UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
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 |
|---|---|---|---|---|
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $3,004.80 | $5,008.00 | $3.42 – $17.62 | 11 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $641.40 | $1,069.00 | $4.51 – $19.31 | 11 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $9.00 | $15.00 | $0.05 – $0.14 | 9 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $3,588.60 | $5,981.00 | $476.30 – $2,383.34 | 9 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,228.80 | $2,048.00 | $77.29 – $1,222.94 | 14 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $4,242.60 | $7,071.00 | $185.63 – $2,659.86 | 14 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $4,812.60 | $8,021.00 | $363.84 – $5,213.49 | 14 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $3,217.80 | $5,363.00 | $82.73 – $2,383.34 | 12 |
| Rpl tun-cvad w subq port CPT 36582 | $8,004.00 | $13,340.00 | $348.25 – $4,829.02 | 12 |
| Rpl tun-cvad w subq pump CPT 36583 | $8,004.00 | $13,340.00 | $351.07 – $8,293.65 | 12 |
| Rpl tun cvc wo subq port CPT 36581 | $4,201.80 | $7,003.00 | $236.08 – $4,829.02 | 12 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $245.22 – $9,573.28 | 9 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $237.48 – $8,951.31 | 9 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $182.36 – $9,573.28 | 9 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | not published | not published | $273.38 – $7,586.32 | 5 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $134.05 – $5,414.43 | 9 |
| Rsv assay w/optic CPT 87807 | $73.80 | $123.00 | $12.31 – $79.67 | 14 |
| Rubella antibody igg CPT 86762 | $80.40 | $134.00 | $14.89 – $104.15 | 14 |
| Rubeola antibody igg CPT 86765 | $72.00 | $120.00 | $11.80 – $70.85 | 14 |
| Russell viper venom diluted CPT 85613 | $48.60 | $81.00 | $9.91 – $69.22 | 14 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $1,441.80 | $2,403.00 | $17.95 – $58.05 | 11 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $262.80 | $438.00 | $21.61 – $163.15 | 15 |
| Salivary gland imaging CPT 78230 | $1,228.80 | $2,048.00 | $51.09 – $800.87 | 14 |
| Salivary glnd img serial img CPT 78231 | $1,228.80 | $2,048.00 | $45.85 – $647.49 | 14 |
| Sarscov coronavirus ag ia CPT 87426 | $84.60 | $141.00 | $17.76 – $68.52 | 12 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $819.60 | $1,366.00 | $118.73 – $435.88 | 12 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $394.20 | $657.00 | $80.39 – $381.88 | 12 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $379.80 | $633.00 | $106.35 – $567.38 | 12 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $394.20 | $657.00 | $85.82 – $383.66 | 12 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $394.20 | $657.00 | $77.61 – $374.81 | 12 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $394.20 | $657.00 | $79.28 – $801.00 | 11 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $2,643.60 | $4,406.00 | $539.25 – $2,485.84 | 9 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $885.82 – $4,978.02 | 9 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $189.60 | $316.00 | $21.17 – $191.25 | 10 |
| Screen cerv/vag thin layer HCPCS G0123 | $145.20 | $242.00 | $16.19 – $146.56 | 10 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $505.77 – $2,182.77 | 8 |
| Screening Colonoscopy (high risk) HCPCS G0105 | not published | not published | $639.89 – $2,241.85 | 8 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $100.20 | $167.00 | $18.22 – $115.05 | 13 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $60.00 | $100.00 | $9.20 – $172.92 | 13 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $108.00 | $180.00 | $7.51 – $74.16 | 11 |
| Screening Mammogram CPT 77067 | $257.40 | $429.00 | $49.68 – $613.11 | 11 |
| Screening prostate cancer PSA HCPCS G0103 | $97.80 | $163.00 | $15.43 – $144.59 | 10 |
| Screen pap by tech w md supv HCPCS P3000 | $55.20 | $92.00 | $13.83 – $130.20 | 11 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $394.20 | $657.00 | $57.64 – $524.98 | 15 |
| Sc ther infusion reset pump CPT 96371 | $148.20 | $247.00 | $55.66 – $109.97 | 12 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $12,577.80 | $20,963.00 | $258.87 – $6,301.51 | 5 |
| Sedimentation rate erythrocyte automated CPT 85652 | $13.80 | $23.00 | $2.79 – $19.52 | 14 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $97.20 | $162.00 | $20.77 – $193.00 | 6 |
