▸ Hospital · PA · CCN 390178

UPMC Horizon

110 NORTH MAIN STREET, GREENVILLE, PA, 16125

98 bedsAcute Care Hospitals2

Compliance grade

100/100

Procedures tracked

156

of 209 target codes

Payers

with negotiated rates

Rates published

53,894

last crawl 2026-05-24

▸ Compare with other hospitals All PA hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/250523970_upmc-horizon_standardcharges.csv? · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	8	—	—	$614	$11,354	$12,640
emergency
ED visit level 1	CPT	99281	16	$240	$144	$51.26	$96	$310
ED visit level 2	CPT	99282	17	$393	$235.8	$36.28	$157.2	$334.05
ED visit level 3	CPT	99283	17	$643	$385.8	$62.31	$264.53	$546.55
ED visit level 4	CPT	99284	17	$950	$570	$104.86	$380	$807.5
ED visit level 5	CPT	99285	17	$1,910	$1,146	$152.61	$737.26	$1,623.5
Critical care, first hour	CPT	99291	17	$2,124	$1,274.4	$166.79	$846.55	$1,805.4
imaging
CT head without contrast	CPT	70450	17	$2,413	$1,447.8	$90.77	$919.36	$2,051.05
CT head with contrast	CPT	70460	17	$2,916	$1,749.6	$147.4	$1,111	$2,478.6
CT head with and without contrast	CPT	70470	17	$3,553	$2,131.8	$151.95	$1,353.7	$3,020.05
CT neck with contrast	CPT	70491	17	$3,057	$1,834.2	$151.25	$1,164.72	$2,598.45
MRI brain without contrast	CPT	70551	17	$4,118	$2,470.8	$206.32	$1,589.55	$3,500.3
MRI brain with contrast	CPT	70552	17	$4,310	$2,586	$304.83	$1,678.75	$3,663.5
MRI brain with and without contrast	CPT	70553	17	$6,003	$3,601.8	$304.83	$2,341.17	$5,102.55
Chest X-ray single view	CPT	71045	17	$510	$306	$12.51	$194.82	$433.5
Chest X-ray 2 views	CPT	71046	17	$710	$426	$22.93	$271.22	$603.5
Chest X-ray 3 views	CPT	71047	17	$211	$126.6	$29.15	$84.4	$227.64
CT chest without contrast	CPT	71250	17	$3,025	$1,815	$90.77	$1,152.53	$2,571.25
CT chest with contrast	CPT	71260	17	$3,536	$2,121.6	$151.95	$1,347.22	$3,005.6
CT chest with and without contrast	CPT	71270	17	$4,310	$2,586	$151.95	$1,642.11	$3,663.5
MRI chest without contrast	CPT	71550	17	$5,748	$3,448.8	$206.32	$2,189.99	$4,885.8
MRI chest with and without contrast	CPT	71552	17	$8,475	$5,085	$304.83	$3,267.12	$7,203.75
Lumbosacral spine X-ray	CPT	72100	17	$719	$431.4	$34.16	$274.66	$611.15
CT cervical spine without contrast	CPT	72125	17	$3,025	$1,815	$90.77	$1,152.53	$2,571.25
CT thoracic spine without contrast	CPT	72128	17	$3,025	$1,815	$90.77	$1,152.53	$2,571.25
CT lumbar spine without contrast	CPT	72131	17	$3,025	$1,815	$90.77	$1,152.53	$2,571.25
MRI cervical spine without contrast	CPT	72141	17	$8,102	$4,861.2	$206.32	$3,086.86	$6,886.7
MRI thoracic spine without contrast	CPT	72146	17	$8,102	$4,861.2	$206.32	$3,086.86	$6,886.7
MRI lumbar spine without contrast	CPT	72148	17	$8,102	$4,861.2	$206.32	$3,086.86	$6,886.7
MRI lumbar spine with and without contrast	CPT	72149	17	$2,953	$1,771.8	$304.83	$1,151.67	$2,510.05
MRI cervical spine with and without contrast	CPT	72156	17	$6,003	$3,601.8	$304.83	$2,341.17	$5,102.55
MRI lumbar spine with contrast	CPT	72158	17	$6,003	$3,601.8	$304.83	$2,341.17	$5,102.55
CT pelvis without contrast	CPT	72192	17	$2,982	$1,789.2	$90.77	$1,149.56	$2,534.7
CT pelvis with contrast	CPT	72193	17	$3,390	$2,034	$151.95	$1,306.85	$2,881.5
Shoulder X-ray	CPT	73030	16	$741	$444.6	$28.68	$289.73	$629.85
Humerus X-ray	CPT	73060	16	$405	$243	$28.11	$158.36	$344.25
Hand X-ray 3 views	CPT	73130	16	$772	$463.2	$26.86	$301.85	$656.2
