UPMC Chautauqua at Wca

207 Foote Avenue, Jamestown, NY 14701 · Acute care hospital · Emergency room

These are UPMC Chautauqua at Wca's own posted figures from its standard-charges file dated March 6, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

207 of the services we track have a posted price here; 159 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	$1,895.40	$3,159.00	$189.54 – $2,843.10
Emergency room visit, level 1 (minor) CPT 99281	$189.60	$316.00	$73.42 – $284.40
Emergency room visit, level 2 CPT 99282	$243.00	$405.00	$41.23 – $625.05
Emergency room visit, level 3 (moderate) CPT 99283	$360.60	$601.00	$70.81 – $905.25
Emergency room visit, level 4 CPT 99284	$415.20	$692.00	$119.16 – $1,248.15
Emergency room visit, level 5 (most severe) CPT 99285	$811.80	$1,353.00	$144.32 – $1,512.67
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$100.20	$167.00	$30.62 – $5,586.63

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$97.80	$163.00	$31.71 – $150.87
New patient office visit, about 30 minutes CPT 99203	$129.60	$216.00	$43.29 – $198.52
New patient office visit, about 45 minutes CPT 99204	$165.60	$276.00	$61.00 – $263.07
New patient office visit, about 60 minutes CPT 99205	$217.80	$363.00	$61.00 – $326.70
Office visit, established patient, about 10 to 19 minutes CPT 99212	$97.80	$163.00	$30.00 – $150.87
Office visit, established patient, about 20 to 29 minutes CPT 99213	$97.80	$163.00	$31.71 – $150.87
Office visit, established patient, about 30 to 39 minutes CPT 99214	$129.60	$216.00	$45.92 – $198.52
Office visit, established patient, about 40 to 54 minutes CPT 99215	$165.60	$276.00	$61.00 – $248.40
Office visit, established patient, brief (often a nurse) CPT 99211	$67.20	$112.00	$7.75 – $116.26

