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 |
|---|---|---|---|---|
| Observation direct referral from physician office for admission HCPCS G0379 | $596.80 | $746.00 | $459.83 – $1,036.23 | 15 |
| Observation per hour HCPCS G0378 | $251.20 | $314.00 | $3,417.89 – $3,417.89 | 1 |
| Obstetric panel inc HIV tstg CPT 80081 | $230.00 | $389.00 | $75.61 – $339.86 | 23 |
| Obstetrics panel CPT 80055 | $190.00 | $249.00 | $12.00 – $217.06 | 23 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $32.40 | $40.50 | $2.44 – $8.26 | 10 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $328.00 | $410.00 | $132.43 – $360.20 | 2 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $139.60 | $174.50 | $17.44 – $65.10 | 10 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $16.40 | $20.50 | $0.36 – $10.78 | 10 |
| Open bx/exc inguinofem nodes CPT 38531 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Opn impltj nea sacral nerve CPT 64581 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Opn mpltj hpglsl nstm ary pg CPT 64582 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Optx acrclv dslc aq/chrn grf CPT 23552 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Optx medial ankle fx CPT 27766 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Organic acids total quant ea spec CPT 83918 | $98.40 | $123.00 | $22.75 – $107.14 | 23 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Ortho dvc repair per 15 min HCPCS L4205 | $158.40 | $198.00 | $30.02 – $52.54 | 15 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $392.80 | $491.00 | $220.43 – $599.56 | 16 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $542.40 | $678.00 | $210.51 – $700.39 | 16 |
| Oscillation chest wall mechanical per session CPT 94669 | $489.60 | $612.00 | $152.54 – $343.75 | 15 |
| Osmolality blood CPT 83930 | $27.20 | $34.00 | $3.00 – $30.01 | 23 |
| Osmolality urine CPT 83935 | $28.00 | $35.00 | $3.00 – $30.96 | 23 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Ot evaluation high complexity patient/family CPT 97167 | $792.00 | $990.00 | $56.80 – $209.88 | 20 |
| Ot evaluation low complexity patient/family CPT 97165 | $335.20 | $419.00 | $56.80 – $209.88 | 20 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $526.40 | $658.00 | $56.80 – $209.88 | 20 |
| Oth resp proc, indiv HCPCS G0238 | $216.00 | $270.00 | $18.37 – $41.39 | 15 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $208.00 | $260.00 | $43.32 – $76.58 | 19 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $236.80 | $296.00 | $25.94 – $71.50 | 20 |
| Otoplasty 69300 CPT 69300 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Ot re-evaluation patient/family CPT 97168 | $206.40 | $258.00 | $50.86 – $138.35 | 20 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $220.80 | $276.00 | $32.79 – $57.96 | 20 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $176.00 | $220.00 | $20.52 – $136.00 | 19 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $176.00 | $220.00 | $21.18 – $64.77 | 18 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $220.80 | $276.00 | $27.47 – $56.80 | 20 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $215.20 | $269.00 | $30.56 – $56.95 | 20 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $148.80 | $186.00 | $30.44 – $56.80 | 19 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $21.20 | $26.50 | $5.01 – $6.43 | 2 |
| Palonosetron hcl HCPCS J2469 | $115.40 | $144.25 | $3.56 – $16.80 | 10 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $118.60 | $148.25 | $9.64 – $48.58 | 10 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $24.40 | $30.50 | $16.24 – $30.53 | 2 |
| Parathormone (pth) intact CPT 83970 | $171.20 | $214.00 | $41.69 – $187.41 | 23 |
| Parathyrd planar w/spect&ct CPT 78072 | $2,225.60 | $2,782.00 | $322.69 – $2,961.19 | 21 |
