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 |
|---|---|---|---|---|
| Mayo chikv chikungunya antibodies igg CPT 86790 | $53.60 | $67.00 | $9.66 – $58.48 | 18 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $48.80 | $61.00 | $9.88 – $53.66 | 23 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $52.80 | $66.00 | $12.81 – $59.67 | 23 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $484.00 | $605.00 | $117.65 – $547.40 | 23 |
| Mayo chromium CPT 82495 | $84.00 | $105.00 | $6.00 – $92.07 | 23 |
| Mayo coccidioides antibody CPT 86635 | $47.20 | $59.00 | $11.58 – $53.89 | 23 |
| Mayo cocou cortisone urine CPT 82542 | $100.00 | $125.00 | $19.27 – $109.37 | 23 |
| Mayo cortisol free CPT 82530 | $69.60 | $87.00 | $16.88 – $79.39 | 23 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $140.00 | $175.00 | $11.16 – $191.27 | 24 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $50.40 | $63.00 | $12.24 – $56.95 | 23 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $55.20 | $69.00 | $13.38 – $60.16 | 23 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $104.80 | $131.00 | $21.00 – $114.73 | 23 |
| Mayo dihydrotestosterone CPT 82642 | $121.60 | $152.00 | $21.96 – $132.93 | 18 |
| Mayo estrone CPT 82679 | $104.00 | $130.00 | $13.00 – $113.27 | 23 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $68.00 | $85.00 | $13.00 – $74.18 | 23 |
| Mayo everolimus therapeutic drug level CPT 80169 | $57.60 | $72.00 | $13.87 – $62.33 | 23 |
| Mayo factor v CPT 85220 | $464.80 | $581.00 | $5.00 – $80.13 | 23 |
| Mayo factor vii CPT 85230 | $464.80 | $581.00 | $5.00 – $81.27 | 23 |
| Mayo factor viii vw factor antigen CPT 85246 | $352.00 | $440.00 | $23.17 – $107.81 | 23 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $136.00 | $170.00 | $23.17 – $107.81 | 23 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $196.00 | $245.00 | $23.17 – $107.81 | 23 |
| Mayo factor x CPT 85260 | $105.60 | $132.00 | $12.00 – $81.27 | 23 |
| Mayo fbl culture fungi blood CPT 87103 | $84.80 | $106.00 | $12.46 – $92.89 | 23 |
| Mayo ffspg allergen clam igg CPT 86001 | $17.60 | $22.00 | $5.78 – $35.50 | 23 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $81.60 | $102.00 | $14.47 – $98.38 | 23 |
| Mayo hemosiderin qualitative urine CPT 83070 | $20.00 | $25.00 | $3.00 – $21.57 | 23 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $145.60 | $182.00 | $17.55 – $159.31 | 19 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $145.60 | $182.00 | $26.32 – $159.31 | 18 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $57.60 | $72.00 | $13.93 – $62.61 | 23 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $107.20 | $134.00 | $12.00 – $117.18 | 23 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $36.80 | $46.00 | $8.98 – $41.21 | 23 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $56.80 | $71.00 | $13.66 – $61.38 | 23 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $112.80 | $141.00 | $20.50 – $123.35 | 23 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $71.20 | $89.00 | $8.64 – $78.41 | 19 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $62.40 | $78.00 | $15.14 – $69.67 | 23 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $85.00 | $108.00 | $21.02 – $94.48 | 23 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $86.40 | $108.00 | $21.02 – $97.78 | 23 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $66.40 | $83.00 | $12.05 – $72.96 | 18 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $49.60 | $62.00 | $12.10 – $54.39 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $145.60 | $182.00 | $28.07 – $159.31 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $145.60 | $182.00 | $17.55 – $159.31 | 19 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $178.40 | $223.00 | $43.27 – $194.49 | 23 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $300.00 | $375.00 | $57.75 – $327.74 | 23 |
| Mayo infliximab therapeutic drug level CPT 80230 | $148.00 | $185.00 | $19.29 – $175.11 | 19 |
| Mayo inhab inhibin a CPT 86336 | $64.80 | $81.00 | $7.80 – $70.78 | 19 |
| Mayo insulin antibodies CPT 86337 | $88.80 | $111.00 | $11.00 – $97.20 | 23 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $104.00 | $130.00 | $13.56 – $123.08 | 19 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $55.20 | $69.00 | $13.38 – $60.16 | 23 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $53.60 | $67.00 | $11.00 – $58.07 | 23 |
