – $1,449.89 | 16 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $349.25 – $4,893.48 | 16 |
| Herpes simplex 1 ag if CPT 87274 | $180.60 | $301.00 | $11.84 – $31.36 | 13 |
| Herpes simplex 2 ag if CPT 87273 | $168.60 | $281.00 | $11.84 – $29.24 | 16 |
| Herpes simplex type 1 antibody igg CPT 86695 | $133.80 | $223.00 | $13.03 – $25.48 | 16 |
| Herpes simplex type 2 antibody igg CPT 86696 | $133.80 | $223.00 | $19.13 – $51.38 | 16 |
| Herpes simplex virus isolation CPT 87255 | $573.60 | $956.00 | $33.46 – $90.88 | 16 |
| Heterophile antibodies screening CPT 86308 | $158.40 | $264.00 | $5.12 – $10.00 | 16 |
| Hexa gene CPT 81255 | $1,438.20 | $2,397.00 | $50.85 – $272.24 | 16 |
| Hhv-6 dna quant CPT 87533 | $636.60 | $1,061.00 | $41.27 – $110.80 | 13 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $712.20 | $1,187.00 | $18.14 – $166.40 | 16 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $712.20 | $1,187.00 | $21.86 – $166.40 | 16 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $221.40 | $369.00 | $13.03 – $118.50 | 13 |
| Hip X-ray CPT 73502 | $274.20 | $457.00 | $19.54 – $118.50 | 13 |
| Histamine CPT 83088 | $469.80 | $783.00 | $13.00 – $80.26 | 16 |
| Histochemical stains add-on CPT 88314 | $125.40 | $209.00 | $19.61 – $205.57 | 12 |
| Hiv-1 ag ia CPT 87390 | $248.40 | $414.00 | $10.50 – $45.32 | 17 |
| Hla class i high defin qual CPT 86832 | $469.20 | $782.00 | $133.14 – $349.65 | 16 |
| Hla class ii high defin qual CPT 86833 | $469.20 | $782.00 | $121.04 – $351.86 | 16 |
| Hla class ii phenotype qual CPT 86831 | $324.00 | $540.00 | $72.62 – $100.93 | 16 |
| Hla class ii semiquant panel CPT 86835 | $1,957.80 | $3,263.00 | $319.18 – $471.05 | 16 |
| Hla class i phenotype qual CPT 86830 | $207.00 | $345.00 | $84.73 – $117.77 | 16 |
| Hla class i semiquant panel CPT 86834 | $2,169.00 | $3,615.00 | $353.38 – $521.52 | 16 |
| Hla i & ii type verify lr CPT 81371 | $3,100.80 | $5,168.00 | $262.69 – $445.78 | 16 |
| Hla i & ii typing hr CPT 81378 | $2,532.00 | $4,220.00 | $341.53 – $636.84 | 16 |
| Hla i & ii typing lr CPT 81370 | $3,345.00 | $5,575.00 | $397.42 – $610.00 | 16 |
| Hla ii typing 1 loc hr CPT 81382 | $1,952.40 | $3,254.00 | $122.24 – $445.78 | 16 |
| Hla i low res one antigen equiv ea CPT 81374 | $1,253.40 | $2,089.00 | $73.46 – $191.05 | 16 |
| Hla i typing 1 locus hr CPT 81380 | $1,671.60 | $2,786.00 | $175.17 – $268.88 | 16 |
| Hla i typing complete lr CPT 81372 | $2,709.00 | $4,515.00 | $241.09 – $435.88 | 16 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $1,273.20 | $2,122.00 | $103.22 – $191.05 | 16 |
| Hla typing a b or c CPT 86813 | $642.60 | $1,071.00 | $57.32 – $112.07 | 16 |
| Hla x-match noncytotoxc addl CPT 86826 | $385.80 | $643.00 | $30.68 – $71.28 | 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.