UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
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 |
|---|---|---|---|---|
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $325.80 | $543.00 | $1.60 – $37.15 | 5 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $19.80 | $33.00 | $4.34 – $11.75 | 5 |
| Liberta rc ipg HCPCS C1820 | $52,306.80 | $87,178.00 | $79,490.65 – $79,490.65 | 1 |
| Lidocaine injection HCPCS J2001 | $723.60 | $1,206.00 | $0.83 – $0.83 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $0.45 | $0.75 | $0.15 – $0.15 | 1 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.45 | $0.75 | $0.00 – $0.00 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $303.00 | $505.00 | $13.65 – $38.24 | 12 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $136.40 – $1,699.17 | 12 |
| Ligation major artery neck CPT 37615 | $3,192.60 | $5,321.00 | $714.63 – $3,300.84 | 11 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $883.80 | $1,473.00 | $2.25 – $56.16 | 5 |
| Lipase CPT 83690 | $210.00 | $350.00 | $5.50 – $13.42 | 12 |
| Lipoprotein blood high res frac & quant CPT 83701 | $188.40 | $314.00 | $30.51 – $65.08 | 12 |
| Lipoprotein blood quant CPT 83704 | $320.40 | $534.00 | $31.77 – $82.72 | 11 |
| Lipoprotein direct measurement hdl CPT 83718 | $249.60 | $416.00 | $7.61 – $15.97 | 12 |
| Lipoprotein direct measurement ldl CPT 83721 | $129.00 | $215.00 | $9.27 – $13.80 | 12 |
| Lithium therapeutic drug level CPT 80178 | $168.60 | $281.00 | $6.14 – $12.89 | 12 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $1,030.20 | $1,717.00 | $66.41 – $578.51 | 12 |
| Liver Function Test CPT 80076 | $201.00 | $335.00 | $7.59 – $21.90 | 12 |
| Liver/spleen imag static only CPT 78215 | $2,667.00 | $4,445.00 | $76.19 – $421.41 | 12 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $358.05 – $3,402.68 | 12 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $10.80 | $18.00 | $0.61 – $1.46 | 5 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $435.60 | $726.00 | $81.78 – $238.59 | 9 |
| Loop ostmy bridg ster HCPCS A4421 | $81.00 | $135.00 | $33.75 – $114.75 | 12 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $1,342.20 | $2,237.00 | $0.87 – $16.61 | 6 |
| Low back disk surgery CPT 63030 | not published | not published | $1,646.97 – $7,491.76 | 11 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $645.60 | $1,076.00 | $69.13 – $193.58 | 12 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,785.80 | $4,643.00 | $157.72 – $1,145.54 | 12 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,654.40 | $4,424.00 | $165.60 – $947.50 | 12 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,795.80 | $2,993.00 | $94.21 – $815.23 | 12 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $5,999.40 | $9,999.00 | $316.41 – $3,035.91 | 13 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $4,621.20 | $7,702.00 | $316.41 – $1,720.21 | 13 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,801.60 | $6,336.00 | $214.16 – $1,564.49 | 13 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $419.40 | $699.00 | $34.28 – $111.52 | 12 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $666.60 | $1,111.00 | $40.28 – $148.29 | 12 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $666.60 | $1,111.00 | $38.50 – $183.16 | 12 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $419.40 | $699.00 | $26.48 – $92.34 | 11 |
| Lumizyme injection HCPCS J0221 | $966.60 | $1,611.00 | $130.44 – $227.25 | 9 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $988.80 | $1,648.00 | $20.90 – $326.57 | 12 |
| Lung function test (mbc/mvv) CPT 94200 | $109.80 | $183.00 | $9.90 – $78.76 | 12 |
| Lung Function Test (Spirometry) CPT 94010 | $171.60 | $286.00 | $16.50 – $164.09 | 12 |
| Lung perfusion imaging CPT 78580 | $1,322.40 | $2,204.00 | $86.90 – $485.77 | 12 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $423.60 | $706.00 | $84.16 – $227.84 | 9 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $313.20 | $522.00 | $26.51 – $46.18 | 9 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $483.00 | $805.00 | $97.47 – $281.42 | 9 |
| Lymphatics/lymph node imaging CPT 78195 | $6,783.00 | $11,305.00 | $198.00 – $564.50 | 12 |
| Lymphocyte culture mixed CPT 86821 | $667.80 | $1,113.00 | $33.98 – $154.92 | 12 |
| Lymphocyte transformation mitogen CPT 86353 | $537.60 | $896.00 | $45.56 – $134.51 | 12 |
| Lymph vessel x-ray trunk CPT 75805 | $1,597.20 | $2,662.00 | $96.25 – $3,300.84 | 12 |
| Lymph vessel x-ray trunk CPT 75807 | $1,784.40 | $2,974.00 | $103.40 – $3,300.84 | 12 |