| Mayo legionella antibody CPT 86713 | $64.00 | $80.00 | $15.45 – $70.89 | 23 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $64.00 | $80.00 | $15.64 – $72.76 | 23 |
| Mayo metanephrines plasma CPT 83835 | $70.40 | $88.00 | $13.00 – $76.91 | 23 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $76.80 | $96.00 | $12.17 – $54.71 | 23 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $76.80 | $96.00 | $14.72 – $55.20 | 21 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $60.80 | $76.00 | $7.91 – $66.06 | 23 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $77.60 | $97.00 | $15.30 – $84.63 | 23 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $605.60 | $757.00 | $92.60 – $840.81 | 16 |
| Mayo muramidase CPT 85549 | $78.40 | $98.00 | $16.44 – $85.13 | 23 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $76.80 | $96.00 | $13.80 – $55.20 | 16 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $75.20 | $94.00 | $18.23 – $81.95 | 23 |
| Mayo myoglobin CPT 83874 | $54.40 | $68.00 | $13.05 – $58.66 | 23 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $88.00 | $110.00 | $18.20 – $96.29 | 23 |
| Mayo oxalate 24 hour urine CPT 83945 | $60.00 | $75.00 | $13.00 – $65.60 | 23 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $62.40 | $78.00 | $15.18 – $70.62 | 23 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $49.60 | $62.00 | $12.17 – $55.90 | 23 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $88.80 | $111.00 | $18.16 – $81.63 | 23 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $57.60 | $72.00 | $13.00 – $62.47 | 23 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $35.20 | $44.00 | $2.00 – $38.32 | 23 |
| Mayo pregnenolone CPT 84140 | $85.60 | $107.00 | $20.88 – $97.17 | 23 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $68.80 | $86.00 | $16.76 – $75.32 | 23 |
| Mayo proinsulin CPT 84206 | $110.40 | $138.00 | $8.00 – $121.17 | 23 |
| Mayo psaft prostate specific antigen free CPT 84154 | $45.00 | $96.00 | $18.57 – $83.49 | 23 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $76.80 | $96.00 | $9.20 – $83.54 | 19 |
| Mayo receptor assay transferrin soluble CPT 84238 | $152.00 | $190.00 | $22.00 – $166.03 | 23 |
| Mayo renin CPT 84244 | $91.20 | $114.00 | $12.00 – $99.83 | 23 |
| Mayo repu protein electrophoresis urine CPT 84166 | $45.00 | $93.00 | $18.01 – $80.95 | 23 |
| Mayo selenium CPT 84255 | $106.40 | $133.00 | $19.15 – $115.91 | 18 |
| Mayo serotonin CPT 84260 | $128.80 | $161.00 | $31.00 – $140.65 | 23 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $80.80 | $101.00 | $19.54 – $87.85 | 23 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $57.60 | $72.00 | $13.87 – $62.33 | 23 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $17.60 | $22.00 | $4.00 – $19.39 | 23 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $869.60 | $1,087.00 | $104.46 – $948.50 | 19 |
| Mayo tgrp testosterone free CPT 84402 | $105.60 | $132.00 | $25.72 – $115.63 | 23 |
| Mayo tgrp testosterone total CPT 84403 | $107.20 | $134.00 | $26.07 – $117.18 | 23 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $92.00 | $115.00 | $17.74 – $100.65 | 23 |
| Mayo thyroglobulin CPT 84432 | $66.40 | $83.00 | $16.22 – $73.98 | 23 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $42.40 | $53.00 | $10.28 – $46.22 | 23 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $51.20 | $64.00 | $9.29 – $56.25 | 18 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $59.20 | $74.00 | $14.30 – $64.29 | 23 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $56.80 | $71.00 | $13.68 – $61.47 | 23 |
| Mayo vasoactive intestinal peptide CPT 84586 | $147.20 | $184.00 | $35.68 – $166.02 | 23 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $84.00 | $105.00 | $8.00 – $91.89 | 23 |
| Mayo vitamin b3 (niacin) CPT 84591 | $70.40 | $88.00 | $12.80 – $77.45 | 18 |
| Mayo vitamin k CPT 84597 | $57.60 | $72.00 | $6.86 – $62.29 | 19 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $55.20 | $69.00 | $13.38 – $60.16 | 23 |
| Med genetics&genetic counseling svcs each 30 min CPT 96041 | $242.40 | $303.00 | $46.46 – $217.81 | 17 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $500.80 | $626.00 | $88.50 – $299.25 | 3 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $48.80 | $61.00 | $2.11 – $7.53 | 10 |
| Metabolic Blood Panel (Basic) CPT 80048 | $20.00 | $46.00 | $8.54 – $38.41 | 24 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $25.00 | $57.00 | $10.67 – $47.94 | 24 |
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.