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 |
|---|---|---|---|---|
| Hpa-3 genotyping CPT 81107 | $310.40 | $388.00 | $61.11 – $554.88 | 19 |
| Hpa-4 genotyping CPT 81108 | $310.40 | $388.00 | $61.11 – $554.88 | 19 |
| Hpa-5 genotyping CPT 81109 | $310.40 | $388.00 | $61.11 – $554.88 | 19 |
| Hpa-6 genotyping CPT 81110 | $310.40 | $388.00 | $61.11 – $554.88 | 19 |
| Hpv combo assay ca screen HCPCS G0476 | $150.40 | $188.00 | $35.44 – $159.31 | 24 |
| H pylori (c-13) breath CPT 83013 | $280.00 | $350.00 | $60.10 – $305.81 | 23 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $130.00 | $162.50 | $5.38 – $18.73 | 10 |
| Hydration IV infusion each additional hour CPT 96361 | $548.00 | $685.00 | $11.25 – $77.98 | 20 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $1,096.80 | $1,371.00 | $39.53 – $356.09 | 20 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $208.20 | $260.25 | $21.31 – $72.03 | 10 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $37.60 | $47.00 | $0.45 – $2.45 | 10 |
| Hydroxyurea 500 mg HCPCS S0176 | $10.80 | $13.50 | $1.44 – $1.44 | 1 |
| Hymenotomy CPT 56442 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Hysterosalpingography s&i CPT 74740 | $784.00 | $980.00 | $181.29 – $1,342.45 | 16 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $130.40 | $163.00 | $374.69 – $379.26 | 2 |
| I131 iodide cap, rx HCPCS A9517 | $187.20 | $234.00 | $17.35 – $284.87 | 18 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $145.60 | $182.00 | $26.32 – $159.31 | 18 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $1,154.80 | $1,443.50 | $140.23 – $1,087.14 | 18 |
| Igh@ var region somatic mutation analy CPT 81263 | $1,225.60 | $1,532.00 | $297.47 – $1,337.12 | 23 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $190.40 | $238.00 | $42.53 – $374.64 | 10 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $761.60 | $952.00 | $71.44 – $1,027.44 | 23 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $244.00 | $305.00 | $50.17 – $488.22 | 23 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $188.00 | $235.00 | $68.11 – $237.46 | 16 |
| Immune complex assay CPT 86332 | $101.60 | $127.00 | $24.61 – $110.64 | 23 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $85.00 | $108.00 | $21.02 – $94.48 | 23 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $85.00 | $108.00 | $21.02 – $94.48 | 23 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $49.60 | $62.00 | $8.00 – $54.39 | 23 |
| Immunofixation electrophoresis serum CPT 86334 | $92.80 | $116.00 | $22.56 – $101.42 | 23 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $90.40 | $113.00 | $15.03 – $504.08 | 10 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $55.20 | $69.00 | $19.13 – $657.80 | 23 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $15,634.00 – $15,634.00 | 1 |
| Implant neuroelectrodes CPT 64555 | $11,147.20 | $13,934.00 | $157.40 – $428.13 | 3 |
| Implant neuroelectrodes CPT 64561 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Implant ureth bulk agent HCPCS L8606 | $2,270.00 | $2,837.50 | $261.63 – $261.63 | 1 |
| Impl neurostim electr perc CPT 63650 | $19,857.60 | $24,822.00 | $466.19 – $1,268.03 | 7 |
| Impl oi implt sk tc esp<100 CPT 69716 | not published | not published | $35,016.00 – $35,016.00 | 1 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $35,016.00 – $35,016.00 | 1 |
| In-111 autol wbc diag per dose HCPCS A9570 | $6,836.00 | $8,545.00 | $773.54 – $15,029.56 | 18 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $6,134.40 | $7,668.00 | $29.38 – $79.90 | 7 |
| Incision of anal sphincter CPT 46080 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Incision of eardrum CPT 69421 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Incision of heel bone CPT 28300 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Incision of metatarsal CPT 28308 | not published | not published | $3,133.64 – $8,754.00 | 2 |
| Incision of spinal nerve 64772 CPT 64772 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Incision of tongue fold CPT 41010 | not published | not published | $1,430.62 – $5,627.00 | 2 |
| Incision tendon sheath CPT 26055 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | $2,003.60 | $2,504.50 | $11.74 – $1,274.88 | 16 |
