UPMC Western Psychiatric
3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435
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 |
|---|---|---|---|---|
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $64.80 | $108.00 | $3.75 – $25.27 | 2 |
| Chlorpromazine 100 mg tablet HCPCS Q0161 | $2.40 | $4.00 | $0.31 – $0.31 | 1 |
| Cidofovir injection HCPCS J0740 | $27,738.00 | $46,230.00 | $546.29 – $1,299.66 | 4 |
| Cilastatin sodium injection HCPCS J0743 | $626.40 | $1,044.00 | $10.25 – $24.44 | 2 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $513.00 | $855.00 | $2.90 – $25.15 | 2 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | $876.00 | $1,460.00 | $207.12 – $207.12 | 1 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $749.40 | $1,249.00 | $2.29 – $137.52 | 2 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $576.60 | $961.00 | $10.68 – $103.19 | 4 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $43.80 | $73.00 | $0.50 – $1.83 | 2 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $348.60 | $581.00 | $18.17 – $93.78 | 2 |
| Clozapine, 25 mg HCPCS S0136 | $6.15 | $10.25 | $2.30 – $2.30 | 1 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $8.70 | $14.50 | $2.65 – $2.93 | 4 |
| Colistimethate sodium inj HCPCS J0770 | $1,284.60 | $2,141.00 | $13.06 – $45.33 | 2 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $1,431.00 | $2,385.00 | $59.04 – $431.27 | 4 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $480.00 | $800.00 | $25.37 – $209.46 | 2 |
| Counseling smoke cess interm >10mins CPT 99407 | $50.40 | $84.00 | $42.99 – $42.99 | 1 |
| Crisis psychotherapy 90839 CPT 90839 | $424.20 | $707.00 | $253.75 – $253.75 | 1 |
| Crisis psychotherapy additional 30 mins 90840 CPT 90840 | $212.40 | $354.00 | $117.68 – $117.68 | 1 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | $436.20 | $727.00 | $99.22 – $142.43 | 4 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $10.80 | $18.00 | $1.00 – $1.84 | 2 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $3.75 | $6.25 | $0.48 – $0.53 | 3 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $67.20 | $112.00 | $1.10 – $3.71 | 2 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $268.20 | $447.00 | $50.93 – $72.58 | 2 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $51.45 | $85.75 | $0.80 – $2.74 | 2 |
| Cyclosporine oral 100 mg HCPCS J7502 | $198.60 | $331.00 | $2.04 – $10.96 | 2 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $112.20 | $187.00 | $0.83 – $26.48 | 2 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | $5,413.80 | $9,023.00 | $1,359.41 – $1,989.52 | 4 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $198.60 | $331.00 | $3.45 – $35.62 | 2 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $166.20 | $277.00 | $25.08 – $361.17 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $68.40 | $114.00 | $11.75 – $17.17 | 4 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $2.25 | $3.75 | $0.03 – $0.59 | 2 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $134.40 | $224.00 | $32.38 – $61.13 | 4 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $52.50 | $87.50 | $2.93 – $9.32 | 4 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $681.00 | $1,135.00 | $117.13 – $281.70 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $808.20 | $1,347.00 | $21.70 – $144.66 | 4 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $292.80 | $488.00 | $1.22 – $52.41 | 2 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $112.80 | $188.00 | $9.01 – $19.03 | 2 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $20.40 | $34.00 | $4.45 – $8.16 | 4 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $61.80 | $103.00 | $19.75 – $32.32 | 4 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $59.70 | $99.50 | $3.52 – $9.98 | 4 |
| Device intraute mirena HCPCS J7298 | $2,289.60 | $3,816.00 | $638.73 – $638.73 | 1 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | $505.80 | $843.00 | $85.04 – $107.95 | 4 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $0.60 | $1.00 | $0.02 – $0.17 | 2 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $11.40 | $19.00 | $0.09 – $1.84 | 2 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $2,170.80 | $3,618.00 | $63.06 – $366.33 | 4 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $96.60 | $161.00 | $1.41 – $13.53 | 2 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $118.20 | $197.00 | $1.65 – $1.65 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $119.40 | $199.00 | $1.81 – $20.17 | 2 |