MRI upper extremity joint without contrast	CPT	73221	16	$6,988	$4,192.8	$206.32	$2,725.32	$5,939.8
MRI upper extremity joint with and without contrast	CPT	73223	16	$6,988	$4,192.8	$304.83	$2,725.32	$5,939.8
Knee X-ray 1-2 views	CPT	73560	16	$600	$360	$30.28	$234.6	$510
Ankle X-ray 3 views	CPT	73610	16	$901	$540.6	$26.35	$352.29	$765.85
MRI lower extremity joint without contrast	CPT	73721	16	$8,102	$4,861.2	$206.32	$3,159.78	$6,886.7
MRI lower extremity joint with and without contrast	CPT	73723	16	$6,988	$4,192.8	$304.83	$2,725.32	$5,939.8
CT abdomen without contrast	CPT	74150	17	$2,950	$1,770	$90.77	$1,137.23	$2,507.5
CT abdomen with contrast	CPT	74160	17	$3,458	$2,074.8	$151.95	$1,333.06	$2,939.3
CT abdomen with and without contrast	CPT	74170	17	$4,187	$2,512.2	$151.95	$1,614.09	$3,558.95
CT abdomen and pelvis without contrast	CPT	74176	17	$5,931	$3,558.6	$185.12	$2,289.37	$5,041.35
CT abdomen and pelvis with contrast	CPT	74177	17	$6,848	$4,108.8	$289.48	$2,643.33	$5,820.8
CT abdomen and pelvis with and without contrast	CPT	74178	17	$8,255	$4,953	$304.83	$3,186.43	$7,016.75
MRI abdomen without contrast	CPT	74181	17	$4,118	$2,470.8	$206.32	$1,589.55	$3,500.3
MRI abdomen with and without contrast	CPT	74183	17	$6,988	$4,192.8	$304.83	$2,662.43	$5,939.8
Abdominal ultrasound complete	CPT	76700	17	$2,661	$1,596.6	$90.77	$1,016.5	$2,261.85
Abdominal ultrasound limited	CPT	76705	17	$2,661	$1,596.6	$65.62	$1,016.5	$2,261.85
Retroperitoneal ultrasound complete	CPT	76770	17	$850	$510	$85.58	$330.65	$722.5
Obstetric ultrasound first trimester	CPT	76801	17	$1,646	$987.6	$90.77	$634.53	$1,399.1
Obstetric ultrasound after first trimester	CPT	76805	17	$1,646	$987.6	$85.25	$634.53	$1,399.1
Obstetric ultrasound with fetal anatomy	CPT	76811	17	$2,638	$1,582.8	$189.31	$1,016.95	$2,242.3
Transvaginal ultrasound	CPT	76830	17	$1,035	$621	$80.33	$395.37	$879.75
Pelvic ultrasound complete	CPT	76856	17	$1,964	$1,178.4	$80.33	$750.25	$1,669.4
Scrotal ultrasound	CPT	76870	17	$1,467	$880.2	$77.7	$560.39	$1,246.95
Diagnostic mammography unilateral	CPT	77065	16	$896	$537.6	$49	$358.4	$761.6
Diagnostic mammography bilateral	CPT	77066	16	$985	$591	$49	$394	$837.25
Screening mammography bilateral	CPT	77067	16	$342	$205.2	$49	$136.8	$551.43
EKG tracing only	CPT	93005	17	$316	$189.6	$11.51	$121.82	$268.6
Transthoracic echocardiogram complete	CPT	93306	17	$3,127	$1,876.2	$155.12	$1,205.46	$2,657.95
Transthoracic echocardiogram	CPT	93307	17	$1,596	$957.6	$154.42	$622.44	$1,356.6
Stress echocardiogram	CPT	93350	17	$4,638	$2,782.8	$84.15	$1,787.95	$3,942.3
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	9	—	—	$9,312.94	$16,342	$24,278
Intracranial hemorrhage/CVA w CC	MS-DRG	065	9	—	—	$4,678.7	$8,563.82	$15,251
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	9	—	—	$3,169.46	$6,029.7	$11,914
Respiratory infections & inflammations w MCC	MS-DRG	177	9	—	—	$7,236.86	$12,857	$18,710
COPD w MCC	MS-DRG	190	9	—	—	$5,129.76	$9,321.02	$12,623
COPD w CC	MS-DRG	191	9	—	—	$3,903.93	$7,262.54	$11,153
COPD w/o CC/MCC	MS-DRG	192	9	—	—	$2,973.1	$5,700.1	$9,470.42
Simple pneumonia & pleurisy w CC	MS-DRG	194	9	—	—	$3,732.12	$6,974.17	$10,565
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	9	—	—	$2,910.58	$5,595.16	$9,470.42
AMI discharged alive w MCC	MS-DRG	280	9	—	—	$7,428.59	$13,179	$18,952