| Parathyroid planar img w/tomo spect CPT 78071 | $1,713.60 | $2,142.00 | $334.39 – $2,259.58 | 21 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $294.40 | $368.00 | $25.00 – $335.83 | 20 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Partial removal finger bone CPT 26236 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Partial removal foot fascia CPT 28060 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Partial removal of foot bone CPT 28288 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Partial removal of thyroid CPT 60220 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Partial removal of thyroid CPT 60225 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Partial thyroid excision CPT 60210 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Part removal of metatarsal CPT 28110 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Passy muir valve metal trach HCPCS L8501 | $134.40 | $168.00 | $93.75 – $255.00 | 16 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $6,612.60 | $8,265.75 | $116.90 – $4,741.80 | 24 |
| Pelvic CT scan (with contrast) CPT 72193 | $475.50 | $2,362.00 | $108.13 – $1,006.60 | 23 |
| Pelvic CT scan (without contrast) CPT 72192 | $281.00 | $1,610.00 | $84.38 – $602.31 | 23 |
| Pelvic MRI (with and without contrast) CPT 72197 | $706.00 | $2,646.00 | $348.37 – $2,106.92 | 23 |
| Pelvic MRI (with contrast) CPT 72196 | $639.00 | $2,350.00 | $254.25 – $2,106.92 | 23 |
| Pelvic MRI (without contrast) CPT 72195 | $455.50 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| Pelvic Ultrasound (complete) CPT 76856 | $517.60 | $647.00 | $58.13 – $602.31 | 21 |
| Pelvic Ultrasound (limited) CPT 76857 | $468.00 | $585.00 | $23.75 – $602.31 | 22 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $2,174.60 | $2,718.25 | $35.39 – $1,204.28 | 24 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $150.80 | $188.50 | $3.97 – $14.08 | 10 |
| Penile injection CPT 54235 | $490.40 | $613.00 | $182.41 – $411.06 | 15 |
| Perc cryo ablate renal tum CPT 50593 | $13,924.80 | $17,406.00 | $7,808.42 – $7,808.42 | 1 |
| Perc d-e cor stent ather s HCPCS C9602 | $28,191.20 | $35,239.00 | $673.61 – $17,956.72 | 3 |
| Perc drug-el cor stent sing HCPCS C9600 | $27,389.60 | $34,237.00 | $602.38 – $11,340.57 | 3 |
| Percut ablate liver rf CPT 47382 | $8,124.00 | $10,155.00 | $798.67 – $2,172.40 | 7 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $887.80 | $1,109.75 | $69.11 – $293.16 | 8 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,207.20 | $2,759.00 | $242.41 – $659.36 | 7 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Pet CT skull-mid thgh initial CPT 78815 | $6,880.00 | $8,600.00 | $1,422.80 – $8,570.95 | 21 |
| Pet CT whole body initial CPT 78816 | $6,880.00 | $8,600.00 | $1,422.80 – $8,570.95 | 21 |
| Pet fdg brain metoblic eval sb CPT 78608 | $5,280.00 | $6,600.00 | $766.59 – $8,570.95 | 21 |
| Pet image w/ct lmtd CPT 78814 | $6,880.00 | $8,600.00 | $1,422.80 – $8,570.95 | 21 |
| Ph body fluid CPT 83986 | $15.20 | $19.00 | $2.00 – $16.25 | 23 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $119.40 | $149.25 | $28.39 – $103.04 | 10 |
| Phenobarbital therapeutic drug level CPT 80184 | $64.00 | $80.00 | $15.45 – $69.46 | 23 |
| Phentolaine mesylate inj HCPCS J2760 | $1,768.00 | $2,210.00 | $432.02 – $1,572.55 | 24 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $56.00 | $70.00 | $1.00 – $17.50 | 10 |
| Phenytoin total therapeutic drug level CPT 80185 | $55.20 | $69.00 | $13.00 – $60.16 | 23 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Phosphorus CPT 84100 | $15.00 | $25.00 | $4.79 – $22.27 | 23 |
| Phosphorus 24 hour urine CPT 84105 | $24.00 | $30.00 | $5.84 – $26.24 | 23 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $423.00 | $528.75 | $2.73 – $9.12 | 10 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $131.80 | $164.75 | $2.14 – $7.84 | 10 |
| Place gastrostomy tube perc CPT 49440 | $3,048.80 | $3,811.00 | $220.67 – $600.24 | 7 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,616.80 | $2,021.00 | $103.24 – $280.81 | 7 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,368.80 | $1,711.00 | $88.39 – $1,189.18 | 20 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $3,552.80 | $4,441.00 | $224.45 – $610.50 | 7 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $196.80 | $246.00 | $1,250.00 – $3,400.00 | 2 |
| Placement of seton CPT 46020 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Place non-slctv cath thoracic arta CPT 36221 | $5,274.40 | $6,593.00 | $216.77 – $589.63 | 7 |
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.