| Dextrose 5 % IV bolus HCPCS J7070 | $60.60 | $101.00 | $3.11 – $25.34 | 2 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.60 | $1.00 | $0.08 – $0.17 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $33.45 | $55.75 | $1.95 – $7.35 | 2 |
| Dicyclomine injection HCPCS J0500 | $691.20 | $1,152.00 | $3.31 – $11.36 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $29.85 | $49.75 | $3.09 – $9.05 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,176.20 | $18,627.00 | $1,271.55 – $5,685.05 | 4 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $1,414.20 | $2,357.00 | $15.39 – $60.00 | 2 |
| Dimenhydrinate injection HCPCS J1240 | $33.90 | $56.50 | $1.31 – $6.14 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $13.80 | $23.00 | $0.76 – $2.41 | 2 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $138.60 | $231.00 | $7.08 – $16.70 | 2 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $86.40 | $144.00 | $0.63 – $40.58 | 2 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $26.40 | $44.00 | $0.75 – $0.83 | 2 |
| Dornase alfa non-comp unit HCPCS J7639 | $571.80 | $953.00 | $11.12 – $55.16 | 2 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $631.20 | $1,052.00 | $3.02 – $112.77 | 2 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $1.65 | $2.75 | $0.11 – $0.11 | 1 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $126.60 | $211.00 | $4.69 – $7.63 | 2 |
| Drug of abuse screen urine CPT 80305 | $1,074.00 | $1,790.00 | $10.28 – $13.86 | 4 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $414.00 | $690.00 | $44.82 – $49.30 | 3 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | $85.80 | $143.00 | $13.37 – $35.37 | 4 |
| EKG (Tracing Only) CPT 93005 | $436.20 | $727.00 | $16.44 – $16.44 | 1 |
| Electroconvulsive therapy 90870 CPT 90870 | $1,226.40 | $2,044.00 | $321.75 – $635.61 | 4 |
| Elranatamab-bcmm 40 mg/ml subcutaneous solution HCPCS J1323 | $463.20 | $772.00 | $184.07 – $202.48 | 3 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $66.00 | $110.00 | $0.59 – $9.78 | 2 |
| Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution HCPCS J9321 | $102.60 | $171.00 | $21.37 – $61.42 | 4 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $1,009.20 | $1,682.00 | $0.48 – $0.48 | 1 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $30.75 | $51.25 | $7.59 – $8.63 | 4 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $143.40 | $239.00 | $8.54 – $25.50 | 4 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $253.20 | $422.00 | $16.20 – $29.44 | 2 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $204.00 | $340.00 | $23.11 – $23.11 | 1 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $1,000.80 | $1,668.00 | $9.86 – $43.65 | 2 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $109.20 | $182.00 | $11.92 – $64.62 | 2 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $10.95 | $18.25 | $0.22 – $0.26 | 2 |
| Established Patient Office Visit (level 1) CPT 99211 | $186.60 | $311.00 | $33.36 – $33.36 | 1 |
| Established Patient Office Visit (level 2) CPT 99212 | $283.20 | $472.00 | $39.83 – $39.83 | 1 |
| Established Patient Office Visit (level 3) CPT 99213 | $426.00 | $710.00 | $53.29 – $53.29 | 1 |
| Established Patient Office Visit (level 4) CPT 99214 | $568.20 | $947.00 | $62.45 – $62.45 | 1 |
| Established Patient Office Visit (level 5) CPT 99215 | $709.20 | $1,182.00 | $72.83 – $72.83 | 1 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $51.00 | $85.00 | $1.18 – $7.25 | 2 |
| Etanercept injection HCPCS J1438 | $1,801.80 | $3,003.00 | $240.20 – $1,188.97 | 3 |
| Etonogestrel implant system HCPCS J7307 | $2,545.20 | $4,242.00 | $1,096.33 – $1,096.33 | 1 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $44.40 | $74.00 | $0.94 – $7.67 | 2 |
| Evaluation psychiatric diagnostic CPT 90791 | $993.00 | $1,655.00 | $165.43 – $285.01 | 3 |
| Exemestane, 25 mg HCPCS S0156 | $43.20 | $72.00 | $12.45 – $12.45 | 1 |
| Factor ix complex HCPCS J7194 | $7.80 | $13.00 | $0.96 – $1.87 | 4 |
| Factor ix recombinant nos HCPCS J7195 | $34.65 | $57.75 | $1.85 – $2.06 | 4 |
| Factor viii recombinant nos HCPCS J7192 | $21.60 | $36.00 | $1.61 – $2.52 | 4 |
| Factor viii recomb novoeight HCPCS J7182 | $3.15 | $5.25 | $1.25 – $1.69 | 4 |
| Fam adapt bhv tx gdn phy/qhp CPT 97156 | $66.00 | $110.00 | $9.51 – $31.24 | 3 |
| Family therapy without pt 50min 90846 CPT 90846 | $287.40 | $479.00 | $72.14 – $168.50 | 3 |
| Family therapy with patient 50 min 90847 CPT 90847 | $308.40 | $514.00 | $83.92 – $168.50 | 3 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $0.30 | $0.50 | $0.01 – $0.01 | 1 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $16.20 | $27.00 | $1.10 – $1.73 | 2 |
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.