AMI discharged alive w CC	MS-DRG	281	9	—	—	$4,256.35	$7,854.1	$13,073
AMI discharged alive w/o CC/MCC	MS-DRG	282	9	—	—	$3,348.68	$6,330.54	$11,793
Heart failure & shock w MCC	MS-DRG	291	9	—	—	$5,945.28	$10,689	$14,646
Heart failure & shock w CC	MS-DRG	292	9	—	—	$3,931.72	$7,309.18	$9,994.68
Heart failure & shock w/o CC/MCC	MS-DRG	293	9	—	—	$2,621.15	$5,109.35	$9,470.42
Cardiac arrhythmia w MCC	MS-DRG	308	9	—	—	$5,575.72	$10,069	$13,591
Cardiac arrhythmia w CC	MS-DRG	309	9	—	—	$3,407.03	$6,428.47	$9,470.42
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	9	—	—	$2,621.61	$5,110.11	$9,470.42
GI hemorrhage w CC	MS-DRG	378	9	—	—	$4,541.62	$8,332.93	$13,315
GI hemorrhage w/o CC/MCC	MS-DRG	379	9	—	—	$2,919.38	$5,609.95	$9,470.42
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	9	—	—	$3,610.33	$6,769.7	$9,470.42
Fractures of femur w/o MCC	MS-DRG	533	8	—	—	$7,260.02	$12,896	$26,422
Kidney/UTI w MCC	MS-DRG	689	8	—	—	$5,373.35	$9,729.48	$15,770
Kidney/UTI w/o MCC	MS-DRG	690	8	—	—	$3,748.79	$6,970.04	$8,628.62
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	8	—	—	$8,995.72	$15,810	$24,243
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	8	—	—	$4,738.9	$8,664.48	$12,381
lab
Basic metabolic panel (BMP)	CPT	80048	17	$266	$159.6	$7.57	$102.54	$226.1
Electrolyte panel	CPT	80051	17	$117	$70.2	$6.28	$44	$99.45
Comprehensive metabolic panel	CPT	80053	17	$335	$201	$9.45	$127.97	$284.75
Lipid panel	CPT	80061	17	$144	$86.4	$11.99	$56.09	$122.4
Renal function panel	CPT	80069	17	$310	$186	$7.77	$119.51	$263.5
Hepatic function panel	CPT	80076	17	$237	$142.2	$7.31	$91.36	$201.45
Urinalysis non-automated	CPT	81002	17	$65	$39	$3.12	$25.29	$55.25
Urinalysis automated	CPT	81003	17	$100	$60	$2.01	$38.55	$85
Glucose quantitative	CPT	82947	17	$49	$29.4	$3.52	$19.09	$41.65
Hemoglobin A1c	CPT	83036	17	$107	$64.2	$7	$41.68	$90.95
Thyroid stimulating hormone (TSH)	CPT	84443	17	$167	$100.2	$15.04	$65.05	$141.95
Complete blood count with automated differential	CPT	85025	17	$80	$48	$6	$31.12	$68
Complete blood count without differential	CPT	85027	17	$68	$40.8	$5.79	$26.32	$57.8
Urine culture bacterial	CPT	87086	17	$80	$48	$7.23	$31.16	$68
Urine culture identification	CPT	87088	17	$101	$60.6	$7.24	$39.34	$85.85
Tissue exam by pathologist level IV	CPT	88305	17	$381	$228.6	$27.89	$148.4	$323.85
maternity
Fetal non-stress test	CPT	59025	17	$1,269	$761.4	$19.25	$489.2	$1,078.65
office
Office visit, new patient, 15-29 min	CPT	99202	17	$434	$260.4	$36.08	$173.6	$368.9
Office visit, new patient, 30-44 minutes	CPT	99203	17	$564	$338.4	$36.08	$225.6	$479.4
Office visit, new patient, 45-59 min	CPT	99204	17	$723	$433.8	$36.08	$287.97	$614.55
Office visit, new patient, 60-74 min	CPT	99205	17	$877	$526.2	$36.08	$343.78	$745.45
Office visit, established patient, 5 min	CPT	99211	17	$235	$141	$21	$92.12	$199.75
Office visit, established patient, 10-19 min	CPT	99212	17	$315	$189	$27.3	$123.48	$267.75
Office visit, established patient, 20-29 minutes	CPT	99213	17	$360	$216	$36.08	$141.12	$306
Office visit, established patient, 30-39 minutes	CPT	99214	17	$418	$250.8	$36.08	$164.75	$355.3
Office visit, established patient, 40-54 min	CPT	99215	17	$448	$268.8	$36.08	$179.2	$380.8
preventive
Upper GI endoscopy diagnostic	CPT	43235	17	$3,121	$1,872.6	$137.74	$1,217.19	$2,652.85
Upper GI endoscopy with biopsy	CPT	43239	17	$4,127	$2,476.2	$163.44	$1,609.53	$3,507.95