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$45.00	$75.00	$43.33 – $67.50
Abdominal X-ray, 1 view CPT 74018	$122.40	$204.00	$26.43 – $269.80
Ankle X-ray, 3 or more views CPT 73610	$122.40	$204.00	$38.21 – $269.80
Bone density scan (DEXA), hips and spine CPT 77080	$240.00	$400.00	$38.35 – $360.00
Breast ultrasound, one breast, complete CPT 76641	$126.00	$210.00	$108.40 – $325.85
Breast ultrasound, one breast, limited CPT 76642	$124.20	$207.00	$88.88 – $269.80
Chest X-ray, 1 view CPT 71045	$109.80	$183.00	$19.28 – $269.80
Chest X-ray, 2 views CPT 71046	$139.20	$232.00	$29.55 – $269.80
CT angiogram of the chest (checks for lung clots) CPT 71275	$799.20	$1,332.00	$217.51 – $1,198.80
CT angiogram of the head CPT 70496	$796.80	$1,328.00	$217.51 – $1,195.20
CT scan of the abdomen and pelvis, with contrast CPT 74177	$474.60	$791.00	$328.95 – $1,094.32
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$627.60	$1,046.00	$376.56 – $1,094.32
CT scan of the abdomen and pelvis, without contrast CPT 74176	$249.60	$416.00	$191.38 – $740.68
CT scan of the abdomen, without contrast CPT 74150	$507.00	$845.00	$129.93 – $760.50
CT scan of the chest, with contrast CPT 71260	$669.60	$1,116.00	$180.86 – $1,004.40
CT scan of the chest, without contrast CPT 71250	$507.00	$845.00	$129.93 – $760.50
CT scan of the head, without contrast CPT 70450	$495.00	$825.00	$114.49 – $742.50
CT scan of the neck (cervical spine), without contrast CPT 72125	$507.00	$845.00	$129.93 – $760.50
CT scan of the pelvis, with contrast CPT 72193	$669.60	$1,116.00	$175.11 – $1,004.40
CT scan of the sinuses or face, without contrast CPT 70486	$507.60	$846.00	$129.93 – $761.40
Diagnostic mammogram, both breasts CPT 77066	$225.60	$376.00	$144.73 – $338.40
Diagnostic mammogram, one breast CPT 77065	$177.00	$295.00	$114.60 – $265.50
Foot X-ray, 3 or more views CPT 73630	$122.40	$204.00	$35.87 – $269.80
Hand X-ray, 3 or more views CPT 73130	$122.40	$204.00	$34.33 – $269.80
Knee X-ray, 3 views CPT 73562	$130.80	$218.00	$42.48 – $269.80
Leg or arm vein ultrasound, both sides CPT 93970	$436.20	$727.00	$183.32 – $740.68
Leg or arm vein ultrasound, one side CPT 93971	$222.60	$371.00	$114.80 – $333.90
Lower back X-ray, 2 or 3 views CPT 72100	$158.40	$264.00	$40.66 – $325.85
MRI of the abdomen, without and with contrast CPT 74183	$978.60	$1,631.00	$373.87 – $1,467.90
MRI of the brain, without and with contrast CPT 70553	$975.00	$1,625.00	$350.00 – $1,462.50
MRI of the brain, without contrast CPT 70551	$682.20	$1,137.00	$214.40 – $1,023.30
MRI of the knee or other leg joint, without contrast CPT 73721	$685.80	$1,143.00	$221.13 – $1,028.70
MRI of the lower back (lumbar spine), without contrast CPT 72148	$682.20	$1,137.00	$209.89 – $1,023.30
MRI of the mid back (thoracic spine), without contrast CPT 72146	$682.20	$1,137.00	$209.20 – $1,023.30
MRI of the neck (cervical spine), without contrast CPT 72141	$682.20	$1,137.00	$209.54 – $1,023.30
MRI of the pelvis, without and with contrast CPT 72197	$978.60	$1,631.00	$373.18 – $1,467.90
MRI of the shoulder or other arm joint, without contrast CPT 73221	$685.80	$1,143.00	$221.48 – $1,028.70
Neck X-ray, 2 or 3 views CPT 72040	$251.40	$419.00	$33.12 – $377.10
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$181.80	$303.00	$95.62 – $325.85
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$181.80	$303.00	$96.88 – $325.85
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$181.80	$303.00	$105.11 – $325.85
