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 |
|---|---|---|---|---|
| Metabolic panel ionized ca CPT 80047 | $60.00 | $75.00 | $11.91 – $62.33 | 23 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $49.80 | $62.25 | $4.79 – $22.26 | 10 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $12.20 | $15.25 | $0.19 – $0.70 | 10 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $963.00 | $1,203.75 | $10.29 – $628.80 | 18 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $151.20 | $189.00 | $20.72 – $74.52 | 10 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $1,001.40 | $1,251.75 | $609.00 – $609.00 | 1 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $6.00 | $7.50 | $0.11 – $0.84 | 9 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $127.20 | $159.00 | $4.76 – $15.92 | 23 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $124.80 | $156.00 | $1.68 – $7.00 | 23 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $28.80 | $36.00 | $1.03 – $3.96 | 10 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $30.80 | $38.50 | $0.62 – $2.08 | 9 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $51.60 | $64.50 | $1.35 – $5.25 | 10 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $412.20 | $515.25 | $25.60 – $99.20 | 10 |
| Microdissection manual CPT 88381 | $279.20 | $349.00 | $115.82 – $869.36 | 4 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $33.00 | $41.25 | $0.31 – $1.03 | 10 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $169.60 | $212.00 | $18.00 – $68.22 | 10 |
| Middle cerebral artery echo CPT 76821 | $289.60 | $362.00 | $59.57 – $602.31 | 21 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $108.60 | $135.75 | $5.82 – $21.98 | 10 |
| Minocycline hydrochloride HCPCS J2265 | $1,598.40 | $1,998.00 | $3.15 – $924.00 | 18 |
| Mlh1 gene CPT 81288 | $800.00 | $1,000.00 | $96.16 – $873.13 | 20 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $549.20 | $686.50 | $2.18 – $16.21 | 10 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $27.20 | $34.00 | $2.18 – $26.02 | 10 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $183.20 | $229.00 | $11.20 – $40.31 | 10 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $680.00 | $850.00 | $148.16 – $1,307.11 | 23 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $357.60 | $447.00 | $44.35 – $513.93 | 23 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $370.40 | $463.00 | $137.86 – $1,709.54 | 23 |
| MRA abdomen post contrast CPT 74185 | $735.50 | $2,646.00 | $348.37 – $1,485.51 | 23 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $734.50 | $2,646.00 | $235.78 – $1,466.71 | 23 |
| MRI breast c-+ w/cad uni CPT 77048 | $680.00 | $2,600.00 | $275.67 – $1,395.12 | 23 |
| MRI breast without cont bi CPT 77047 | $448.85 | $2,225.00 | $166.34 – $1,342.45 | 23 |
| MRI breast w IV cont bi CPT 77049 | $705.34 | $2,600.00 | $274.33 – $1,381.96 | 23 |
| MRI chest without contrast CPT 71550 | $457.00 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| MRI chest without & w/contrast CPT 71552 | $706.00 | $2,646.00 | $348.37 – $2,106.92 | 23 |
| MRI loex nonjt w IV cont CPT 73719 | $645.50 | $2,350.00 | $348.37 – $2,106.92 | 23 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $463.00 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $712.50 | $2,646.00 | $336.25 – $2,106.92 | 23 |
| MRI orbit/face/neck without contrast CPT 70540 | $463.50 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $713.00 | $2,646.00 | $348.37 – $2,106.92 | 23 |
| MRI tmj CPT 70336 | $658.00 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $463.50 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $712.50 | $2,646.00 | $336.25 – $2,106.92 | 23 |
| Mthfr gene analy common variants CPT 81291 | $272.00 | $340.00 | $32.67 – $296.64 | 16 |
| Mumps antibody igg CPT 86735 | $54.40 | $68.00 | $6.53 – $59.25 | 19 |
| Muscle test cran nerv unilat CPT 95867 | $309.60 | $387.00 | $18.75 – $526.31 | 20 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $9.00 | $11.25 | $0.16 – $0.53 | 10 |
| Mycophenolic acid HCPCS J7518 | $19.40 | $24.25 | $0.34 – $1.33 | 10 |
