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 |
|---|---|---|---|---|
| Inj., meropenem, vaborbactam HCPCS J2186 | $36.45 | $60.75 | $2.35 – $11.36 | 3 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | $691.20 | $1,152.00 | $119.63 – $273.35 | 4 |
| Inj multihance HCPCS A9577 | $86.40 | $144.00 | $1.74 – $12.80 | 2 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | $963.60 | $1,606.00 | $40.65 – $74.32 | 2 |
| Inj progesterone per 50 mg HCPCS J2675 | $11.40 | $19.00 | $0.70 – $2.91 | 2 |
| Inj secretin synthetic human HCPCS J2850 | $169.20 | $282.00 | $42.59 – $44.57 | 3 |
| Inj secukinumab intrav 1mg HCPCS J3247 | $43.50 | $72.50 | $17.84 – $19.62 | 3 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | $105.60 | $176.00 | $18.59 – $22.86 | 2 |
| Inj teclistamab cqyv 0.5 mg HCPCS J9380 | $85.20 | $142.00 | $12.43 – $36.94 | 4 |
| Inj testostero enanthate 1mg HCPCS J3121 | $0.60 | $1.00 | $0.05 – $0.06 | 2 |
| Inj testosterone cypionate HCPCS J1071 | $0.60 | $1.00 | $0.03 – $0.04 | 2 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $12.75 | $21.25 | $4.42 – $4.86 | 3 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $8,027.40 | $13,379.00 | $1,382.98 – $2,967.86 | 4 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $173.40 | $289.00 | $0.45 – $1.62 | 2 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $2,178.60 | $3,631.00 | $0.15 – $2.10 | 2 |
| Ipratropium bromide non-comp HCPCS J7644 | $49.35 | $82.25 | $0.39 – $6.14 | 2 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $1,572.00 | $2,620.00 | $1.75 – $281.12 | 2 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $194.40 | $324.00 | $18.11 – $32.93 | 4 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $6.75 | $11.25 | $0.23 – $1.21 | 2 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $126.60 | $211.00 | $0.30 – $15.15 | 4 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $4.50 | $7.50 | $0.11 – $0.34 | 2 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $0.90 | $1.50 | $0.38 – $1.27 | 6 |
| Lactated ringers intravenous solution HCPCS J7120 | $108.00 | $180.00 | $2.41 – $18.26 | 2 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $115.20 | $192.00 | $3.22 – $20.45 | 2 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $2,967.00 | $4,945.00 | $176.45 – $530.71 | 4 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $3,559.80 | $5,933.00 | $934.99 – $1,903.35 | 4 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $12.15 | $20.25 | $0.04 – $1.36 | 2 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $325.80 | $543.00 | $2.54 – $36.41 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.45 | $0.75 | $0.00 – $0.00 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $883.80 | $1,473.00 | $3.57 – $55.04 | 2 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $9.75 | $16.25 | $0.96 – $1.43 | 2 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $96.00 | $160.00 | $1.38 – $16.27 | 2 |
| Lumizyme injection HCPCS J0221 | $966.60 | $1,611.00 | $201.09 – $227.25 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $310.80 | $518.00 | $28.96 – $46.18 | 4 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $3.60 | $6.00 | $0.48 – $0.57 | 2 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $3.30 | $5.50 | $0.31 – $0.31 | 1 |
| Megestrol 20 mg tabs 100 each bottle HCPCS S0179 | $9.00 | $15.00 | $1.18 – $1.18 | 1 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $10.80 | $18.00 | $1.84 – $15.69 | 2 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $108.00 | $180.00 | $18.83 – $34.40 | 4 |
| Mercaptopurine 50 mg HCPCS S0108 | $149.40 | $249.00 | $6.22 – $6.22 | 1 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $177.00 | $295.00 | $0.42 – $9.60 | 2 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $642.60 | $1,071.00 | $1.86 – $114.87 | 2 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $2.70 | $4.50 | $0.86 – $1.75 | 2 |
| Methadone injection HCPCS J1230 | $55.95 | $93.25 | $3.48 – $19.33 | 2 |
