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 |
|---|---|---|---|---|
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $72.00 | $120.00 | $18.11 – $19.38 | 9 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $555.60 | $926.00 | $0.23 – $0.25 | 5 |
| Irradiation of blood product each unit reference CPT 86945 | $98.40 | $164.00 | $26.52 – $40.41 | 9 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $142.20 | $237.00 | $21.43 – $60.59 | 12 |
| Irrigation tray HCPCS A4320 | $2.40 | $4.00 | $6.40 – $12.98 | 4 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $149.40 | $249.00 | $81.90 – $87.63 | 9 |
| Ivc venogram s&i CPT 75825 | $1,510.20 | $2,517.00 | $28.80 – $3,210.81 | 12 |
| IV Fluids (each additional hour) CPT 96361 | $322.20 | $537.00 | $9.90 – $47.07 | 12 |
| IV Fluids (first hour) CPT 96360 | $1,143.00 | $1,905.00 | $34.79 – $214.93 | 12 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $285.60 | $476.00 | $12.57 – $34.07 | 9 |
| IV Medicine Infusion (additional drug) CPT 96367 | $285.60 | $476.00 | $21.16 – $72.60 | 12 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $285.60 | $476.00 | $13.52 – $47.07 | 12 |
| IV Medicine Infusion (first hour) CPT 96365 | $1,143.00 | $1,905.00 | $43.23 – $214.93 | 12 |
| IV Push Injection (each additional drug) CPT 96375 | $147.00 | $245.00 | $14.31 – $47.07 | 12 |
| IV Push Injection (first drug) CPT 96374 | $165.60 | $276.00 | $34.12 – $214.93 | 12 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,283.40 | $2,139.00 | $35.20 – $245.75 | 12 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $361.20 | $602.00 | $139.21 – $148.95 | 9 |
| Jak2 targeted sequence analysis CPT 81279 | $1,170.00 | $1,950.00 | $162.98 – $202.20 | 12 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $675.60 | $1,126.00 | $21.12 – $121.94 | 12 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $412.80 | $688.00 | $21.12 – $108.48 | 12 |
| John cunningham antibody CPT 86711 | $3,164.40 | $5,274.00 | $16.69 – $20.26 | 12 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $174.60 | $291.00 | $5.50 – $8.92 | 12 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $24.60 | $30.75 | $0.29 – $0.31 | 9 |
| Kidney imag w/bld flow multi CPT 78709 | $1,161.00 | $1,935.00 | $237.62 – $553.58 | 12 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,552.20 | $2,587.00 | $88.32 – $549.10 | 12 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $732.60 | $1,221.00 | $62.72 – $315.40 | 12 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $697.80 | $1,163.00 | $62.72 – $266.18 | 12 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $382.20 | $637.00 | $171.99 – $573.30 | 13 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $10,797.00 | $17,995.00 | $4,858.65 – $16,195.50 | 13 |
| Kit gene analys d816 variant CPT 81273 | $1,111.20 | $1,852.00 | $109.89 – $136.32 | 12 |
| Kit lead specify 5-6-5 HCPCS C1778 | $12,081.00 | $20,135.00 | $160.40 – $721.80 | 14 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $597.85 – $3,309.88 | 12 |
| Knee arthroscopy/surgery CPT 29882 | $5,152.80 | $8,588.00 | $597.85 – $3,309.88 | 12 |
| Knee MRI (with and without contrast) CPT 73723 | $4,010.40 | $6,684.00 | $343.82 – $2,200.73 | 11 |
| Knee MRI (with contrast) CPT 73722 | $3,051.00 | $5,085.00 | $393.92 – $1,225.96 | 11 |
| Knee MRI (without contrast) CPT 73721 | $2,514.00 | $4,190.00 | $232.71 – $1,299.56 | 11 |
| Knee X-ray CPT 73564 | $477.00 | $795.00 | $28.70 – $109.49 | 11 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $608.40 | $1,014.00 | $21.12 – $90.67 | 11 |
| Knee X-ray (3 views, both knees) CPT 73562 | $399.00 | $665.00 | $21.12 – $90.67 | 11 |
| Knee X-ray (standing, both knees) CPT 73565 | $237.60 | $396.00 | $22.22 – $89.83 | 12 |
| Kras gene addl variants CPT 81276 | $429.00 | $715.00 | $173.53 – $210.98 | 12 |
| Kras gene variants exon 2 CPT 81275 | $325.80 | $543.00 | $173.78 – $210.98 | 12 |
| Kyleena, 19.5 mg HCPCS J7296 | $3,100.20 | $5,167.00 | $1,200.72 – $1,200.72 | 1 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $327.00 | $545.00 | $0.54 – $1.80 | 14 |
| Lactate dehydrogenase (ldh) CPT 83615 | $42.60 | $71.00 | $5.98 – $9.20 | 12 |
| Lactated ringers intravenous solution HCPCS J7120 | $32.40 | $40.50 | $2.41 – $2.65 | 5 |
| Lactic acid CPT 83605 | $121.80 | $203.00 | $8.80 – $12.63 | 12 |
| Lactoferrin fecal qualitative CPT 83630 | $351.60 | $586.00 | $13.54 – $21.51 | 12 |
| Lactoferrin fecal quant CPT 83631 | $175.20 | $292.00 | $19.40 – $28.08 | 12 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $993.28 – $7,355.55 | 11 |
