UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
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 |
|---|---|---|---|---|
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $117.00 | $195.00 | $2.03 – $30.01 | 5 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $3,070.40 | $12,937.45 | $111.41 – $2,169.89 | 10 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $6,521.40 | $10,869.00 | $1,092.53 – $1,868.75 | 10 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $379.80 | $633.00 | $0.03 – $3.57 | 5 |
| Levetiracetam therapeutic drug level CPT 80177 | $141.00 | $235.00 | $12.02 – $16.64 | 11 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $610.80 | $1,018.00 | $1.60 – $95.52 | 5 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $19.80 | $33.00 | $4.34 – $11.00 | 5 |
| Lidocaine injection HCPCS J2001 | not published | $11.04 | $2.12 – $2.12 | 1 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.20 | $0.25 | $0.00 – $0.00 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $226.20 | $377.00 | $13.32 – $15.87 | 11 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $1,026.00 – $3,273.80 | 9 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $136.40 – $1,621.93 | 10 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $253.60 | $317.00 | $2.25 – $144.39 | 5 |
| Lipase CPT 83690 | $54.00 | $90.00 | $5.50 – $7.44 | 11 |
| Lipoprotein blood quant CPT 83704 | $280.20 | $467.00 | $31.01 – $36.93 | 10 |
| Lipoprotein direct measurement hdl CPT 83718 | $45.00 | $75.00 | $7.43 – $8.85 | 11 |
| Lipoprotein direct measurement ldl CPT 83721 | $62.40 | $104.00 | $9.52 – $13.80 | 11 |
| Lip surgery procedure CPT 40799 | $124.20 | $207.00 | $48.19 – $239.10 | 8 |
| Lithium therapeutic drug level CPT 80178 | $67.20 | $112.00 | $5.99 – $9.20 | 11 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $917.40 | $1,529.00 | $155.04 – $497.52 | 11 |
| Liver Function Test CPT 80076 | $198.60 | $331.00 | $7.41 – $10.38 | 11 |
| Liver/spleen imag static only CPT 78215 | $1,032.60 | $1,721.00 | $76.19 – $402.25 | 10 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $10.40 | $13.00 | $0.61 – $3.76 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $66.40 | $83.00 | $0.87 – $22.00 | 7 |
| Low back disk surgery CPT 63030 | not published | not published | $2,773.79 – $7,355.55 | 9 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $666.60 | $1,111.00 | $91.94 – $166.48 | 10 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,750.20 | $2,917.00 | $153.92 – $913.53 | 10 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,636.80 | $2,728.00 | $165.60 – $756.11 | 10 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,368.00 | $2,280.00 | $91.94 – $650.82 | 10 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,827.40 | $6,379.00 | $308.78 – $2,417.12 | 10 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,449.80 | $4,083.00 | $308.78 – $1,371.07 | 10 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,205.00 | $3,675.00 | $209.00 – $1,246.82 | 10 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $154.80 | $258.00 | $34.30 – $106.45 | 10 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $257.40 | $429.00 | $40.28 – $120.47 | 10 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $366.60 | $611.00 | $38.50 – $149.15 | 10 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $112.80 | $188.00 | $26.49 – $90.67 | 9 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $1,466.58 – $10,719.92 | 9 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $281.40 | $469.00 | $20.90 – $311.72 | 10 |
| Lung function test (mbc/mvv) CPT 94200 | $115.80 | $193.00 | $9.90 – $67.46 | 10 |
| Lung Function Test (Spirometry) CPT 94010 | $301.20 | $502.00 | $16.50 – $156.63 | 10 |
| Lung perfusion imaging CPT 78580 | $1,263.00 | $2,105.00 | $86.90 – $402.25 | 10 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $400.20 | $667.00 | $130.78 – $223.70 | 9 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $87.60 | $146.00 | $26.51 – $45.34 | 9 |
| Lymphatics/lymph node imaging CPT 78195 | $691.20 | $1,152.00 | $198.00 – $538.84 | 10 |
| Lymphocyte transformation mitogen CPT 86353 | $453.00 | $755.00 | $44.47 – $77.91 | 11 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $38.50 – $509.79 | 10 |
| Macroscopic exam arthropod CPT 87168 | $54.00 | $90.00 | $3.87 – $4.61 | 10 |
| Macroscopic exam parasite CPT 87169 | $53.40 | $89.00 | $3.91 – $4.65 | 10 |
