WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $121.60 | $152.00 | $17.50 – $132.93 | 23 |
| 17-hydroxypregnenolone CPT 84143 | $95.20 | $119.00 | $23.04 – $107.24 | 23 |
| 2nd order venous cath CPT 36012 | $1,457.60 | $1,822.00 | $143.13 – $389.30 | 7 |
| 3-d radiotherapy plan CPT 77295 | $8,770.40 | $10,963.00 | $401.83 – $2,312.57 | 20 |
| 3d recon without postprocess indpndt CPT 76376 | $427.20 | $534.00 | $11.02 – $11.02 | 1 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $28.80 | $36.00 | $28.21 – $28.21 | 1 |
| 5' nucleotidase - sendout CPT 83915 | $46.40 | $58.00 | $11.26 – $52.39 | 23 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $140.00 | $175.00 | $12.23 – $247.20 | 10 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $49.60 | $62.00 | $12.13 – $56.44 | 23 |
| Abd aorta w/runoff s&i CPT 75630 | $6,960.00 | $8,700.00 | $193.73 – $17,462.81 | 8 |
| Abd/low ext cath 1st CPT 36245 | $1,803.20 | $2,254.00 | $168.13 – $457.30 | 7 |
| Abd/low ext cath 2nd CPT 36246 | $2,519.20 | $3,149.00 | $317.61 – $863.91 | 7 |
| Abd/low ext cath 3rd CPT 36247 | $2,519.20 | $3,149.00 | $370.00 – $1,006.40 | 7 |
| Abd/low ext cath addl CPT 36248 | $1,803.20 | $2,254.00 | $60.73 – $165.17 | 7 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $560.00 | $2,645.00 | $139.38 – $1,006.60 | 23 |
| Abdominal CT scan (with contrast) CPT 74160 | $468.50 | $2,362.00 | $112.50 – $1,006.60 | 23 |
| Abdominal CT scan (without contrast) CPT 74150 | $273.50 | $1,610.00 | $96.88 – $602.31 | 23 |
| Abdominal MRI (with and without contrast) CPT 74183 | $706.00 | $2,544.00 | $348.37 – $2,106.92 | 23 |
| Abdominal MRI (without contrast) CPT 74181 | $457.00 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,588.80 | $1,986.00 | $105.41 – $1,584.63 | 20 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,365.60 | $1,707.00 | $71.88 – $602.31 | 22 |
| Abdominal Ultrasound (limited) CPT 76705 | $875.20 | $1,094.00 | $46.88 – $602.31 | 22 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Ablate arrhythmia add on CPT 93655 | $25,273.60 | $31,592.00 | $409.40 – $1,113.57 | 2 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $11,082.40 | $13,853.00 | $5,357.80 – $5,357.80 | 1 |
| Ablate heart dysrhythm focus CPT 93650 | $17,430.40 | $21,788.00 | $681.41 – $7,588.10 | 3 |
| Ablate inf turbinate submuc 30802 CPT 30802 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $14,685.60 | $18,357.00 | $117.35 – $264.44 | 15 |
| Ablation cryo abd perit om CPT 49999 | $475.20 | $594.00 | $703.17 – $1,584.63 | 15 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $234.00 – $5,627.00 | 14 |
| Abscess drain retroperitoneal surg code CPT 49406 | $5,934.40 | $7,418.00 | $217.03 – $590.34 | 7 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $58.80 | $73.50 | $5.50 – $18.39 | 10 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $500.20 | $625.25 | $1.72 – $1.72 | 1 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $267.20 | $334.00 | $17.88 – $66.71 | 10 |
| Acetylcholine receptor modulating antibody CPT 86043 | $49.60 | $62.00 | $9.64 – $36.15 | 21 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $1,180.20 | $1,475.25 | $22.80 – $94.50 | 10 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $527.20 | $659.00 | $110.33 – $300.08 | 20 |
| Actinotherapy uv light CPT 96900 | $215.20 | $269.00 | $19.63 – $66.34 | 16 |
| Acute hepatitis panel CPT 80074 | $198.40 | $248.00 | $48.11 – $216.24 | 23 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $34.20 | $42.75 | $3.00 – $14.00 | 10 |
| #acylcarnitineprfl CPT 82017 | $69.60 | $87.00 | $8.44 – $76.59 | 19 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $167.40 | $209.25 | $2.82 – $11.14 | 10 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $1,675.00 | $2,093.75 | $1.61 – $1.61 | 1 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $788.00 | $985.00 | $69.43 – $209.71 | 20 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $1,460.00 | $1,825.00 | $156.00 – $560.61 | 20 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $401.60 | $502.00 | $115.25 – $560.61 | 20 |
| Administration immunization 1 vaccine CPT 90471 | $69.60 | $87.00 | $12.50 – $120.30 | 16 |
| Administration immunization each additional vaccine CPT 90472 | $64.80 | $81.00 | $12.50 – $34.00 | 2 |