| Mycoplasma antibody igm CPT 86738 | $55.20 | $69.00 | $13.37 – $61.95 | 23 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $729.60 | $912.00 | $87.70 – $796.32 | 19 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $48.00 | $60.00 | $8.65 – $52.35 | 18 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $218.00 | $272.50 | $5.40 – $77.00 | 10 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $140.00 | $175.00 | $0.28 – $1.00 | 9 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Nasal/sinus endo spendt remove tiss 31288 CPT 31288 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Nasal/sinus endo w/ethmoidectomy part 31254 CPT 31254 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Nasal/sinus endo w/ethmoidectomy tot 31255 CPT 31255 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Nasal/sinus endo w/front sinus expl 31276 CPT 31276 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Natriuretic peptide CPT 83880 | $80.00 | $204.00 | $37.94 – $178.24 | 23 |
| Natural killer cells total count CPT 86357 | $157.60 | $197.00 | $38.11 – $171.29 | 23 |
| N block inj hypogas plxs CPT 64517 | $1,278.40 | $1,598.00 | $131.21 – $1,504.72 | 20 |
| Ndl emg musc 1 xtr/non-limb CPT 95870 | $249.60 | $312.00 | $21.58 – $217.86 | 20 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $472.00 | $2,350.00 | $117.50 – $2,106.92 | 23 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $282.00 | $1,610.00 | $103.73 – $602.31 | 23 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $701.50 | $2,646.00 | $336.25 – $2,106.92 | 23 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $633.50 | $2,350.00 | $336.25 – $2,106.92 | 23 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $454.00 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $735.00 | $2,646.00 | $348.37 – $2,106.92 | 23 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $473.00 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| Neck spine disk surgery CPT 63020 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $119.60 | $149.50 | $17.22 – $30.53 | 2 |
| Nerve conduction 7-8 studies CPT 95910 | $1,476.00 | $1,845.00 | $174.83 – $526.31 | 20 |
| Nerve conduction studies 11-12 CPT 95912 | $2,962.40 | $3,703.00 | $248.41 – $896.79 | 20 |
| Nerve conduction studies 1-2 CPT 95907 | $240.80 | $301.00 | $89.74 – $264.44 | 20 |
| Nerve conduction studies 13+ CPT 95913 | $5,184.80 | $6,481.00 | $288.19 – $896.79 | 20 |
| Nerve conduction studies 3-4 CPT 95908 | $413.60 | $517.00 | $110.75 – $526.31 | 20 |
| Nerve conduction studies 5-6 CPT 95909 | $552.80 | $691.00 | $132.75 – $526.31 | 20 |
| Nerve conduction studies 9-10 CPT 95911 | $1,754.40 | $2,193.00 | $211.92 – $896.79 | 20 |
| Neurolysis celiac plexus CPT 64680 | $2,220.00 | $2,775.00 | $91.88 – $1,504.72 | 20 |
| Neurolysis trigeminal nerve CPT 64600 | $3,140.00 | $3,925.00 | $91.88 – $1,504.72 | 20 |
| Neuromuscular junction testing ea nerve any 1 method CPT 95937 | $82.40 | $103.00 | $15.28 – $264.44 | 20 |
| New Patient Office Visit (level 2) CPT 99202 | $546.40 | $683.00 | $50.00 – $217.81 | 18 |
| New Patient Office Visit (level 3) CPT 99203 | $296.80 | $371.00 | $50.00 – $217.81 | 18 |
| New Patient Office Visit (level 4) CPT 99204 | $386.40 | $483.00 | $50.00 – $217.81 | 18 |
| New Patient Office Visit (level 5) CPT 99205 | $692.80 | $866.00 | $50.00 – $217.81 | 17 |
| Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 | $889.40 | $1,111.75 | $14.60 – $63.00 | 10 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $225.40 | $281.75 | $1.47 – $4.97 | 10 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,713.60 | $2,142.00 | $148.75 – $2,259.58 | 21 |
| Nm imaging bone/joint whole body CPT 78306 | $1,713.60 | $2,142.00 | $76.88 – $2,259.58 | 21 |
| Nm imaging gastric emptying study CPT 78264 | $1,713.60 | $2,142.00 | $123.75 – $2,259.58 | 21 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $1,713.60 | $2,142.00 | $48.75 – $2,259.58 | 21 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $2,225.60 | $2,782.00 | $372.27 – $2,961.19 | 21 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $2,225.60 | $2,782.00 | $86.25 – $2,961.19 | 21 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $1,713.60 | $2,142.00 | $223.39 – $2,259.58 | 21 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $1,092.00 | $1,365.00 | $47.24 – $1,362.98 | 21 |
| No pt prsnt train initial 30 HCPCS G0541 | $201.60 | $252.00 | $32.81 – $76.55 | 15 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $4,364.80 | $5,456.00 | $1,250.00 – $3,400.00 | 20 |
| Nsl/sins ndsc sphn tiss rmvl CPT 31259 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Nsl/sins ndsc total CPT 31253 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $4,527.20 | $5,659.00 | $355.61 – $977.71 | 20 |
| Ntsty modul rad tx dlvr smpl CPT 77385 | $4,527.20 | $5,659.00 | $336.00 – $977.71 | 20 |
| Nuclear Stress Test (Heart) CPT 78452 | $6,240.00 | $7,800.00 | $347.92 – $7,779.35 | 21 |
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.