Hospital Pittsburgh, PA

UPMC Presbyterian

UPMC Presbyterian in Pittsburgh, PA publishes cash prices for 52 common procedures listed here, from its own machine-readable price file updated Mar 6, 2026. Click a procedure to compare it with other hospitals nearby.

200 Lothrop Street, Pittsburgh, PA 15213 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	$8,884.80	$14,808.00	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PLVS W CONTRAST	$8,884.80	$14,808.00	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$2,937.00	$4,895.00	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$2,937.00	$4,895.00	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CON	$4,599.60	$7,666.00	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CON	$4,599.60	$7,666.00	40%
Diagnostic mammogram, one breast CPT 77065 MAMMO DIGITAL DX UNI WWO CAD	$543.00	$905.00	40%
Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DIGITAL DX UNI WWO CAD	$543.00	$905.00	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LOW EXTREM ANY JNT WO	$6,214.20	$10,357.00	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LOW EXTREM ANY JNT WO	$6,214.20	$10,357.00	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LOW EXTREM ANY JNT W/WO	$9,808.20	$16,347.00	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	$9,808.20	$16,347.00	40%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO CON	$6,214.20	$10,357.00	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO CON	$6,214.20	$10,357.00	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W WO CON	$9,808.20	$16,347.00	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WWO CON DONE IN PET	$9,808.20	$16,347.00	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W WO CON	$9,808.20	$16,347.00	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN WWO CON DONE IN PET	$9,808.20	$16,347.00	40%
MRI of the lower back, no contrast dye CPT 72148 MR SP CANAL LUMBAR WO	$6,214.20	$10,357.00	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR SP CANAL LUMBAR WO	$6,214.20	$10,357.00	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS>14WKS	$1,819.80	$3,033.00	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS>14WKS	$1,819.80	$3,033.00	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG 9+PARAM ATTENDED	$7,861.80	$13,103.00	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 9+PARAM ATTENDED	$7,861.80	$13,103.00	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$2,313.00	$3,855.00	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$2,313.00	$3,855.00	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$1,274.40	$2,124.00	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$1,274.40	$2,124.00	40%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$1,154.40	$1,924.00	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBOSAC MIN 4 VWS	$1,154.40	$1,924.00	40%