| Magnesium CPT 83735 | $39.00 | $65.00 | $6.08 – $8.34 | 11 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $239.40 | $399.00 | $0.30 – $1.50 | 5 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $20.40 | $34.00 | $13.27 – $13.27 | 1 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $210.01 – $2,101.74 | 3 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $94.80 | $158.00 | $33.14 – $56.69 | 9 |
| Marker biop eviva buckle ss HCPCS A4648 | $400.80 | $668.00 | $235.21 – $235.21 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $552.76 – $3,942.82 | 9 |
| Mastoids complete CPT 70130 | $348.60 | $581.00 | $45.15 – $113.86 | 9 |
| Mast simple complete CPT 19303 | not published | not published | $647.75 – $6,714.82 | 9 |
| M.avium-intra dna amp prob CPT 87561 | $523.20 | $872.00 | $31.82 – $37.90 | 10 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $96.00 | $160.00 | $13.11 – $19.55 | 11 |
| Mayo aathr protein s free CPT 85306 | $102.00 | $170.00 | $13.89 – $24.36 | 11 |
| Mayo activated protein c resistance assay CPT 85307 | $102.60 | $171.00 | $13.89 – $19.48 | 11 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $141.00 | $235.00 | $34.98 – $41.66 | 10 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $190.20 | $317.00 | $13.40 – $15.96 | 10 |
| Mayo alpha 1 antitrypsin CPT 82103 | $66.60 | $111.00 | $12.19 – $19.55 | 11 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $237.60 | $396.00 | $12.10 – $16.29 | 11 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $1,227.60 | $2,046.00 | $110.31 – $131.36 | 10 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,702.80 | $2,838.00 | $45.38 – $115.06 | 11 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $2,547.60 | $4,246.00 | $120.56 – $147.96 | 11 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $14,400.60 | $24,001.00 | $380.23 – $1,252.80 | 10 |
| Mayo androstenedione CPT 82157 | $144.60 | $241.00 | $26.55 – $31.62 | 11 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $74.40 | $124.00 | $13.24 – $23.20 | 11 |
| Mayo antithrombin iii antigen CPT 85301 | $97.20 | $162.00 | $9.80 – $17.19 | 11 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $102.60 | $171.00 | $13.65 – $23.92 | 11 |
| Mayo avwpr vw factor activity CPT 85397 | $415.80 | $693.00 | $27.99 – $33.33 | 11 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $189.00 | $315.00 | $30.88 – $37.90 | 11 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $102.60 | $171.00 | $9.23 – $12.94 | 11 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $1,051.20 | $1,752.00 | $103.86 – $156.43 | 10 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $80.40 | $134.00 | $11.70 – $20.50 | 11 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $85.80 | $143.00 | $11.96 – $20.96 | 11 |
| Mayo brcmg brucella antibody igm CPT 86622 | $70.20 | $117.00 | $8.10 – $12.32 | 11 |
| Mayo c1 esterase inhibitor CPT 83883 | $96.60 | $161.00 | $12.33 – $14.69 | 10 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $276.00 | $460.00 | $15.30 – $18.22 | 10 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $427.80 | $713.00 | $19.92 – $34.42 | 11 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $1,672.20 | $2,787.00 | $110.84 – $153.40 | 11 |
| Mayo ceruloplasmin CPT 82390 | $54.00 | $90.00 | $9.74 – $11.60 | 11 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $129.60 | $216.00 | $12.81 – $15.25 | 10 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $119.40 | $199.00 | $11.68 – $13.91 | 10 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $241.20 | $402.00 | $10.72 – $12.77 | 11 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $89.40 | $149.00 | $11.50 – $20.18 | 11 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $764.40 | $1,274.00 | $105.64 – $185.15 | 11 |
| Mayo chromium CPT 82495 | $60.00 | $100.00 | $6.60 – $21.29 | 11 |
| Mayo coccidioides antibody CPT 86635 | $112.80 | $188.00 | $10.40 – $18.23 | 11 |
| Mayo cocou cortisone urine CPT 82542 | $108.00 | $180.00 | $21.20 – $26.02 | 11 |
| Mayo cortisol free CPT 82530 | $84.60 | $141.00 | $15.15 – $26.85 | 11 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $123.00 | $205.00 | $12.28 – $44.24 | 11 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $115.80 | $193.00 | $10.99 – $19.26 | 11 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $93.60 | $156.00 | $12.02 – $16.68 | 11 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $166.20 | $277.00 | $22.92 – $27.29 | 11 |
| Mayo dihydrotestosterone CPT 82642 | $239.40 | $399.00 | $26.55 – $31.62 | 10 |
| Mayo efpo chloride stool CPT 82438 | $89.40 | $149.00 | $3.30 – $5.25 | 11 |
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.