Sigmoidoscopy diagnostic	CPT	45330	17	$997	$598.2	$58.47	$491.32	$1,631.07
Sigmoidoscopy with biopsy	CPT	45331	17	$3,121	$1,872.6	$70.04	$1,217.19	$2,652.85
Colonoscopy diagnostic	CPT	45378	17	$2,500	$1,500	$198.55	$977.5	$2,315.6
Colonoscopy with biopsy	CPT	45380	17	$4,127	$2,476.2	$247.96	$1,609.53	$3,507.95
Colonoscopy with polyp removal	CPT	45385	17	$4,127	$2,476.2	$294.89	$1,609.53	$3,507.95
surgery
PCI w drug-eluting stent w MCC	MS-DRG	246	1	—	—	$9,470.42	$9,470.42	$9,470.42
PCI w drug-eluting stent w/o MCC	MS-DRG	247	1	—	—	$9,470.42	$9,470.42	$9,470.42
Total hip replacement	CPT	27130	9	—	—	$1,556	$12,880	$23,019
Total knee replacement	CPT	27447	9	—	—	$1,542	$12,880	$23,019
Shoulder arthroscopy with decompression	CPT	29826	4	—	—	$808	$1,817.25	$2,655.58
Shoulder arthroscopy with rotator cuff repair	CPT	29827	9	—	—	$1,141	$7,083.12	$12,780
Knee arthroscopy with meniscectomy	CPT	29881	11	—	—	$597.85	$2,769.48	$5,804.67
ACL reconstruction	CPT	29888	9	—	—	$808	$7,083.12	$12,780
Major small/large bowel procedures w MCC	MS-DRG	329	9	—	—	$9,470.42	$36,440	$49,800
Major small/large bowel procedures w CC	MS-DRG	330	9	—	—	$9,470.42	$19,344	$30,624
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	9	—	—	$7,793.51	$13,791	$23,015
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	9	—	—	$7,833.8	$13,859	$22,064
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	9	—	—	$6,325.02	$11,326	$18,347
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	9	—	—	$9,470.42	$27,194	$57,789
Laparoscopic appendectomy	CPT	44970	9	—	—	$1,067.82	$5,784.86	$10,438
Spinal fusion (non-cervical) w MCC	MS-DRG	459	1	—	—	$9,470.42	$9,470.42	$9,470.42
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	1	—	—	$9,470.42	$9,470.42	$9,470.42
Major joint replacement w MCC	MS-DRG	469	9	—	—	$9,470.42	$24,288	$38,405
Major joint replacement w/o MCC	MS-DRG	470	9	—	—	$8,932.74	$15,704	$20,854
Laparoscopic cholecystectomy	CPT	47562	9	—	—	$1,141	$5,784.86	$10,438
Lap cholecystectomy with cholangiography	CPT	47563	9	—	—	$1,141	$5,784.86	$10,438
Hip & femur procedures except major joint w MCC	MS-DRG	480	9	—	—	$9,470.42	$23,348	$44,077
Hip & femur procedures except major joint w CC	MS-DRG	481	9	—	—	$9,470.42	$16,991	$30,918
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	9	—	—	$7,553.16	$13,388	$22,393
Lap salpingo-oophorectomy	CPT	58661	9	—	—	$1,141	$5,784.86	$10,438
OR procedure for obesity w MCC	MS-DRG	619	8	—	—	$13,372	$23,155	$37,835
OR procedure for obesity w CC	MS-DRG	620	8	—	—	$7,410.99	$13,150	$22,082
OR procedure for obesity w/o CC/MCC	MS-DRG	621	8	—	—	$6,985.4	$12,435	$17,828
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	8	—	—	$5,745.68	$10,354	$15,096
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	8	—	—	$9,489.38	$16,562	$18,180

Payer mix (top 17)

Payer	Codes covered	Median rate
Blue Cross Blue Shield	152	$450.5
upmc health plan	152	$350.56
Anthem BCBS	152	$608
Aetna	151	$404.69
pa health & wellness	151	$248.89
UnitedHealthcare	151	$287.6
amerihealth caritas	151	$226.59
Cigna	151	$638.4
upmc work partners	142	$739.67
geisinger	100	$168.71
intergroup	99	$1,069.9
prime net	99	$1,349.72
private health care systems	99	$1,316.8
health coalition partners	99	$1,152.2
First Health	99	$1,086.36
Humana	99	$1,399.1
health partners plans (jefferson health plan)	90	$156.16