Lab tests

Procedure	Cash price	List price	Off list
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$210.00	$350.00	40%
Basic metabolic panel (blood test) CPT 80048 WHOLE BLOOD BASIC METABOLIC PN	$210.00	$350.00	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$210.00	$350.00	40%
Basic metabolic panel (blood test) inpatient CPT 80048 WHOLE BLOOD BASIC METABOLIC PN	$210.00	$350.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL W/RFX LDL	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARD IQ LIPID PN W/REF DIR LDL	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P8093	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P4483	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIO IQ LIPID PANEL	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P4483	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIO IQ LIPID PANEL	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P8093	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARD IQ LIPID PN W/REF DIR LDL	$720.00	$1,200.00	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL W/RFX LDL	$720.00	$1,200.00	40%
Complete blood count (CBC) with differential CPT 85025 OXLDL	$241.20	$402.00	40%
Complete blood count (CBC) with differential CPT 85025 CBC & PLT & AUTO COMP DIFF	$241.20	$402.00	40%
Complete blood count (CBC) with differential CPT 85025 CBC W/DIFF & PLATELETS	$241.20	$402.00	40%
Complete blood count (CBC) with differential inpatient CPT 85025 OXLDL	$241.20	$402.00	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/DIFF & PLATELETS	$241.20	$402.00	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC & PLT & AUTO COMP DIFF	$241.20	$402.00	40%
Complete blood count (CBC), no differential CPT 85027 CBC & PLT ONLY	$210.00	$350.00	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC & PLT ONLY	$210.00	$350.00	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$618.60	$1,031.00	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOL PN P5147	$618.60	$1,031.00	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOL PN P5147	$618.60	$1,031.00	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$618.60	$1,031.00	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL P1635	$424.20	$707.00	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$424.20	$707.00	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL P1635	$424.20	$707.00	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$424.20	$707.00	40%
Liver function blood test panel CPT 80076 HEPATIC FUNC PN PLASMA OR SER	$436.20	$727.00	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION - PANEL A	$436.20	$727.00	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$436.20	$727.00	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION - PANEL A	$436.20	$727.00	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNC PN PLASMA OR SER	$436.20	$727.00	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$436.20	$727.00	40%
Obstetric blood test panel CPT 80055 OBSTETRICS PANEL	$896.40	$1,494.00	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRICS PANEL	$896.40	$1,494.00	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA PNL 2770	$1,343.40	$2,239.00	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA PNL 2770	$1,343.40	$2,239.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX REFLEX	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL REFLEX TO FREE PSA	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL PSA PNL 2770	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRA-SENSITIVE	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DIAGNOSTIC PSA	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRA-SENSITIVE	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL REFLEX TO FREE PSA	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE HEALTH INDEX REFLEX	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE HEALTH INDEX	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DIAGNOSTIC PSA	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL PSA PNL 2770	$431.40	$719.00	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$431.40	$719.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P0267	$46.80	$78.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P0229	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT (BASELINE) PNL 5464	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN PL 2848	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (APTT)	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PTT	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ACTIVATED	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBO TIME PTT P0070	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA W/RFX HEXAGONAL CONFIRM	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P4377	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACT PART THROMBOP TIME P P7021	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P2635	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P3417	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME P4384	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL PROTHROMBIN TIME P4160	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBPL TIME PART(PTT) P6881	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P0267	$46.80	$78.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN PL 2848	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P0229	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACT PART THROMBOP TIME P P7021	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBPL TIME PART(PTT) P6881	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL PROTHROMBIN TIME P4160	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P4384	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P4377	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA W/RFX HEXAGONAL CONFIRM	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P3417	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME P2635	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPL TIME PARTL(PTT)P2441	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT (BASELINE) PNL 5464	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (APTT)	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PTT	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT ACTIVATED	$301.20	$502.00	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBO TIME PTT P0070	$301.20	$502.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P4160	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 ISTAT PT/INR	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME POCT CC	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P2680	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME PNL 2848	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P0070	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PT PROTHROMBIN TIME	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P0229	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P P7021	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT PROTHROMBIN TIME	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P0070	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME PNL 2848	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P2680	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME POCT CC	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ISTAT PT/INR	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P4160	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P P7021	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$308.40	$514.00	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P0229	$308.40	$514.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH THIRD GENERATION	$94.80	$158.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/HAMA TREATMENT	$94.80	$158.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/FREE T4 RFX	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID FUNCTION CASCADE SERUM	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/HAMA TREATMENT	$94.80	$158.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH THIRD GENERATION	$94.80	$158.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH W/FREE T4 RFX	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$218.40	$364.00	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID FUNCTION CASCADE SERUM	$218.40	$364.00	40%
Urinalysis with microscope exam, automated CPT 81001 UR COMPL W/REFLEX TO CULTURE	$468.60	$781.00	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS R & M	$468.60	$781.00	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UR COMPL W/REFLEX TO CULTURE	$468.60	$781.00	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS R & M	$468.60	$781.00	40%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS DIPSTICK W MICRO	$33.60	$56.00	40%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$33.60	$56.00	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W/SCOPE	$33.60	$56.00	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS DIPSTICK W MICRO	$33.60	$56.00	40%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-C	$49.20	$82.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$49.20	$82.00	40%
Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS/CLINITEK	$49.20	$82.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINE MACRO	$49.20	$82.00	40%
Urinalysis without microscope exam, automated CPT 81003 PH URINE-C	$49.20	$82.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTOMATED	$49.20	$82.00	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCPE P1635	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACRO	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTOMATED	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCPE P1635	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS/CLINITEK	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE-C	$49.20	$82.00	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-C	$49.20	$82.00	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIPSTICK	$21.60	$36.00	40%
Urinalysis without microscope exam, manual CPT 81002 URINANALYSIS DIPSTICK WO MICRO	$21.60	$36.00	40%
Urinalysis without microscope exam, manual CPT 81002 NON AUTOMATED W/O MICRO P3632	$21.60	$36.00	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 NON AUTOMATED W/O MICRO P3632	$21.60	$36.00	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINANALYSIS DIPSTICK WO MICRO	$21.60	$36.00	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIPSTICK	$21.60	$36.00	40%

