Hospital Oil City, PA

UPMC Northwest

UPMC Northwest in Seneca, PA publishes cash prices for 42 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.

100 Fairfield Drive, Seneca, PA 16346 Collected Sep 23, 2026 Source price file

Scans and imaging

Procedure	Cash price	List price	Off list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PLVS W CONTRAST	$1,368.00	$2,280.00	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PLVS W CONTRAST	$1,368.00	$2,280.00	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,226.40	$2,044.00	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$1,226.40	$2,044.00	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CON	$1,368.00	$2,280.00	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CON	$1,368.00	$2,280.00	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGITAL DX BILAT WWO CAD	$591.60	$986.00	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGITAL DX BILAT WWO CAD	$591.60	$986.00	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO DIGITAL DX UNI WWO CAD	$487.20	$812.00	40%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DIGITAL DX UNI WWO CAD	$487.20	$812.00	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LOW EXTREM ANY JNT WO	$2,205.00	$3,675.00	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LOW EXTREM ANY JNT WO	$2,205.00	$3,675.00	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LOW EXTREM ANY JNT W/WO	$3,815.40	$6,359.00	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LOW EXTREM ANY JNT W/WO	$3,815.40	$6,359.00	40%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO CON	$2,205.00	$3,675.00	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO CON	$2,205.00	$3,675.00	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W WO CON	$3,827.40	$6,379.00	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W WO CON	$3,827.40	$6,379.00	40%
MRI of the lower back, no contrast dye CPT 72148 MR SP CANAL LUMBAR WO	$2,205.00	$3,675.00	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR SP CANAL LUMBAR WO	$2,205.00	$3,675.00	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS>14WKS	$610.80	$1,018.00	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS>14WKS	$610.80	$1,018.00	40%
Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGI SCR BILAT WWO CAD	$205.20	$342.00	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGI SCR BILAT WWO CAD	$205.20	$342.00	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$354.00	$590.00	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$354.00	$590.00	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$564.00	$940.00	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$564.00	$940.00	40%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$257.40	$429.00	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$257.40	$429.00	40%

Lab tests

Procedure	Cash price	List price	Off list
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$84.60	$141.00	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$84.60	$141.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ LIPID PANEL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P4483	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P8093	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARD IQ LIPID PN W/REF DIR LDL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P5181	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL W/RFX LDL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL W/RFX LDL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P5181	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ LIPID PANEL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P4483	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P8093	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$133.20	$222.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARD IQ LIPID PN W/REF DIR LDL	$133.20	$222.00	40%
Complete blood count (CBC) with differential CPT 85025 OXLDL	$89.40	$149.00	40%
Complete blood count (CBC) with differential CPT 85025 CBC W/DIFF & PLATELETS	$89.40	$149.00	40%
Complete blood count (CBC) with differential CPT 85025 CBC & PLT & AUTO COMP DIFF	$89.40	$149.00	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/DIFF & PLATELETS	$89.40	$149.00	40%
Complete blood count (CBC) with differential inpatient CPT 85025 OXLDL	$89.40	$149.00	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC & PLT & AUTO COMP DIFF	$89.40	$149.00	40%
Complete blood count (CBC), no differential CPT 85027 CBC & PLT ONLY	$51.00	$85.00	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC & PLT ONLY	$51.00	$85.00	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOL PN P5147	$126.60	$211.00	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$126.60	$211.00	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$126.60	$211.00	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOL PN P5147	$126.60	$211.00	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$105.00	$175.00	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$105.00	$175.00	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL P5144	$198.60	$331.00	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$198.60	$331.00	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL P5144	$198.60	$331.00	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$198.60	$331.00	40%
Obstetric blood test panel CPT 80055 OBSTETRICS PANEL	$594.60	$991.00	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRICS PANEL	$594.60	$991.00	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE REFLEX	$129.60	$216.00	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA PNL 2770	$129.60	$216.00	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE REFLEX	$129.60	$216.00	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA PNL 2770	$129.60	$216.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL PSA PNL 2770	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRA-SENSITIVE	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL REFLEX TO FREE PSA	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA POST-PROSTECTOMY HAMA	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DIAGNOSTIC PSA	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRA-SENSITIVE	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL PSA PNL 2770	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DIAGNOSTIC PSA	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA POST-PROSTECTOMY HAMA	$96.60	$161.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL REFLEX TO FREE PSA	$96.60	$161.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P9418	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 INHIBITOR ASSAY PTT W/REFLEX	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACT PART THROMBOP TIME P P7021	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P0229	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBPL TIME PART(PTT) P6881	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL PROTHROMBIN TIME P4160	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN PL 2848	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P3391	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA W/RFX HEXAGONAL CONFIRM	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P3417	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT (BASELINE) PNL 5464	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P0267	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P2635	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ACTIVATED	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PTT	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT ACTIVATED	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PTT	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 INHIBITOR ASSAY PTT W/REFLEX	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACT PART THROMBOP TIME P P7021	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P0229	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBPL TIME PART(PTT) P6881	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL PROTHROMBIN TIME P4160	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN PL 2848	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P3391	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA W/RFX HEXAGONAL CONFIRM	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P9418	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P3417	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT (BASELINE) PNL 5464	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P0267	$119.40	$199.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P2635	$119.40	$199.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME PNL 2848	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT PROTHROMBIN TIME	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P2680	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P5674	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P4160	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P0229	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P P7021	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P4160	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P2680	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME PNL 2848	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P5674	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P0229	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P P7021	$34.80	$58.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT PROTHROMBIN TIME	$34.80	$58.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/FREE T4 RFX	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/HAMA TREATMENT	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID FUNCTION CASCADE SERUM	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THS P5910	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH THIRD GENERATION	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/HAMA TREATMENT	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THS P5910	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/FREE T4 RFX	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID FUNCTION CASCADE SERUM	$89.40	$149.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH THIRD GENERATION	$89.40	$149.00	40%
Urinalysis with microscope exam, automated CPT 81001 UR COMPL W/REFLEX TO CULTURE	$36.00	$60.00	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS R & M	$36.00	$60.00	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UR COMPL W/REFLEX TO CULTURE	$36.00	$60.00	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS R & M	$36.00	$60.00	40%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-C	$17.40	$29.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED	$17.40	$29.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINE KETONE	$17.40	$29.00	40%
Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS/CLINITEK	$17.40	$29.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINE MACRO	$17.40	$29.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-C	$17.40	$29.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED	$17.40	$29.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACRO	$17.40	$29.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS/CLINITEK	$17.40	$29.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONE	$17.40	$29.00	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK	$18.60	$31.00	40%
Urinalysis without microscope exam, manual CPT 81002 NON AUTOMATED W/O MICRO P3632	$18.60	$31.00	40%
Urinalysis without microscope exam, manual CPT 81002 URINE DIP	$18.60	$31.00	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK	$18.60	$31.00	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 NON AUTOMATED W/O MICRO P3632	$18.60	$31.00	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIP	$18.60	$31.00	40%

