UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
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 |
|---|---|---|---|---|
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $262.80 | $438.00 | $29.48 – $162.54 | 15 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $262.80 | $438.00 | $29.48 – $162.54 | 15 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $262.80 | $438.00 | $27.51 – $162.54 | 15 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $188.40 | $314.00 | $21.61 – $419.44 | 10 |
| Lso flex no ri stays pre ots HCPCS L0628 | $294.60 | $491.00 | $69.09 – $395.02 | 3 |
| L/s ratio fetal lung CPT 83661 | $79.80 | $133.00 | $17.94 – $35.18 | 14 |
| Lumbar diskogram s&i CPT 72295 | $4,030.20 | $6,717.00 | $47.16 – $2,984.77 | 15 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $1,016.56 – $28,108.82 | 11 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $650.40 | $1,084.00 | $14.93 – $475.97 | 14 |
| Lung function test (mbc/mvv) CPT 94200 | $145.20 | $242.00 | $7.07 – $90.78 | 14 |
| Lung Function Test (Spirometry) CPT 94010 | $346.20 | $577.00 | $11.79 – $239.15 | 14 |
| Lung perfusion imaging CPT 78580 | $1,228.80 | $2,048.00 | $62.23 – $614.19 | 14 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $4,770.00 | $7,950.00 | $205.06 – $331.41 | 11 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $6,976.20 | $11,627.00 | $41.56 – $67.17 | 11 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $616.20 | $1,027.00 | $313.82 – $507.18 | 9 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $27,310.20 | $45,517.00 | $253.28 – $409.34 | 8 |
| Lymphatics/lymph node imaging CPT 78195 | $1,574.40 | $2,624.00 | $170.30 – $822.74 | 14 |
| Lymphocyte transformation mitogen CPT 86353 | $272.40 | $454.00 | $48.54 – $92.28 | 14 |
| Lymphocytotoxicity assay CPT 86805 | $1,055.40 | $1,759.00 | $22.96 – $303.22 | 14 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $44.45 – $1,750.16 | 14 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $80.01 – $4,859.86 | 14 |
| Macroscopic exam arthropod CPT 87168 | $24.00 | $40.00 | $3.41 – $28.84 | 11 |
| Macroscopic exam parasite CPT 87169 | $24.00 | $40.00 | $3.45 – $31.81 | 11 |
| Magnesium CPT 83735 | $33.60 | $56.00 | $6.63 – $10.72 | 14 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $1.80 | $3.00 | $0.48 – $0.97 | 6 |
| Magnetic image bone marrow CPT 77084 | $1,656.00 | $2,760.00 | $228.61 – $823.82 | 15 |
| Manual diff wbc count b-coat CPT 85009 | $19.20 | $32.00 | $4.50 – $8.11 | 14 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $744.00 | $1,240.00 | $50.03 – $1,611.00 | 8 |
| Map tachycard site(s) CPT 93609 | $3,363.00 | $5,605.00 | $297.18 – $1,519.12 | 8 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $138.00 | $230.00 | $51.97 – $83.98 | 11 |
| Marker biop eviva buckle ss HCPCS A4648 | $1,213.20 | $2,022.00 | $194.38 – $194.38 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $578.47 – $5,852.98 | 11 |
| Mastoids complete CPT 70130 | $262.80 | $438.00 | $36.02 – $162.62 | 12 |
| Mast simple complete CPT 19303 | not published | not published | $1,016.56 – $9,967.92 | 11 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $73.80 | $123.00 | $14.32 – $23.15 | 14 |
| Mayo aathr protein s free CPT 85306 | $77.40 | $129.00 | $15.17 – $28.85 | 14 |
| Mayo activated protein c resistance assay CPT 85307 | $77.40 | $129.00 | $15.17 – $24.51 | 14 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $85.80 | $143.00 | $22.37 – $217.06 | 11 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $40.80 | $68.00 | $11.76 – $86.20 | 8 |
| Mayo alpha 1 antitrypsin CPT 82103 | $67.80 | $113.00 | $13.31 – $23.15 | 14 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $109.20 | $182.00 | $11.00 – $24.13 | 14 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $529.80 | $883.00 | $90.74 – $146.66 | 14 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $792.60 | $1,321.00 | $109.60 – $219.20 | 14 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $6,701.40 | $11,169.00 | $926.96 – $1,856.00 | 11 |
| Mayo androstenedione CPT 82157 | $148.20 | $247.00 | $25.00 – $46.85 | 14 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $74.40 | $124.00 | $14.45 – $27.47 | 14 |
| Mayo antithrombin iii antigen CPT 85301 | $55.20 | $92.00 | $10.70 – $20.36 | 14 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $83.40 | $139.00 | $14.90 – $28.33 | 14 |
