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 |
|---|---|---|---|---|
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $2,253.60 | $2,817.00 | $26.25 – $1,170.47 | 20 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $3,187.20 | $3,984.00 | $118.80 – $1,504.72 | 20 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,510.40 | $1,888.00 | $60.95 – $165.78 | 7 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,729.60 | $2,162.00 | $106.95 – $1,504.72 | 20 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,700.00 | $2,125.00 | $51.98 – $141.37 | 7 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,512.80 | $1,891.00 | $90.01 – $1,504.72 | 20 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,404.80 | $3,006.00 | $111.50 – $1,170.47 | 20 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,320.00 | $2,900.00 | $101.65 – $1,170.47 | 20 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $422.40 | $528.00 | $40.00 – $498.91 | 20 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $548.80 | $686.00 | $38.83 – $498.91 | 20 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $548.80 | $686.00 | $43.09 – $498.91 | 20 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $389.60 | $487.00 | $16.26 – $77.98 | 20 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $389.60 | $487.00 | $38.77 – $356.09 | 20 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $190.40 | $238.00 | $15.88 – $120.30 | 20 |
| Inject sacroiliac joint CPT 27096 | $2,447.20 | $3,059.00 | $76.49 – $1,170.47 | 20 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | $876.20 | $1,095.25 | $146.72 – $500.50 | 23 |
| Inj for ext venography CPT 36005 | $443.20 | $554.00 | $54.56 – $148.41 | 7 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $3,902.60 | $4,878.25 | $6.11 – $3,563.00 | 18 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $95.00 | $118.75 | $2.63 – $25.60 | 2 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $109.00 | $136.25 | $11.86 – $39.67 | 10 |
| Inj multihance HCPCS A9577 | $4.00 | $5.00 | $1.74 – $6.37 | 9 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $2,644.80 | $3,306.00 | $66.88 – $181.90 | 7 |
| Inj proc elbow arthro CPT 24220 | $944.00 | $1,180.00 | $43.75 – $119.00 | 7 |
| Inj proc myelogram lumbar CPT 62284 | $3,385.60 | $4,232.00 | $99.42 – $270.44 | 7 |
| Inj retro urethrocysto CPT 51610 | $285.60 | $357.00 | $43.13 – $117.30 | 7 |
| Inj testosterone cypionate HCPCS J1071 | $121.00 | $151.25 | $5.60 – $21.00 | 10 |
| Inj w/fluor eval cv device CPT 36598 | $595.20 | $744.00 | $72.50 – $356.09 | 16 |
| Insert cath pleura with image CPT 32557 | $1,232.00 | $1,540.00 | $165.75 – $450.84 | 7 |
| Insert cath pleura without image CPT 32556 | $3,650.40 | $4,563.00 | $121.63 – $330.82 | 7 |
| Insert drug delivery implant CPT 11981 | $192.80 | $241.00 | $94.66 – $257.48 | 20 |
| Insert intrauterine device iud CPT 58300 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Insertion catheter bladder non indwelling CPT 51701 | $213.60 | $267.00 | $31.81 – $217.86 | 20 |
| Insertion catheter bladder temporary simple CPT 51702 | $231.20 | $289.00 | $34.39 – $217.86 | 20 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $9,328.00 | $11,660.00 | $209.79 – $570.62 | 2 |
| Insertion intra aortic balloon assist device percutaneous CPT 33967 | $1,572.00 | $1,965.00 | $250.90 – $829.23 | 12 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $8,252.80 | $10,316.00 | $238.90 – $649.81 | 2 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $2,099.20 | $2,624.00 | $141.51 – $384.91 | 7 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $18,232.80 | $22,791.00 | $578.84 – $1,574.44 | 3 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | $18,232.80 | $22,791.00 | $576.48 – $1,568.01 | 3 |
| Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator CPT 33225 | $14,454.40 | $18,068.00 | $419.95 – $1,142.26 | 2 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,008.00 | $2,510.00 | $109.24 – $297.13 | 7 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,962.40 | $2,453.00 | $87.20 – $237.18 | 7 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | $59,126.40 | $73,908.00 | $1,049.63 – $32,061.58 | 3 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $13,698.40 | $17,123.00 | $206.13 – $560.66 | 3 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $12,016.00 | $15,020.00 | $445.85 – $1,212.71 | 3 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $10,404.80 | $13,006.00 | $92.15 – $8,275.98 | 3 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $5,223.20 | $6,529.00 | $399.15 – $11,702.00 | 4 |
