UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
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 |
|---|---|---|---|---|
| Glucose blood quantitative CPT 82947 | $52.20 | $87.00 | $3.89 – $5.12 | 12 |
| Glucose body fluid CPT 82945 | $52.20 | $87.00 | $3.89 – $5.56 | 12 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $95.40 | $159.00 | $46.35 – $74.35 | 12 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $199.80 | $333.00 | $12.72 – $16.00 | 12 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $42.60 | $71.00 | $3.60 – $4.28 | 12 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $35.40 | $44.25 | $0.46 – $0.49 | 9 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $104.80 | $131.00 | $11.04 – $11.81 | 9 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $280.80 | $468.00 | $18.37 – $22.40 | 12 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $255.60 | $426.00 | $18.31 – $21.76 | 12 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $2,802.00 | $4,670.00 | $733.66 – $785.03 | 9 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $62.40 | $104.00 | $30.23 – $33.56 | 3 |
| Graft axiofill 1000mg HCPCS J3590 | $15,289.20 | $25,482.00 | $1,491.75 – $4,972.50 | 14 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $256.80 | $428.00 | $67.27 – $74.00 | 2 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $28,077.00 | $46,795.00 | $2,995.60 – $13,480.20 | 14 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $28,969.20 | $48,282.00 | $160.00 – $720.00 | 14 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $16,977.00 | $28,295.00 | $80.20 – $360.90 | 14 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $1,233.60 | $2,056.00 | $101.03 – $111.13 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $410.40 | $684.00 | $138.74 – $152.61 | 2 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $6,183.00 | $10,305.00 | $52.75 – $58.03 | 2 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $25,379.40 | $42,299.00 | $15.20 – $68.40 | 14 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $2,112.60 | $3,521.00 | $49.40 – $222.30 | 14 |
| Granisetron hcl injection HCPCS J1626 | $27.00 | $45.00 | $0.19 – $0.20 | 5 |
| Great toe with reduction 28495 CPT 28495 | $825.60 | $1,376.00 | $83.05 – $993.28 | 12 |
| Growth stimulation gene 2 CPT 83006 | $234.00 | $390.00 | $26.33 – $82.54 | 12 |
| G-tube reposition CPT 43761 | $721.20 | $1,202.00 | $103.87 – $335.44 | 12 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,183.40 | $3,639.00 | $137.81 – $1,145.13 | 12 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $9,511.20 | $15,852.00 | $37.20 – $167.40 | 14 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $2,825.40 | $4,709.00 | $4.86 – $16.20 | 14 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,083.60 | $1,806.00 | $46.71 – $155.70 | 13 |
| Guid loc target vol rad tx CPT 77387 | $292.20 | $487.00 | $81.68 – $135.55 | 6 |
| Gw stiffened micro access kit HCPCS C1894 | $3,307.80 | $5,513.00 | $1.08 – $38.80 | 14 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $160.00 | $200.00 | $4.40 – $4.84 | 5 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $9.00 | $11.25 | $0.80 – $0.88 | 5 |
| Hand-held pefr meter a4614 HCPCS A4614 | $25.20 | $42.00 | $24.32 – $53.72 | 4 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $130.20 | $217.00 | $23.13 – $51.75 | 9 |
| Hand X-ray CPT 73130 | $294.60 | $491.00 | $14.72 – $90.67 | 11 |
| Hand X-ray (2 views, both hands) CPT 73120 | $564.60 | $941.00 | $12.80 – $109.49 | 11 |
| Haptoglobin quantitative CPT 83010 | $155.40 | $259.00 | $12.44 – $15.36 | 12 |
| Hbot, full body chamber, 30m HCPCS G0277 | $873.60 | $1,456.00 | $48.28 – $140.67 | 9 |
| Hcg qualitative CPT 84703 | $102.60 | $171.00 | $7.43 – $13.13 | 12 |
| Hcg quantitative CPT 84702 | $301.80 | $503.00 | $14.88 – $21.02 | 12 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $190.20 | $317.00 | $85.59 – $285.30 | 13 |
| Hc nm fusion spect CT unlisted CPT 78999 | $717.60 | $1,196.00 | $303.48 – $413.75 | 8 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $5,647.20 | $9,412.00 | $1,256.82 – $1,777.19 | 9 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $3,516.00 | $5,860.00 | $211.60 – $707.76 | 12 |
| Hdr rdncl skn surf brachytx CPT 77768 | $1,093.20 | $1,822.00 | $205.30 – $494.91 | 11 |
| Head CT scan (with and without contrast) CPT 70470 | $2,704.20 | $4,507.00 | $128.00 – $909.29 | 12 |
| Head CT scan (with contrast) CPT 70460 | $2,371.20 | $3,952.00 | $102.40 – $746.06 | 12 |