| Mayo avwpr vw factor activity CPT 85397 | $156.00 | $260.00 | $25.49 – $49.38 | 14 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $70.80 | $118.00 | $28.07 – $56.14 | 14 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $56.40 | $94.00 | $10.08 – $16.29 | 14 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $837.60 | $1,396.00 | $115.74 – $374.08 | 11 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $72.00 | $120.00 | $12.77 – $24.28 | 14 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $73.80 | $123.00 | $13.06 – $24.83 | 14 |
| Mayo brcmg brucella antibody igm CPT 86622 | $49.80 | $83.00 | $8.84 – $14.59 | 14 |
| Mayo c1 esterase inhibitor CPT 83883 | $124.80 | $208.00 | $10.87 – $68.26 | 11 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $85.80 | $143.00 | $13.48 – $136.81 | 11 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $706.80 | $1,178.00 | $121.00 – $195.55 | 14 |
| Mayo ceruloplasmin CPT 82390 | $54.60 | $91.00 | $10.00 – $17.18 | 14 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $72.00 | $120.00 | $11.28 – $101.42 | 11 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $72.00 | $120.00 | $10.30 – $108.86 | 11 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $66.00 | $110.00 | $9.88 – $18.91 | 14 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $71.40 | $119.00 | $12.55 – $23.90 | 14 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $833.40 | $1,389.00 | $115.33 – $219.28 | 14 |
| Mayo chromium CPT 82495 | $102.60 | $171.00 | $6.00 – $32.45 | 14 |
| Mayo coccidioides antibody CPT 86635 | $64.20 | $107.00 | $11.36 – $21.59 | 14 |
| Mayo cocou cortisone urine CPT 82542 | $122.40 | $204.00 | $6.86 – $38.54 | 14 |
| Mayo cortisol free CPT 82530 | $85.20 | $142.00 | $16.54 – $31.80 | 14 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $123.00 | $205.00 | $11.16 – $67.41 | 14 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $67.80 | $113.00 | $12.00 – $22.81 | 14 |
| Mayo cyanide CPT 82600 | $98.40 | $164.00 | $9.58 – $31.04 | 14 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $74.40 | $124.00 | $13.12 – $21.20 | 14 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $127.80 | $213.00 | $12.10 – $40.43 | 14 |
| Mayo efpo chloride stool CPT 82438 | $25.20 | $42.00 | $3.00 – $8.00 | 14 |
| Mayo estriol CPT 82677 | $122.40 | $204.00 | $17.50 – $38.69 | 14 |
| Mayo estrone CPT 82679 | $126.60 | $211.00 | $13.00 – $39.92 | 14 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $117.00 | $195.00 | $13.00 – $26.14 | 14 |
| Mayo everolimus therapeutic drug level CPT 80169 | $34.80 | $58.00 | $13.59 – $21.97 | 14 |
| Mayo factor ii CPT 85210 | $66.00 | $110.00 | $4.00 – $20.77 | 14 |
| Mayo factor v CPT 85220 | $90.60 | $151.00 | $5.00 – $28.24 | 14 |
| Mayo factor viii vw factor antigen CPT 85246 | $116.40 | $194.00 | $22.71 – $43.19 | 14 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $116.40 | $194.00 | $22.71 – $43.19 | 14 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $116.40 | $194.00 | $22.71 – $43.19 | 14 |
| Mayo factor x CPT 85260 | $91.20 | $152.00 | $12.00 – $28.64 | 14 |
| Mayo factor xi CPT 85270 | $91.20 | $152.00 | $12.00 – $28.64 | 14 |
| Mayo fat/lipids feces quantitative CPT 82710 | $85.80 | $143.00 | $4.02 – $26.88 | 14 |
| Mayo fbl culture fungi blood CPT 87103 | $114.00 | $190.00 | $12.46 – $32.74 | 14 |
| Mayo ffspg allergen clam igg CPT 86001 | $43.80 | $73.00 | $5.78 – $12.51 | 14 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $55.80 | $93.00 | $14.47 – $34.67 | 14 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $192.60 | $321.00 | $436.92 – $1,096.80 | 2 |
| Mayo hemosiderin qualitative urine CPT 83070 | $24.00 | $40.00 | $3.00 – $7.60 | 14 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $195.60 | $326.00 | $28.03 – $248.81 | 11 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $77.40 | $129.00 | $13.65 – $23.54 | 14 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $144.60 | $241.00 | $12.00 – $41.30 | 14 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $49.20 | $82.00 | $8.80 – $16.51 | 14 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $75.60 | $126.00 | $13.16 – $21.63 | 14 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $137.40 | $229.00 | $19.10 – $43.47 | 14 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $87.60 | $146.00 | $13.79 – $80.42 | 11 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $83.40 | $139.00 | $14.84 – $27.91 | 14 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $116.40 | $194.00 | $20.60 – $33.30 | 14 |
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.