| Administration vaccine hepatitis b HCPCS G0010 | $23.20 | $29.00 | $34.61 – $77.98 | 15 |
| Administration vaccine influenza virus HCPCS G0008 | $58.40 | $73.00 | $12.50 – $77.98 | 20 |
| Administration vaccine pneumococcal HCPCS G0009 | $59.20 | $74.00 | $12.50 – $77.98 | 20 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $190.40 | $238.00 | $15.88 – $43.18 | 20 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $232.00 | $290.00 | $50.00 – $136.00 | 7 |
| #afb mycobacteria suscep. #1 CPT 87190 | $30.40 | $38.00 | $7.00 – $33.19 | 23 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $480.00 | $600.00 | $116.51 – $523.73 | 23 |
| Albumin body fluid quantitative each specimen CPT 82042 | $32.80 | $41.00 | $3.89 – $35.32 | 19 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $580.80 | $726.00 | $53.08 – $339.71 | 11 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $660.20 | $825.25 | $53.08 – $177.49 | 24 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $24.00 | $30.00 | $5.84 – $27.20 | 24 |
| Albumin serum plasma or whole blood CPT 82040 | $20.80 | $26.00 | $3.65 – $22.47 | 23 |
| Alkaline phosphatase CPT 84075 | $21.60 | $27.00 | $5.23 – $23.52 | 23 |
| Allergen alpha lactalbumin ige CPT 86008 | $75.20 | $94.00 | $17.71 – $74.05 | 23 |
| Allergen egg white ige CPT 86003 | $21.60 | $27.00 | $5.27 – $24.51 | 24 |
| Alpha-fetoprotein tumor marker CPT 82105 | $69.60 | $87.00 | $16.94 – $76.14 | 23 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $16,385.20 | $20,481.50 | $111.38 – $640.22 | 24 |
| Alt/sgpt CPT 84460 | $22.40 | $28.00 | $5.35 – $24.48 | 23 |
| Aluminum - quest CPT 82108 | $105.60 | $132.00 | $25.73 – $119.75 | 23 |
| Amino acid screen, urine CPT 82128 | $57.60 | $72.00 | $8.00 – $62.97 | 23 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $109.40 | $136.75 | $17.22 – $77.35 | 10 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $257.80 | $322.25 | $13.03 – $45.33 | 10 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $52.20 | $65.25 | $2.14 – $8.16 | 10 |
| Ammonia CPT 82140 | $60.80 | $76.00 | $5.00 – $66.15 | 23 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $892.00 | $1,115.00 | $62.50 – $1,471.68 | 20 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $348.60 | $435.75 | $35.41 – $175.25 | 10 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,862.00 | $2,327.50 | $25.33 – $407.93 | 24 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $39.40 | $49.25 | $0.51 – $2.10 | 10 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $90.60 | $113.25 | $1.39 – $5.50 | 10 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Amylase CPT 82150 | $26.40 | $33.00 | $5.00 – $29.42 | 23 |
| Anal/urinary muscle study CPT 51784 | $955.20 | $1,194.00 | $120.31 – $327.25 | 16 |
| Analysis gene f2 20210g>a variant CPT 81240 | $272.80 | $341.00 | $53.70 – $298.23 | 20 |
| Analysis gene f5 leiden variant CPT 81241 | $305.60 | $382.00 | $66.70 – $333.10 | 20 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $75.20 | $94.00 | $36.37 – $109.82 | 20 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $162.40 | $203.00 | $28.07 – $159.31 | 23 |
| Anca screen with reflex to titer -quest CPT 86021 | $62.40 | $78.00 | $5.00 – $68.33 | 23 |
| An cholangiogram percutaneous compl CPT 47531 | $1,682.40 | $2,103.00 | $97.40 – $264.93 | 7 |
| An fluoro guide for cvp CPT 77001 | $824.80 | $1,031.00 | $57.83 – $205.26 | 7 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $27,444.80 | $34,306.00 | $481.89 – $1,310.73 | 3 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $12,846.40 | $16,058.00 | $313.61 – $853.03 | 7 |
| Ankle arthroscopy/surgery CPT 29897 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Ankle arthroscopy/surgery CPT 29898 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Ankle X-ray CPT 73610 | $398.40 | $498.00 | $23.41 – $497.84 | 22 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | $676.80 | $846.00 | $45.98 – $506.89 | 20 |
| Anoscopy and biopsy CPT 46606 | not published | not published | $1,150.15 – $5,627.00 | 14 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $53.60 | $67.00 | $9.66 – $58.48 | 18 |
| Antibody elution rbc reference CPT 86860 | $141.60 | $177.00 | $8.45 – $488.22 | 21 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $76.80 | $96.00 | $5.00 – $83.40 | 23 |
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.