Surgery and procedures

Procedure	Cash price	List price	Off list
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$2,132.40	$3,554.00	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$2,132.40	$3,554.00	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$2,132.40	$3,554.00	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$2,132.40	$3,554.00	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAG W/WO BRUSHING	$1,500.00	$2,500.00	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAG W/WO BRUSHING	$1,500.00	$2,500.00	40%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W VENTRCLGRPHY	$5,695.80	$9,493.00	40%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W VENTRCLGRPHY	$5,695.80	$9,493.00	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTRLMNR LUM/SAC W/IMG GDE	$3,253.20	$5,422.00	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTRLMNR LUM/SAC W/IMG GDE	$3,253.20	$5,422.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSFRMN EPI LUM/SAC SNGL	$2,674.80	$4,458.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANES LUM/SA TRANSF SNG LEV	$2,674.80	$4,458.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRANSFRMN EPI LUM/SAC SNGL	$2,674.80	$4,458.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANES LUM/SA TRANSF SNG LEV	$2,674.80	$4,458.00	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SINGLE/MULT	$2,132.40	$3,554.00	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SINGLE/MULT	$2,132.40	$3,554.00	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD W/WO BRUSHINGS	$1,558.20	$2,597.00	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD W/WO BRUSHINGS	$1,558.20	$2,597.00	40%

Doctor visits and therapy

Procedure	Cash price	List price	Off list
New patient office visit, about 30 minutes CPT 99203 CLINIC VISIT NEW 99203	$281.40	$469.00	40%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC VISIT NEW 99203	$281.40	$469.00	40%
New patient office visit, about 45 minutes CPT 99204 CLINIC VISIT NEW 99204	$358.80	$598.00	40%
New patient office visit, about 45 minutes inpatient CPT 99204 CLINIC VISIT NEW 99204	$358.80	$598.00	40%
New patient office visit, about 60 minutes CPT 99205 CLINIC VISIT NEW 99205	$526.20	$877.00	40%
New patient office visit, about 60 minutes inpatient CPT 99205 CLINIC VISIT NEW 99205	$526.20	$877.00	40%

Source file: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/250489010_upmc-northwest_standardcharges.csv?