| Methadone oral 5mg HCPCS S0109 | $0.60 | $1.00 | $0.18 – $0.18 | 1 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $155.40 | $259.00 | $4.79 – $5.52 | 2 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $28.65 | $47.75 | $0.19 – $7.08 | 2 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $441.60 | $736.00 | $2.82 – $10.90 | 2 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $406.80 | $678.00 | $0.53 – $9.60 | 3 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $42.45 | $70.75 | $3.95 – $20.72 | 2 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $5.10 | $8.50 | $0.50 – $0.50 | 1 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $114.60 | $191.00 | $0.11 – $0.94 | 2 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $0.90 | $1.50 | $0.12 – $0.13 | 3 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $10.80 | $18.00 | $0.21 – $0.23 | 3 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $10.35 | $17.25 | $1.08 – $1.99 | 2 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $3.15 | $5.25 | $0.02 – $0.03 | 2 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $36.60 | $61.00 | $0.26 – $3.92 | 2 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $24.00 | $40.00 | $0.15 – $2.74 | 2 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $724.80 | $1,208.00 | $1.45 – $95.19 | 2 |
| Minocycline hydrochloride HCPCS J2265 | $1.05 | $1.75 | $0.77 – $2.94 | 3 |
| Minoxidil, 10 mg HCPCS S0139 | $5.25 | $8.75 | $2.26 – $2.26 | 1 |
| Misoprostol, oral, 200 mcg HCPCS S0191 | $80.40 | $134.00 | $20.45 – $20.45 | 1 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $1,714.80 | $2,858.00 | $20.35 – $307.02 | 4 |
| Mitomycin instillation HCPCS J9281 | $858.00 | $1,430.00 | $208.39 – $350.38 | 4 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $2,986.80 | $4,978.00 | $23.88 – $534.08 | 4 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $11.40 | $19.00 | $1.95 – $2.18 | 2 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $43.80 | $73.00 | $6.18 – $12.05 | 2 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $100.20 | $167.00 | $0.16 – $3.94 | 2 |
| Mycophenolic acid HCPCS J7518 | $19.05 | $31.75 | $0.34 – $4.91 | 2 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $5.55 | $9.25 | $0.05 – $0.05 | 1 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $12.30 | $20.50 | $1.99 – $3.70 | 2 |
| Naltrexone, depot form HCPCS J2315 | $33.60 | $56.00 | $3.82 – $4.66 | 4 |
| Nelarabine injection HCPCS J9261 | $748.80 | $1,248.00 | $79.86 – $167.70 | 4 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $34.65 | $57.75 | $1.84 – $1.84 | 1 |
| New Patient Office Visit (level 2) CPT 99202 | $200.40 | $334.00 | $73.52 – $73.52 | 1 |
| New Patient Office Visit (level 3) CPT 99203 | $259.20 | $432.00 | $94.97 – $94.97 | 1 |
| New Patient Office Visit (level 4) CPT 99204 | $400.80 | $668.00 | $121.78 – $121.78 | 1 |
| New Patient Office Visit (level 5) CPT 99205 | $505.80 | $843.00 | $147.82 – $147.82 | 1 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $17.55 | $29.25 | $0.04 – $0.07 | 2 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $4.05 | $6.75 | $0.66 – $1.49 | 2 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $104.40 | $174.00 | $19.18 – $36.26 | 4 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $213.60 | $356.00 | $39.33 – $86.90 | 4 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $53.40 | $89.00 | $0.61 – $8.94 | 2 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $1,515.00 | $2,525.00 | $170.42 – $223.94 | 4 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $487.20 | $812.00 | $133.92 – $133.92 | 1 |
| Off/op consltj new/est sf 20 CPT 99242 | $320.40 | $534.00 | $43.47 – $43.47 | 1 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $38.55 | $64.25 | $0.68 – $0.87 | 2 |
| Olanzapine long-acting inj HCPCS J2358 | $76.20 | $127.00 | $2.92 – $5.55 | 4 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $131.40 | $219.00 | $33.08 – $49.06 | 4 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $428.40 | $714.00 | $14.38 – $14.38 | 1 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $66.00 | $110.00 | $0.09 – $11.20 | 2 |
| Ophthalmic mitomycin HCPCS J7315 | $1,930.20 | $3,217.00 | $345.20 – $345.20 | 1 |
| Oral aprepitant HCPCS J8501 | $73.80 | $123.00 | $2.73 – $9.27 | 2 |
| Oral everolimus HCPCS J7527 | $30.30 | $50.50 | $1.37 – $5.74 | 2 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $105.60 | $176.00 | $17.14 – $31.55 | 4 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $366.00 | $610.00 | $3.05 – $11.19 | 2 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $69.60 | $116.00 | $0.79 – $2.21 | 2 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $97.20 | $162.00 | $0.08 – $17.36 | 2 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $7.35 | $12.25 | $1.84 – $1.84 | 1 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $75.00 | $125.00 | $0.14 – $0.33 | 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.