| Macroscopic exam arthropod CPT 87168 | $55.20 | $92.00 | $3.97 – $11.45 | 11 |
| Macroscopic exam parasite CPT 87169 | $49.80 | $83.00 | $4.01 – $11.45 | 11 |
| Magnesium CPT 83735 | $110.40 | $184.00 | $6.23 – $12.99 | 12 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $237.00 | $395.00 | $0.30 – $0.58 | 5 |
| Magnetic image bone marrow CPT 77084 | $2,412.60 | $4,021.00 | $214.16 – $915.36 | 13 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $146.40 | $244.00 | $5.16 – $5.16 | 1 |
| Map tachycard site(s) CPT 93609 | $3,500.40 | $5,834.00 | $257.40 – $1,771.30 | 8 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $95.40 | $159.00 | $20.27 – $57.74 | 9 |
| Marker biop eviva buckle ss HCPCS A4648 | $2,036.40 | $3,394.00 | $282.06 – $282.06 | 1 |
| Mastoids complete CPT 70130 | $360.00 | $600.00 | $45.13 – $139.45 | 11 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $7,672.80 | $12,788.00 | $7.00 – $24.56 | 3 |
| M.avium-intra dna amp prob CPT 87561 | $393.60 | $656.00 | $32.61 – $91.01 | 11 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $108.60 | $181.00 | $13.44 – $28.20 | 12 |
| Mayo aathr protein s free CPT 85306 | $250.80 | $418.00 | $14.24 – $42.05 | 12 |
| Mayo activated protein c resistance assay CPT 85307 | $158.40 | $264.00 | $14.24 – $41.08 | 12 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $72.00 | $120.00 | $21.80 – $44.32 | 11 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $440.40 | $734.00 | $7.26 – $20.04 | 6 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $154.80 | $258.00 | $13.74 – $28.86 | 11 |
| Mayo alpha 1 antitrypsin CPT 82103 | $438.00 | $730.00 | $12.49 – $26.20 | 12 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $111.60 | $186.00 | $12.10 – $41.36 | 12 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,227.60 | $2,046.00 | $113.03 – $139.78 | 11 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,702.80 | $2,838.00 | $45.36 – $115.06 | 12 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $1,261.80 | $2,103.00 | $84.46 – $157.44 | 12 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $13,845.00 | $23,075.00 | $380.06 – $3,194.33 | 11 |
| Mayo androstenedione CPT 82157 | $490.20 | $817.00 | $27.21 – $57.10 | 12 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $249.60 | $416.00 | $13.57 – $28.49 | 12 |
| Mayo antithrombin iii antigen CPT 85301 | $108.60 | $181.00 | $10.05 – $29.67 | 12 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $111.60 | $186.00 | $13.99 – $41.30 | 12 |
| Mayo avwpr vw factor activity CPT 85397 | $229.80 | $383.00 | $28.68 – $62.88 | 12 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $372.00 | $620.00 | $14.11 – $40.32 | 12 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $100.20 | $167.00 | $9.46 – $27.27 | 12 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $1,114.20 | $1,857.00 | $103.81 – $166.45 | 11 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $240.00 | $400.00 | $11.99 – $36.18 | 12 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $99.00 | $165.00 | $12.26 – $25.73 | 12 |
| Mayo brcmg brucella antibody igm CPT 86622 | $72.00 | $120.00 | $8.30 – $20.77 | 12 |
| Mayo c1 esterase inhibitor CPT 83883 | $349.80 | $583.00 | $12.64 – $26.55 | 11 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $166.20 | $277.00 | $15.68 – $45.20 | 11 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $241.80 | $403.00 | $19.91 – $70.20 | 12 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $1,180.80 | $1,968.00 | $113.58 – $257.16 | 12 |
| Mayo ceruloplasmin CPT 82390 | $186.00 | $310.00 | $9.98 – $20.96 | 12 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $401.40 | $669.00 | $13.12 – $38.79 | 11 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $240.00 | $400.00 | $11.97 – $35.37 | 11 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $57.00 | $95.00 | $10.87 – $15.76 | 12 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $130.20 | $217.00 | $11.78 – $35.41 | 12 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $833.40 | $1,389.00 | $108.25 – $227.30 | 12 |
| Mayo chromium CPT 82495 | $325.20 | $542.00 | $6.60 – $23.31 | 12 |
| Mayo coccidioides antibody CPT 86635 | $131.40 | $219.00 | $10.66 – $31.92 | 12 |
| Mayo cocou cortisone urine CPT 82542 | $711.60 | $1,186.00 | $21.20 – $48.39 | 12 |
| Mayo cortisol free CPT 82530 | $138.00 | $230.00 | $15.53 – $33.08 | 12 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $146.40 | $244.00 | $12.28 – $79.06 | 12 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $126.60 | $211.00 | $11.26 – $34.64 | 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.