Screening mammogram, both breasts CPT 77067	$205.20	$342.00	$116.60 – $307.80
Shoulder X-ray, 2 or more views CPT 73030	$133.80	$223.00	$35.89 – $269.80
Transvaginal pregnancy ultrasound CPT 76817	$181.80	$303.00	$97.67 – $325.85
Transvaginal ultrasound CPT 76830	$181.80	$303.00	$95.62 – $325.85
Ultrasound of the abdomen, complete CPT 76700	$181.80	$303.00	$119.09 – $325.85
Ultrasound of the neck or thyroid CPT 76536	$181.80	$303.00	$95.44 – $325.85
Wrist X-ray, 3 or more views CPT 73110	$122.40	$204.00	$34.33 – $269.80
X-ray of the lower back, 4 or more views CPT 72110	$240.00	$400.00	$45.77 – $360.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$20.40	$34.00	$8.46 – $30.60
Blood culture CPT 87040	$25.20	$42.00	$10.32 – $37.80
Blood draw (venipuncture) CPT 36415	$7.20	$12.00	$2.55 – $22.80
BNP test (heart failure) CPT 83880	$83.40	$139.00	$36.05 – $125.10
C-reactive protein (CRP) test CPT 86140	$12.60	$21.00	$3.00 – $18.90
Chlamydia test (DNA/NAAT) CPT 87491	$85.80	$143.00	$23.19 – $128.70
Complete blood count (CBC) with differential CPT 85025	$18.60	$31.00	$6.00 – $27.90
Complete blood count (CBC), automated CPT 85027	$15.60	$26.00	$6.47 – $23.40
Comprehensive metabolic panel (blood test) CPT 80053	$25.80	$43.00	$10.56 – $38.70
COVID-19 PCR test CPT 87635	$75.00	$125.00	$35.49 – $128.68
D-dimer test (blood clots) CPT 85379	$24.60	$41.00	$10.18 – $36.90
Drug screen, instrument chemistry CPT 80307	$52.80	$88.00	$19.70 – $155.84
Ferritin (iron stores) test CPT 82728	$33.60	$56.00	$12.00 – $50.40
Free T4 (thyroid) test CPT 84439	$21.60	$36.00	$8.00 – $32.40
Glucose (blood sugar) test CPT 82947	$9.60	$16.00	$3.93 – $14.40
Gonorrhea test (DNA/NAAT) CPT 87591	$85.80	$143.00	$23.19 – $128.70
Hemoglobin A1c test CPT 83036	$24.00	$40.00	$7.00 – $36.00
Hepatitis C antibody test CPT 86803	$102.00	$170.00	$14.27 – $153.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$34.20	$57.00	$24.08 – $60.39
Iron test CPT 83540	$30.60	$51.00	$6.47 – $45.90
Kidney function panel CPT 80069	$21.00	$35.00	$8.68 – $31.50
Lipase test (pancreas) CPT 83690	$16.80	$28.00	$5.00 – $25.20
Lipid panel, cholesterol and triglycerides CPT 80061	$32.40	$54.00	$13.39 – $48.60
Liver function panel CPT 80076	$48.00	$80.00	$8.17 – $72.00
Magnesium test CPT 83735	$16.80	$28.00	$6.70 – $25.20
Obstetric blood test panel CPT 80055	$93.00	$155.00	$12.00 – $139.50
Partial thromboplastin time (PTT), clotting test CPT 85730	$14.40	$24.00	$6.01 – $21.60
Pregnancy blood test (hCG), quantitative CPT 84702	$36.60	$61.00	$15.05 – $54.90
Prothrombin time (PT/INR), clotting test CPT 85610	$9.60	$16.00	$4.00 – $14.40
PSA (prostate specific antigen), free CPT 84154	$45.00	$75.00	$18.39 – $67.50
PSA (prostate specific antigen), total CPT 84153	$45.00	$75.00	$18.39 – $67.50
TB skin test CPT 86580	$10.20	$17.00	$5.05 – $75.04
Thyroid stimulating hormone (TSH) CPT 84443	$41.40	$69.00	$16.80 – $62.10
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$108.60	$181.00	$18.74 – $163.72
Troponin test (heart damage) CPT 84484	$24.00	$40.00	$9.87 – $36.00
Urinalysis, automated, with microscope CPT 81001	$7.80	$13.00	$3.00 – $11.70
Urinalysis, automated, without microscope CPT 81003	$6.00	$10.00	$2.25 – $9.00
Urine culture, colony count CPT 87086	$19.80	$33.00	$8.00 – $29.70
Urine pregnancy test CPT 81025	$15.60	$26.00	$3.22 – $23.40
Vitamin B12 test CPT 82607	$36.60	$61.00	$13.00 – $54.90
Vitamin D test CPT 82306	$72.60	$121.00	$29.60 – $108.90