| Semen analysis presence/motility CPT 89321 | $86.40 | $144.00 | $9.63 – $87.20 | 11 |
| Serpina1 gene CPT 81332 | $252.00 | $420.00 | $45.14 – $69.84 | 12 |
| Set radiation therapy field CPT 77280 | $655.20 | $1,092.00 | $47.81 – $907.43 | 14 |
| Set radiation therapy field CPT 77285 | $1,029.00 | $1,715.00 | $66.81 – $1,611.94 | 14 |
| Set radiation therapy field CPT 77290 | $1,273.20 | $2,122.00 | $94.97 – $2,512.37 | 14 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $3.60 | $6.00 | $0.01 – $0.22 | 4 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $10.20 | $17.00 | $0.02 – $1.36 | 5 |
| Sex chromatin identification CPT 88130 | $43.20 | $72.00 | $14.37 – $108.85 | 11 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $91.17 – $3,584.95 | 8 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $520.80 | $868.00 | $40.64 – $875.08 | 12 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $520.80 | $868.00 | $48.26 – $875.08 | 12 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $819.00 | $1,365.00 | $63.50 – $875.08 | 12 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $1,341.60 | $2,236.00 | $80.01 – $875.08 | 12 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $520.80 | $868.00 | $35.56 – $875.08 | 12 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $520.80 | $868.00 | $44.45 – $875.08 | 12 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $575.40 | $959.00 | $52.07 – $875.08 | 12 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $520.80 | $868.00 | $31.75 – $875.08 | 12 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $660.00 | $1,100.00 | $48.26 – $875.08 | 12 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $7,034.40 | $11,724.00 | $142.97 – $9,570.62 | 3 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $1,016.56 – $10,960.19 | 9 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $648.78 – $4,978.02 | 12 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $713.94 – $10,960.19 | 12 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $682.16 – $4,978.02 | 12 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $171.60 | $286.00 | $16.13 – $109.18 | 12 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $188.40 | $314.00 | $24.89 – $151.94 | 15 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $1,016.56 – $10,960.19 | 9 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $262.80 | $438.00 | $20.82 – $589.04 | 13 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,713.80 | $4,523.00 | $405.28 – $3,282.06 | 14 |
| Shoulder MRI (with contrast) CPT 73222 | $2,713.80 | $4,523.00 | $327.20 – $3,578.07 | 14 |
| Shoulder MRI (without contrast) CPT 73221 | $1,656.00 | $2,760.00 | $208.69 – $2,115.40 | 14 |
| Shoulder X-ray CPT 73030 | $188.40 | $314.00 | $21.61 – $419.44 | 13 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $188.40 | $314.00 | $18.76 – $419.44 | 13 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $262.80 | $438.00 | $36.93 – $379.19 | 15 |
| Sialography s&i CPT 70390 | $547.80 | $913.00 | $27.51 – $481.70 | 15 |
| Sialolithotomy 42330 CPT 42330 | $3,971.40 | $6,619.00 | $81.28 – $4,975.65 | 12 |
| Sickling rbc CPT 85660 | $28.80 | $48.00 | $3.00 – $37.16 | 14 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $80.86 – $1,398.78 | 12 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $142.24 – $1,808.99 | 12 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $99.89 – $1,398.78 | 12 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $63.50 – $1,808.99 | 12 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $154.88 – $1,808.99 | 12 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $81.60 | $136.00 | $79.01 – $187.67 | 9 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,294.80 | $2,158.00 | $131.00 – $2,074.74 | 16 |
| Sinus CT scan (with contrast) CPT 70487 | $1,294.80 | $2,158.00 | $104.80 – $1,659.92 | 16 |
| Sinus CT scan (without contrast) CPT 70486 | $796.80 | $1,328.00 | $101.53 – $1,183.72 | 16 |
| Sinus/juglr venogram s&i CPT 75860 | $5,906.40 | $9,844.00 | $19.65 – $4,829.02 | 15 |
| Sinus X-ray (complete) CPT 70220 | $188.40 | $314.00 | $29.48 – $161.09 | 15 |
| Sinus X-ray (limited) CPT 70210 | $188.40 | $314.00 | $21.61 – $135.09 | 15 |
| Sipuleucel-t - su HCPCS Q2043 | $150.00 | $250.00 | $36,686.38 – $88,435.71 | 11 |
| Sirolimus, oral HCPCS J7520 | $20.40 | $34.00 | $0.87 – $9.86 | 10 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $91.38 – $2,654.34 | 5 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $97.30 – $2,638.27 | 5 |
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.