| Laminotomy single lumbar CPT 63042 | not published | not published | $993.28 – $7,355.55 | 11 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $372.00 | $465.00 | $34.05 – $36.43 | 9 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $993.28 – $6,007.35 | 11 |
| Laparoscopy remove adnexa CPT 58661 | $7,589.40 | $12,649.00 | $993.28 – $6,007.35 | 11 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $818.32 – $6,007.35 | 11 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $1,473.60 | $2,456.00 | $25.85 – $993.28 | 12 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $4,599.00 | $7,665.00 | $373.84 – $993.28 | 11 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $4,228.80 | $7,048.00 | $129.80 – $1,759.17 | 12 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $270.89 – $3,761.11 | 12 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $4,649.40 | $7,749.00 | $1,549.80 – $6,974.10 | 14 |
| Lead capillary CPT 83655 | $165.60 | $276.00 | $11.00 – $13.21 | 12 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $5,084.40 | $8,474.00 | $67.60 – $304.20 | 14 |
| Left compres band >=3" <5"/yd HCPCS A6449 | $3.60 | $6.00 | $1.79 – $3.68 | 4 |
| Left compres band <3"/yd HCPCS A6448 | $4.20 | $7.00 | $1.19 – $2.46 | 4 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $1,678.20 | $2,797.00 | $152.76 – $488.86 | 12 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $2,680.20 | $4,467.00 | $105.60 – $774.47 | 11 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,358.60 | $3,931.00 | $101.17 – $667.21 | 11 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,227.60 | $2,046.00 | $146.18 – $509.08 | 12 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $16.60 | $20.75 | $3.22 – $3.54 | 5 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $2,789.60 | $3,487.00 | $176.45 – $188.80 | 9 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $1,045.80 | $1,743.00 | $1,730.32 – $1,851.44 | 9 |
| Levalbuterol non-comp con HCPCS J7612 | $3.60 | $6.00 | $0.27 – $0.30 | 3 |
| Levalbuterol non-comp unit HCPCS J7614 | $12.00 | $20.00 | $0.09 – $0.10 | 3 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $276.00 | $460.00 | $0.04 – $0.04 | 5 |
| Levetiracetam therapeutic drug level CPT 80177 | $330.60 | $551.00 | $13.09 – $18.52 | 12 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $37.00 | $46.25 | $2.54 – $2.79 | 5 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $24.60 | $41.00 | $6.87 – $7.56 | 5 |
| Liberta rc ipg HCPCS C1820 | $39,513.60 | $65,856.00 | $2,003.80 – $9,017.10 | 14 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.16 | $0.20 | $0.00 – $0.00 | 5 |
| Lidocaine therapeutic drug level CPT 80176 | $164.40 | $274.00 | $14.30 – $16.64 | 12 |
| Ligation/major artery/extremity 37618 CPT 37618 | $3,848.40 | $6,414.00 | $418.88 – $1,336.33 | 4 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $164.00 | $205.00 | $3.57 – $3.93 | 5 |
| Lipase CPT 83690 | $139.80 | $233.00 | $5.50 – $7.52 | 12 |
| Lipoprotein blood high res frac & quant CPT 83701 | $325.20 | $542.00 | $30.51 – $36.96 | 12 |
| Lipoprotein blood quant CPT 83704 | $375.60 | $626.00 | $26.70 – $37.33 | 12 |
| Lipoprotein direct measurement hdl CPT 83718 | $60.60 | $101.00 | $7.70 – $8.96 | 12 |
| Lipoprotein direct measurement ldl CPT 83721 | $164.40 | $274.00 | $10.37 – $15.36 | 12 |
| Lip surgery procedure CPT 40799 | $114.60 | $191.00 | $162.28 – $239.10 | 8 |
| Lithium therapeutic drug level CPT 80178 | $82.80 | $138.00 | $6.54 – $10.24 | 12 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $315.00 | $525.00 | $134.25 – $148.29 | 3 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $944.40 | $1,574.00 | $155.04 – $549.58 | 11 |
| Liver elastography 91200 CPT 91200 | $480.60 | $801.00 | $24.22 – $159.61 | 12 |
| Liver Function Test CPT 80076 | $232.20 | $387.00 | $8.08 – $11.56 | 12 |
| Liver imag w/vasclr flow CPT 78202 | $1,510.20 | $2,517.00 | $64.00 – $549.10 | 12 |
| Liver/spleen imag static only CPT 78215 | $1,308.60 | $2,181.00 | $59.52 – $409.92 | 12 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $394.80 | $658.00 | $216.90 – $232.08 | 9 |
| Loop ostmy bridg ster HCPCS A4421 | $64.80 | $108.00 | $1.54 – $1.54 | 1 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $31.20 | $52.00 | $1.38 – $1.51 | 5 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $253.20 | $422.00 | $93.93 – $183.90 | 12 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,574.80 | $5,958.00 | $171.38 – $1,088.26 | 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.