UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
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 |
|---|---|---|---|---|
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $333.60 | $417.00 | $28.16 – $333.60 | 14 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $244.00 | $305.00 | $0.09 – $48.66 | 14 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $67.60 | $84.50 | $0.06 – $67.20 | 15 |
| Open bx/exc inguinofem nodes CPT 38531 | not published | not published | $274.34 – $4,015.84 | 10 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | $1,040.78 – $4,015.84 | 10 |
| Open thrombectomy of av fistula without revision 36831 CPT 36831 | not published | not published | $847.38 – $5,669.06 | 10 |
| Open tx nose fx w/skele fixj CPT 21330 | not published | not published | $334.40 – $6,203.86 | 13 |
| Opn impltj nea sacral nerve CPT 64581 | not published | not published | $1,368.63 – $6,882.63 | 10 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $433.95 – $7,491.76 | 13 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $844.93 – $7,491.76 | 10 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $844.93 – $7,491.76 | 10 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $844.93 – $3,402.68 | 10 |
| Optx medial ankle fx CPT 27766 | not published | not published | $844.93 – $7,491.76 | 10 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $1,244.42 – $6,203.86 | 10 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $520.30 – $13,493.67 | 13 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $1,040.78 – $19,285.98 | 10 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $396.00 – $7,491.76 | 13 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $474.10 – $7,491.76 | 13 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $844.93 – $7,491.76 | 10 |
| Oral aprepitant HCPCS J8501 | $1,051.20 | $1,752.00 | $1.72 – $56.00 | 15 |
| Oral everolimus HCPCS J7527 | $1,208.40 | $2,014.00 | $0.87 – $22.40 | 13 |
| Organic acids total quant ea spec CPT 83918 | $257.40 | $429.00 | $22.75 – $343.20 | 16 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $99.20 | $124.00 | $14.83 – $99.20 | 14 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $18.40 | $23.00 | $2.75 – $18.40 | 13 |
| Oscillation chest wall mechanical per session CPT 94669 | $214.80 | $358.00 | $24.36 – $212.00 | 14 |
| Osmolality blood CPT 83930 | $98.40 | $164.00 | $3.00 – $131.20 | 16 |
| Osmolality urine CPT 83935 | $102.00 | $170.00 | $3.00 – $136.00 | 16 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $2,320.53 – $13,493.67 | 10 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $1,370.08 – $7,491.76 | 10 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $156.00 | $260.00 | $30.19 – $208.00 | 12 |
| Ot re-evaluation patient/family CPT 97168 | $155.40 | $259.00 | $33.29 – $207.20 | 15 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $307.20 | $512.00 | $13.04 – $409.60 | 15 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $307.20 | $512.00 | $13.64 – $409.60 | 15 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $79.80 | $133.00 | $0.50 – $12.00 | 13 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $58.80 | $98.00 | $0.05 – $78.40 | 13 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $5.80 | $7.25 | $0.84 – $5.60 | 12 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $38.40 | $64.00 | $0.09 – $35.20 | 13 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $34.00 | $42.50 | $5.02 – $2,398.80 | 16 |
| Palonosetron hcl HCPCS J2469 | $1,607.40 | $2,679.00 | $0.22 – $214.40 | 13 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $2,365.60 | $2,957.00 | $6.09 – $2,365.60 | 13 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $104.80 | $131.00 | $5.30 – $104.80 | 12 |
| Papaverin hcl injection HCPCS J2440 | $64.00 | $80.00 | $2.70 – $64.00 | 12 |
| Parathormone (pth) intact CPT 83970 | $618.60 | $1,031.00 | $40.80 – $824.80 | 16 |
| Parenteral 50% dextrose solu HCPCS B4164 | $165.60 | $207.00 | $7.62 – $98.67 | 12 |
| Paricalcitol HCPCS J2501 | $99.20 | $124.00 | $0.60 – $99.20 | 13 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $306.60 | $511.00 | $22.00 – $408.80 | 16 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $130.35 – $3,334.43 | 13 |
| Partial exc bone humerus CPT 24140 | not published | not published | $302.50 – $3,402.68 | 13 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $288.75 – $3,402.68 | 13 |
| Partial removal finger bone CPT 26235 | not published | not published | $302.50 – $1,678.38 | 13 |
| Partial removal finger bone CPT 26236 | not published | not published | $302.50 – $1,678.38 | 13 |