| Head CT scan (without contrast) CPT 70450 | $1,602.60 | $2,671.00 | $99.20 – $627.99 | 12 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $292.80 | $488.00 | $14.72 – $90.67 | 11 |
| Hematocrit CPT 85014 | $48.00 | $80.00 | $2.35 – $4.13 | 12 |
| Hemodialysis one evaluation CPT 90935 | $1,935.60 | $3,226.00 | $211.20 – $720.47 | 11 |
| Hemoglobin CPT 85018 | $27.60 | $46.00 | $2.35 – $4.13 | 12 |
| Hemoglobin fetal qualitative CPT 83033 | $72.00 | $120.00 | $7.18 – $8.73 | 12 |
| Hemoglobin f (fetal) chemical CPT 83030 | $228.00 | $380.00 | $5.50 – $11.73 | 12 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $226.80 | $378.00 | $3.30 – $8.96 | 12 |
| Hemoglobin plasma CPT 83051 | $61.20 | $102.00 | $3.85 – $7.98 | 12 |
| Hemoglobin urine CPT 83069 | $52.20 | $87.00 | $3.08 – $4.31 | 12 |
| Hemolysins and agglutinins incubated CPT 86941 | $129.60 | $216.00 | $11.96 – $17.47 | 12 |
| Hemophilus influenza antibdy CPT 86684 | $139.20 | $232.00 | $15.65 – $27.46 | 12 |
| Heparin assay CPT 85520 | $335.40 | $559.00 | $7.18 – $14.29 | 12 |
| Heparin bolus from bag HCPCS J1644 | $6.00 | $10.00 | $0.21 – $0.23 | 5 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $4.40 | $5.50 | $0.02 – $0.12 | 6 |
| Hepatitis a antibody igm CPT 86709 | $168.00 | $280.00 | $11.13 – $19.46 | 12 |
| Hepatitis b core antibody igm CPT 86705 | $168.00 | $280.00 | $11.64 – $20.80 | 12 |
| Hepatitis b core antibody total CPT 86704 | $455.40 | $759.00 | $11.91 – $19.20 | 12 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,109.60 | $1,387.00 | $11.00 – $143.58 | 9 |
| Hepatitis b surface antibody CPT 86706 | $137.40 | $229.00 | $10.62 – $16.87 | 12 |
| Hepatitis c antibody CPT 86803 | $279.60 | $466.00 | $14.10 – $24.32 | 12 |
| Hereditary colon ca dsordrs CPT 81435 | $13,579.80 | $22,633.00 | $495.41 – $1,408.27 | 12 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $349.25 – $3,600.06 | 12 |
| Herpes simplex 1 ag if CPT 87274 | $158.40 | $264.00 | $9.36 – $13.08 | 12 |
| Herpes simplex 2 ag if CPT 87273 | $143.40 | $239.00 | $11.84 – $15.59 | 12 |
| Herpes simplex type 1 antibody igg CPT 86695 | $271.80 | $453.00 | $13.03 – $23.32 | 12 |
| Herpes simplex type 2 antibody igg CPT 86696 | $91.80 | $153.00 | $19.13 – $27.39 | 12 |
| Herpes simplex virus isolation CPT 87255 | $447.60 | $746.00 | $33.46 – $48.45 | 12 |
| Heterophile antibodies screening CPT 86308 | $56.40 | $94.00 | $5.12 – $9.15 | 12 |
| Hexa gene CPT 81255 | $1,336.80 | $2,228.00 | $50.85 – $191.78 | 12 |
| Hhv-6 dna quant CPT 87533 | $551.40 | $919.00 | $32.60 – $45.59 | 12 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $374.40 | $624.00 | $26.59 – $108.48 | 12 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $414.00 | $690.00 | $32.04 – $108.48 | 12 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $621.00 | $1,035.00 | $19.10 – $90.67 | 11 |
| Hip X-ray CPT 73502 | $653.40 | $1,089.00 | $28.62 – $90.67 | 11 |
| Histamine CPT 83088 | $351.60 | $586.00 | $14.30 – $32.24 | 12 |
| Histochemical stains add-on CPT 88314 | $193.20 | $322.00 | $11.00 – $112.19 | 9 |
| Hiv-1 ag ia CPT 87390 | $223.20 | $372.00 | $11.55 – $26.27 | 12 |
| Hla class i high defin qual CPT 86832 | $556.80 | $928.00 | $146.45 – $353.46 | 12 |
| Hla class ii high defin qual CPT 86833 | $507.00 | $845.00 | $133.14 – $355.69 | 12 |
| Hla class i&ii antibody qual CPT 86828 | $234.60 | $391.00 | $47.87 – $70.07 | 12 |
| Hla class ii phenotype qual CPT 86831 | $402.00 | $670.00 | $79.88 – $92.95 | 12 |
| Hla class i phenotype qual CPT 86830 | $230.40 | $384.00 | $93.20 – $108.45 | 12 |
| Hla i & ii typing hr CPT 81378 | $2,407.80 | $4,013.00 | $341.53 – $482.75 | 12 |
| Hla i & ii typing lr CPT 81370 | $3,220.20 | $5,367.00 | $397.42 – $561.77 | 12 |
| Hla ii typing 1 loc hr CPT 81382 | $1,843.80 | $3,073.00 | $122.24 – $172.77 | 12 |
| Hla i low res one antigen equiv ea CPT 81374 | $791.40 | $1,319.00 | $73.46 – $101.63 | 12 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $1,183.20 | $1,972.00 | $113.54 – $185.49 | 12 |
| Hla typing a b or c CPT 86813 | $799.20 | $1,332.00 | $57.32 – $100.48 | 12 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $0.60 | $1.00 | $0.22 – $0.24 | 4 |
| Ho flex frejka w/cov pre cst HCPCS L1600 | $48.60 | $81.00 | $78.08 – $246.21 | 4 |
| Home sleep test/type 2 porta HCPCS G0398 | $1,572.00 | $2,620.00 | $113.55 – $161.10 | 8 |
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.