| Infect ag drug suscept pheno predict CPT 87900 | $542.40 | $678.00 | $131.65 – $591.79 | 23 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $536.00 | $670.00 | $130.02 – $584.43 | 23 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,070.40 | $1,338.00 | $260.02 – $1,168.82 | 23 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $52.00 | $226.00 | $39.77 – $153.93 | 21 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | $172.00 | $215.00 | $11.51 – $187.87 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $57.60 | $72.00 | $6.91 – $62.74 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $49.60 | $62.00 | $12.10 – $54.39 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $60.00 | $75.00 | $12.18 – $65.29 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $43.20 | $54.00 | $10.43 – $48.18 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $100.00 | $125.00 | $24.32 – $109.32 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $49.60 | $62.00 | $5.99 – $54.39 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $49.60 | $62.00 | $5.99 – $54.39 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $49.60 | $62.00 | $12.10 – $54.39 | 23 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $145.60 | $182.00 | $23.19 – $159.31 | 23 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $145.60 | $182.00 | $23.19 – $159.31 | 24 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $154.40 | $193.00 | $37.64 – $169.21 | 23 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,168.00 | $1,460.00 | $312.59 – $1,892.18 | 18 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $145.60 | $182.00 | $17.55 – $159.31 | 19 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $140.00 | $182.00 | $35.44 – $159.31 | 23 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $145.60 | $182.00 | $23.19 – $159.31 | 24 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $100.00 | $192.00 | $35.49 – $232.95 | 25 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $100.00 | $709.00 | $82.21 – $647.54 | 24 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $122.40 | $153.00 | $23.19 – $159.31 | 23 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $145.60 | $182.00 | $35.44 – $159.31 | 24 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $307.20 | $384.00 | $57.58 – $230.31 | 16 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,667.20 | $2,084.00 | $208.39 – $1,892.18 | 19 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $178.40 | $223.00 | $32.13 – $194.49 | 18 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $178.40 | $223.00 | $39.65 – $194.49 | 23 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $178.40 | $223.00 | $39.65 – $194.49 | 23 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $354.40 | $443.00 | $85.95 – $394.71 | 23 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,038.40 | $1,298.00 | $42.83 – $343.75 | 17 |
| Inj acetaminophen -fresenius HCPCS J0134 | $53.00 | $66.25 | $5.50 – $19.20 | 10 |
| Inj, bupivacaine liposome HCPCS J0666 | $1,982.80 | $2,478.50 | $1.73 – $1,322.02 | 24 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $67.40 | $84.25 | $5.56 – $20.37 | 23 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $1,372.20 | $1,715.25 | $2.85 – $808.91 | 24 |
| Inj ceftolozane tazobactam HCPCS J0695 | $1,027.60 | $1,284.50 | $10.69 – $606.33 | 24 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $660.80 | $826.00 | $41.56 – $113.05 | 7 |
| Inj dx for sinogram CPT 20501 | $124.00 | $155.00 | $43.75 – $119.00 | 7 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $1,209.60 | $1,512.00 | $519.39 – $1,170.47 | 15 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $628.00 | $785.00 | $60.00 – $163.20 | 7 |
| Injection, cangrelor HCPCS C9460 | $5,888.20 | $7,360.25 | $23.56 – $3,575.25 | 18 |
| Injection during cath supravalvular aortography CPT 93567 | $5,427.20 | $6,784.00 | $48.33 – $131.44 | 2 |
| Injection epidural blood patch or clot CPT 62273 | $3,346.40 | $4,183.00 | $60.00 – $6,190.00 | 22 |
| Injection for arthrography wrist (both sides) CPT 25246 | $628.00 | $785.00 | $43.75 – $119.00 | 7 |
| Injection for bladder x-ray CPT 51600 | $530.40 | $663.00 | $40.00 – $108.80 | 7 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $628.00 | $785.00 | $41.25 – $112.20 | 7 |
| Injection,onabotulinumtoxina HCPCS J0585 | $4,046.80 | $5,058.50 | $6.50 – $21.81 | 24 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $740.80 | $926.00 | $200.92 – $679.16 | 16 |
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.