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$631.80	$1,053.00	$177.29 – $947.70
ECG tracing only (no interpretation) CPT 93005	$128.40	$214.00	$6.70 – $192.60
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,352.40	$2,254.00	$176.28 – $2,028.60
Left heart catheterization CPT 93452	$5,552.40	$9,254.00	$601.32 – $8,328.60
Left heart catheterization with coronary angiogram CPT 93458	$4,666.80	$7,778.00	$745.02 – $7,000.20
Nuclear stress test (heart perfusion imaging) CPT 78452	$804.60	$1,341.00	$426.00 – $4,000.25

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$974.00 – $10,910.44
Appendix removal, laparoscopic CPT 44970	not posted		$504.65 – $8,910.67
Breast biopsy with ultrasound guidance CPT 19083	$975.00	$1,625.00	$173.61 – $2,474.55
Colonoscopy with biopsy CPT 45380	$1,004.40	$1,674.00	$166.88 – $1,986.93
Colonoscopy with polyp removal (snare) CPT 45385	$1,004.40	$1,674.00	$212.11 – $1,986.93
Colonoscopy, diagnostic CPT 45378	$1,500.00	$2,500.00	$153.62 – $2,250.00
Colposcopy with biopsy CPT 57454	not posted		$132.43 – $5,586.63
Cystoscopy (bladder scope) CPT 52000	$2,992.80	$4,988.00	$93.75 – $4,489.20
Ear tubes, under general anesthesia CPT 69436	not posted		$123.12 – $2,439.85
Flexible sigmoidoscopy, diagnostic CPT 45330	$598.20	$997.00	$46.53 – $5,586.63
Gallbladder removal, laparoscopic CPT 47562	not posted		$974.00 – $8,910.67
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$921.74 – $15,900.80
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$819.84 – $4,856.01
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$1,045.29 – $8,910.67
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$5,440.80	$9,068.00	$396.88 – $8,161.20
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$679.38 – $4,955.41
Prostate biopsy CPT 55700	$891.00	$1,485.00	$111.88 – $3,128.64
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$1,465.43 – $15,900.80
Removal of a breast lump, open surgery CPT 19120	not posted		$216.25 – $5,848.36
Rotator cuff repair, arthroscopic CPT 29827	not posted		$1,365.00 – $10,910.44
Screening colonoscopy, average risk HCPCS G0121	$1,440.00	$2,400.00	$159.27 – $2,160.00
Screening colonoscopy, high risk HCPCS G0105	$1,590.00	$2,650.00	$159.04 – $2,385.00
Septoplasty (nasal septum repair) CPT 30520	not posted		$1,198.00 – $4,953.06
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$161.83 – $2,439.85
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$924.39 – $3,465.81
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$631.65 – $9,034.84
Total hip replacement CPT 27130	not posted		$1,070.04 – $19,651.17
Total knee replacement CPT 27447	not posted		$1,068.98 – $19,651.17
Upper endoscopy (EGD) with biopsy CPT 43239	$1,152.60	$1,921.00	$115.04 – $1,986.93
Upper endoscopy (EGD), diagnostic CPT 43235	$979.80	$1,633.00	$102.12 – $1,469.70
Vasectomy CPT 55250	not posted		$185.62 – $5,586.63

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	$268.80	$448.00	$13.14 – $616.42
IUD insertion CPT 58300	$148.20	$247.00	$21.56 – $222.30

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$375.00 – $8,902.48
C-section, without complications MS-DRG 788	not posted	$4,127.63 – $9,629.76
Chest pain MS-DRG 313	not posted	$3,099.60 – $7,344.65
COPD flare-up, with major complications MS-DRG 190	not posted	$4,768.65 – $11,054.60
COPD flare-up, without complications MS-DRG 192	not posted	$2,763.81 – $6,598.25
Fainting (syncope) MS-DRG 312	not posted	$3,752.24 – $8,795.33
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$4,221.91 – $9,839.30
Heart failure, with major complications MS-DRG 291	not posted	$5,526.76 – $12,739.73
Heart failure, without complications MS-DRG 293	not posted	$2,436.63 – $5,871.01
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$42,114.95 – $96,721.37
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$8,303.91 – $23,615.00
Irregular heartbeat, without complications MS-DRG 310	not posted	$2,437.06 – $5,871.95
Kidney failure, with complications MS-DRG 683	not posted	$3,770.32 – $8,835.51
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$3,484.90 – $8,201.08
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$10,509.80 – $24,136.84
Normal newborn care MS-DRG 795	not posted	$300.00 – $2,366.77
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$3,350.15 – $7,901.56
Pneumonia, with complications MS-DRG 194	not posted	$3,469.40 – $8,166.62
Pneumonia, with major complications MS-DRG 193	not posted	$5,658.49 – $13,032.53
Pneumonia, without complications MS-DRG 195	not posted	$2,705.69 – $6,469.07
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$6,013.22 – $13,821.02
Sepsis, with major complications MS-DRG 871	not posted	$8,362.46 – $19,205.26
Sepsis, without major complications MS-DRG 872	not posted	$4,405.31 – $10,246.96
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$3,749.22 – $8,788.61
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$3,356.18 – $7,914.96
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$4,349.34 – $10,122.55
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$5,341.21 – $12,327.29
Vaginal delivery, without complications MS-DRG 807	not posted	$2,902.43 – $6,906.37
Weight loss surgery, without complications MS-DRG 621	not posted	$6,493.66 – $14,913.37