Surgery and procedures

Procedure	Cash price	List price	Off list
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY WITH USN	$4,123.20	$6,872.00	40%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY WITH USN	$4,123.20	$6,872.00	40%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$4,330.80	$7,218.00	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/SNARE TECHNIQUE	$4,330.80	$7,218.00	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$4,330.80	$7,218.00	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BX SINGLE/MULT	$4,330.80	$7,218.00	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%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR INIT ING HERNIA >5YRS/RE	$8,450.40	$14,084.00	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR INIT ING HERNIA >5YRS/RE	$8,450.40	$14,084.00	40%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W VENTRCLGRPHY	$11,458.20	$19,097.00	40%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W VENTRCLGRPHY	$11,458.20	$19,097.00	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTRLMNR LUM/SAC W/IMG GDE	$3,595.20	$5,992.00	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NEURAXIAL L/S INJ-W/ IMG GUIDE	$3,595.20	$5,992.00	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NEURAXIAL L/S INJ-W/ IMG GUIDE	$3,595.20	$5,992.00	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTRLMNR LUM/SAC W/IMG GDE	$3,595.20	$5,992.00	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$3,088.20	$5,147.00	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NEURAXIAL LUMBAR/SACRAL INJ	$3,088.20	$5,147.00	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NEURAXIAL L/S INJ	$3,088.20	$5,147.00	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$3,088.20	$5,147.00	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NEURAXIAL LUMBAR/SACRAL INJ	$3,088.20	$5,147.00	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NEURAXIAL L/S INJ	$3,088.20	$5,147.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANES/STEROID EPI L/S SGL	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANES LUM/SA TRANSF SNG LEV	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ EPIDURAL LUMB PLEX SINGLE	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAM EPID LUMB/SAC SNGL	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 ESI TRNSFML LUM/SAC 1ST LV UNI	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAM EPID LUMB/SAC SNGL	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANES/STEROID EPI L/S SGL	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ EPIDURAL LUMB PLEX SINGLE	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANES LUM/SA TRANSF SNG LEV	$2,703.60	$4,506.00	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 ESI TRNSFML LUM/SAC 1ST LV UNI	$2,703.60	$4,506.00	40%
Prostate biopsy CPT 55700 BX PROSTATE NDL/PNCH SGL/MULT	$4,369.80	$7,283.00	40%
Prostate biopsy inpatient CPT 55700 BX PROSTATE NDL/PNCH SGL/MULT	$4,369.80	$7,283.00	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY SINGLE/MULT	$4,330.80	$7,218.00	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY SINGLE/MULT	$4,330.80	$7,218.00	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD W/WO BRUSHINGS	$3,235.80	$5,393.00	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD W/WO BRUSHINGS	$3,235.80	$5,393.00	40%

Doctor visits and therapy

Procedure	Cash price	List price	Off list
Family therapy with the patient, 50 minutes CPT 90847 OP FAMILY W/PT	$406.80	$678.00	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 OP FAMILY W/PT	$406.80	$678.00	40%
Family therapy without the patient, 50 minutes CPT 90846 OP FAMILY W/O PT	$406.80	$678.00	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 OP FAMILY W/O PT	$406.80	$678.00	40%
Group psychotherapy session CPT 90853 IP GROUP THERAPY	$46.80	$78.00	40%
Group psychotherapy session CPT 90853 GROUP THERAPY SESSION	$46.80	$78.00	40%
Group psychotherapy session inpatient CPT 90853 IP GROUP THERAPY	$46.80	$78.00	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY SESSION	$46.80	$78.00	40%
New patient office visit, about 30 minutes CPT 99203 CLINIC VISIT NEW 99203	$255.60	$426.00	40%
New patient office visit, about 30 minutes CPT 99203 NEW OP VISIT LEVEL 3	$255.60	$426.00	40%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW OP VISIT LEVEL 3	$255.60	$426.00	40%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC VISIT NEW 99203	$255.60	$426.00	40%
New patient office visit, about 45 minutes CPT 99204 CLINIC VISIT NEW 99204	$300.00	$500.00	40%
New patient office visit, about 45 minutes CPT 99204 NEW OP VISIT LEVEL 4	$300.00	$500.00	40%
New patient office visit, about 45 minutes inpatient CPT 99204 CLINIC VISIT NEW 99204	$300.00	$500.00	40%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW OP VISIT LEVEL 4	$300.00	$500.00	40%
New patient office visit, about 60 minutes CPT 99205 NEW OP VISIT LEVEL 5	$362.40	$604.00	40%
New patient office visit, about 60 minutes CPT 99205 CLINIC VISIT NEW 99205	$362.40	$604.00	40%
New patient office visit, about 60 minutes inpatient CPT 99205 CLINIC VISIT NEW 99205	$362.40	$604.00	40%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW OP VISIT LEVEL 5	$362.40	$604.00	40%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINUTES	$175.20	$292.00	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINUTES	$175.20	$292.00	40%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINUTES	$235.20	$392.00	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINUTES	$235.20	$392.00	40%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINUTES	$254.40	$424.00	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINUTES	$254.40	$424.00	40%

Source file: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/250965480_upmc-presbyterian-shadyside_standardcharges.csv?