| Insert pessary/other device CPT 57160 | not published | not published | $196.23 – $8,754.00 | 14 |
| Insert/repl sq defib w/eltrd CPT 33270 | $72,809.60 | $91,012.00 | $2,854.98 – $32,061.58 | 3 |
| Insert vad art access left hrt arterial access CPT 33990 | $29,700.80 | $37,126.00 | $349.10 – $581.84 | 9 |
| Insitu hybridization auto CPT 88367 | $173.60 | $217.00 | $125.76 – $1,027.44 | 23 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $235.20 | $294.00 | $65.11 – $591.34 | 10 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $381.60 | $477.00 | $14.42 – $781.20 | 23 |
| Insj biomechanical device 22853 CPT 22853 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Ins mark abd/pel for right perq CPT 49411 | $2,096.00 | $2,620.00 | $197.65 – $2,312.57 | 20 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | $1,317.60 | $1,647.00 | $94.15 – $1,044.96 | 20 |
| Ins pq tunnld ip cath w/img CPT 49418 | $2,670.40 | $3,338.00 | $233.98 – $636.41 | 2 |
| Ins/rplc spi npg/rcvr pocket CPT 63685 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Ins/rpl ldless pm right vent w img & eval CPT 33274 | $5,923.20 | $7,404.00 | $14,303.37 – $19,071.16 | 2 |
| Ins/rpl prph sac/gstr npg/r CPT 64590 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Ins/rpl wireless pulm art sensor incl s&i CPT 33289 | $58,797.60 | $73,497.00 | $21,321.25 – $28,428.33 | 2 |
| Insrt/redo neurostim 1 array CPT 61885 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Inst fibrinolysis agent ini day CPT 32561 | $840.80 | $1,051.00 | $72.11 – $1,044.96 | 16 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $2,836.00 | $3,545.00 | $331.88 – $902.70 | 7 |
| Insulin total CPT 83525 | $47.20 | $59.00 | $11.00 – $51.89 | 23 |
| Interdiscal perq aspir dx CPT 62267 | $1,187.20 | $1,484.00 | $122.26 – $1,189.18 | 17 |
| Interfyl, 1 mg HCPCS Q4171 | $2,996.40 | $3,745.50 | $10.09 – $42.46 | 7 |
| Interrogate subq defib CPT 93261 | $765.60 | $957.00 | $27.97 – $63.02 | 15 |
| Interrog dev eval scrms ip CPT 93291 | $159.20 | $199.00 | $14.98 – $103.84 | 20 |
| Interrog evl pm/ldls pm ip CPT 93288 | $285.60 | $357.00 | $12.39 – $82.48 | 20 |
| Int hrhc lig 2+hroid without img CPT 46946 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Intranasal biopsy 30100 CPT 30100 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Intrapul surf admin endo tube CPT 94610 | $720.00 | $900.00 | $59.23 – $343.75 | 16 |
| Intrinsic factor antibody CPT 86340 | $62.40 | $78.00 | $15.23 – $70.82 | 23 |
| Intro cath dialysis circuit CPT 36901 | $1,716.00 | $2,145.00 | $149.05 – $405.42 | 7 |
| Intro cath dialysis circuit w/pta CPT 36902 | $10,528.00 | $13,160.00 | $222.08 – $604.04 | 7 |
| Intro catheter aorta CPT 36200 | $5,244.00 | $6,555.00 | $138.75 – $377.40 | 4 |
| Intro cath svc/ivc CPT 36010 | $1,604.80 | $2,006.00 | $143.13 – $389.30 | 7 |
| Intro long gi tube CPT 44500 | $1,575.20 | $1,969.00 | $24.59 – $1,584.63 | 20 |
| Intubation endotracheal emergency procedure CPT 31500 | $1,163.20 | $1,454.00 | $90.00 – $392.49 | 20 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $704.80 | $881.00 | $502.39 – $539.30 | 2 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $1.60 | $2.00 | $0.45 – $1.50 | 7 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $1.60 | $2.00 | $0.15 – $0.51 | 7 |
| Iron CPT 83540 | $20.00 | $33.00 | $6.53 – $29.37 | 24 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $211.40 | $264.25 | $22.90 – $84.00 | 10 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $100.00 | $773.00 | $24.35 – $100.40 | 20 |
| Ivc venogram s&i CPT 75825 | $8,673.60 | $10,842.00 | $28.13 – $17,462.81 | 8 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $679.20 | $849.00 | $24.05 – $120.30 | 20 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $330.40 | $413.00 | $14.28 – $38.86 | 7 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $679.20 | $849.00 | $15.36 – $77.98 | 20 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $1,350.40 | $1,688.00 | $49.13 – $356.09 | 20 |
| IV inj ra drug dx study CPT 78808 | $1,713.60 | $2,142.00 | $301.37 – $679.16 | 15 |
| Jak2 targeted sequence analysis CPT 81279 | $605.60 | $757.00 | $148.16 – $840.81 | 20 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $34.40 | $43.00 | $5.00 – $37.09 | 23 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $27.60 | $34.50 | $0.30 – $1.75 | 24 |
| Kidney function study CPT 78725 | $1,713.60 | $2,142.00 | $80.69 – $2,259.58 | 21 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,365.60 | $1,707.00 | $61.25 – $602.31 | 22 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $12,504.00 – $12,504.00 | 1 |
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.