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$168.60	$281.00	$29.38 – $450.84
Lower back nerve root injection with imaging guidance CPT 64483	$480.60	$801.00	$118.80 – $1,441.46
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,408.80	$2,348.00	$101.65 – $2,113.20
Lower back spinal injection (epidural), without imaging CPT 62322	$1,845.60	$3,076.00	$88.94 – $2,768.40

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$122.40	$204.00	$33.65 – $479.44

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$213.60	$356.00	$94.77 – $479.44
Sleep study with CPAP titration CPT 95811	$1,305.60	$2,176.00	$516.47 – $3,117.50
Sleep study, overnight in a sleep lab CPT 95810	$1,188.00	$1,980.00	$281.92 – $3,117.50

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$150.60	$251.00	$18.75 – $479.44

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$75.00	$125.00	$19.56 – $112.50
Physical therapy evaluation, low complexity CPT 97161	$90.60	$151.00	$66.99 – $201.42
Physical therapy evaluation, moderate complexity CPT 97162	$98.40	$164.00	$66.99 – $268.58
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$75.00	$125.00	$10.47 – $112.50
Therapeutic activities, 15 minutes CPT 97530	$96.00	$160.00	$16.25 – $144.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$104.40	$174.00	$57.51 – $460.71
Family psychotherapy, without the patient, 50 minutes CPT 90846	$104.40	$174.00	$57.51 – $235.02
Group psychotherapy CPT 90853	$44.40	$74.00	$24.76 – $154.73
Psychiatric diagnostic evaluation CPT 90791	$261.00	$435.00	$65.16 – $391.50
Psychotherapy, 30 minutes CPT 90832	$158.40	$264.00	$32.50 – $237.60
Psychotherapy, 45 minutes CPT 90834	$212.40	$354.00	$48.75 – $318.60
Psychotherapy, 60 minutes CPT 90837	$240.00	$400.00	$65.00 – $360.00

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$42.60	$71.00	$13.36 – $218.09
IV hydration, each additional hour CPT 96361	$144.00	$240.00	$11.25 – $542.79
IV hydration, first hour CPT 96360	$144.00	$240.00	$35.18 – $645.61
IV push injection of a drug, first CPT 96374	$108.60	$181.00	$38.77 – $645.61
IV push injection, each additional drug CPT 96375	$60.00	$100.00	$16.26 – $141.37

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$70.40	$88.00	? – $79.20
Fentanyl injection, per 0.1 mg HCPCS J3010	$6.20	$7.75	? – $6.97
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$23.40	$29.25	? – $26.32
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$1.20	$1.50	? – $1.35
Morphine injection, up to 10 mg HCPCS J2270	$15.00	$18.75	$2.18 – $16.88
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$26.60	$33.25	? – $29.93
Saline IV solution, 1000 ml HCPCS J7030	$4.40	$5.50	? – $4.95

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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