| Partial removal of fibula CPT 27641 | not published | not published | $736.75 – $3,402.68 | 10 |
| Partial removal of foot bone CPT 28288 | not published | not published | $271.15 – $3,402.68 | 13 |
| Partial removal of hand bone CPT 26230 | not published | not published | $302.50 – $3,402.68 | 13 |
| Partial removal of lip CPT 40530 | not published | not published | $246.40 – $3,401.07 | 13 |
| Partial removal of nose CPT 30150 | not published | not published | $763.40 – $6,203.86 | 13 |
| Partial removal of radius CPT 25230 | not published | not published | $1,040.78 – $3,402.68 | 10 |
| Partial removal of thyroid CPT 60220 | not published | not published | $736.75 – $6,118.60 | 10 |
| Partial removal of ulna CPT 25240 | not published | not published | $1,040.78 – $3,402.68 | 10 |
| Partial thyroid excision CPT 60210 | not published | not published | $1,646.97 – $6,118.60 | 10 |
| Part removal of metatarsal CPT 28110 | not published | not published | $293.11 – $3,402.68 | 13 |
| Passy muir valve metal trach HCPCS L8501 | $1,273.20 | $2,122.00 | $157.36 – $1,697.60 | 13 |
| Path clin consltj mod 21-40 CPT 80504 | $447.60 | $746.00 | $22.20 – $596.80 | 14 |
| Path clin consltj sf 5-20 CPT 80503 | $198.60 | $331.00 | $11.09 – $264.80 | 14 |
| Pcv21 vaccine im CPT 90684 | $252.80 | $316.00 | $11.00 – $327.89 | 15 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $12,202.80 | $20,338.00 | $19.98 – $1,355.20 | 14 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $1,189.60 | $1,487.00 | $67.14 – $1,189.60 | 14 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,242.40 | $5,404.00 | $170.18 – $4,323.20 | 16 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,917.20 | $4,862.00 | $154.10 – $3,889.60 | 16 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,863.00 | $3,105.00 | $101.65 – $2,484.00 | 16 |
| Pelvic MRI (with and without contrast) CPT 72197 | $6,218.40 | $10,364.00 | $341.40 – $8,291.20 | 17 |
| Pelvic MRI (with contrast) CPT 72196 | $5,074.20 | $8,457.00 | $312.15 – $6,765.60 | 17 |
| Pelvic MRI (without contrast) CPT 72195 | $3,940.80 | $6,568.00 | $231.07 – $5,254.40 | 17 |
| Pelvic Ultrasound (complete) CPT 76856 | $1,002.00 | $1,670.00 | $84.15 – $1,336.00 | 16 |
| Pelvic Ultrasound (limited) CPT 76857 | $633.60 | $1,056.00 | $35.20 – $844.80 | 16 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $436.20 | $727.00 | $19.25 – $581.60 | 16 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $436.20 | $727.00 | $33.72 – $581.60 | 16 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $188.00 | $235.00 | $28.11 – $188.00 | 14 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $635.20 | $794.00 | $2.75 – $205.60 | 14 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $526.20 | $877.00 | $8.73 – $58.40 | 14 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $85.20 | $142.00 | $0.50 – $12.00 | 13 |
| Pentamidine non-comp unit HCPCS J2545 | $1,608.80 | $2,011.00 | $44.03 – $1,608.80 | 13 |
| Perc cryo ablate renal tum CPT 50593 | not published | not published | $7,000.76 – $10,918.43 | 10 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $13,883.40 | $23,139.00 | $2,163.27 – $18,511.20 | 11 |
| Perc d-e cor stent ather s HCPCS C9602 | $13,883.40 | $23,139.00 | $2,163.27 – $18,511.20 | 11 |
| Perc drug-el cor stent sing HCPCS C9600 | $11,297.40 | $18,829.00 | $2,163.27 – $15,063.20 | 11 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $618.60 | $1,031.00 | $25.67 – $824.80 | 13 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,677.20 | $4,462.00 | $136.98 – $3,569.60 | 16 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $1,040.78 – $4,015.84 | 10 |
| Perq plmt bile duct stent CPT 47538 | $13,188.60 | $21,981.00 | $295.36 – $17,584.80 | 16 |
| Perq plmt bile duct stent CPT 47539 | $13,188.60 | $21,981.00 | $399.45 – $17,584.80 | 16 |
| Perq plmt bile duct stent CPT 47540 | $13,188.60 | $21,981.00 | $476.83 – $17,584.80 | 16 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $2,281.20 | $3,802.00 | $75.02 – $3,041.60 | 16 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $443.77 – $3,402.68 | 10 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $31,394.40 | $52,324.00 | $64.03 – $4,112.42 | 13 |
| Ph body fluid CPT 83986 | $53.40 | $89.00 | $2.00 – $71.20 | 16 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $42.00 | $70.00 | $2.99 – $30.17 | 13 |
| Phenobarbital therapeutic drug level CPT 80184 | $169.20 | $282.00 | $15.12 – $225.60 | 16 |
| Phentolaine mesylate inj HCPCS J2760 | $270.40 | $338.00 | $40.42 – $453.62 | 14 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $0.06 | $0.08 | $0.00 – $0.01 | 12 |
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.