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 |
|---|---|---|---|---|
| Platelet aggregation each agent teg CPT 85576 | $240.00 | $300.00 | $25.16 – $113.09 | 23 |
| Platelet automated CPT 85049 | $64.80 | $81.00 | $3.00 – $20.34 | 23 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $622.40 | $778.00 | $30.00 – $195.26 | 20 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $1,183.20 | $1,479.00 | $30.00 – $318.87 | 20 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $2,944.00 | $3,680.00 | $30.00 – $756.22 | 20 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $3,188.00 | $3,985.00 | $30.00 – $1,048.96 | 20 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $5,962.40 | $7,453.00 | $312.10 – $848.91 | 7 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $1,201.60 | $1,502.00 | $87.83 – $1,189.18 | 20 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $600.80 | $751.00 | $44.26 – $120.39 | 7 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $318.40 | $398.00 | $38.05 – $526.31 | 20 |
| Plmt biliary drainage cath CPT 47534 | $6,028.00 | $7,535.00 | $414.19 – $1,126.59 | 7 |
| Pm device progr eval dual CPT 93280 | $357.60 | $447.00 | $15.27 – $129.40 | 20 |
| Pm device progr eval multi CPT 93281 | $392.80 | $491.00 | $17.64 – $150.08 | 20 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $108.00 | $135.00 | $26.33 – $118.36 | 23 |
| Potassium 24 hour urine CPT 84133 | $20.00 | $25.00 | $4.78 – $21.47 | 23 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $71.60 | $89.50 | $0.11 – $3.68 | 10 |
| Potassium serum/plasma/whole blood CPT 84132 | $25.60 | $32.00 | $4.81 – $21.61 | 23 |
| Ppp2r2b gen detc abnor allel CPT 81343 | $569.60 | $712.00 | $68.50 – $621.98 | 19 |
| Pq dr cath chg w cont s&i CPT 75984 | $753.60 | $942.00 | $12.50 – $59.50 | 7 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Pq thr inj ext pse CPT 36002 | $724.80 | $906.00 | $129.16 – $1,044.96 | 20 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Pr application of long arm splint CPT 29105 | $685.60 | $857.00 | $41.88 – $266.68 | 20 |
| Pr application splint static short arm CPT 29125 | $660.80 | $826.00 | $32.50 – $217.86 | 20 |
| Pr biopsy skin punch single lesion CPT 11104 | $617.60 | $772.00 | $50.53 – $675.27 | 20 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Pr correction hammertoe CPT 28285 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $51.20 | $64.00 | $22.34 – $50.35 | 15 |
| Prcrd drg 6+yr without anomly CPT 33017 | $2,207.20 | $2,759.00 | $228.24 – $683.64 | 12 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $368.80 | $461.00 | $39.42 – $335.83 | 20 |
| Prealbumin CPT 84134 | $60.80 | $76.00 | $14.74 – $68.54 | 23 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $688.00 | $860.00 | $0.69 – $123.55 | 10 |
| Prednisone 1 mg tablet HCPCS J7512 | $9.00 | $11.25 | $0.01 – $4.51 | 10 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $1,019.20 | $1,274.00 | $58.13 – $602.31 | 22 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $873.60 | $1,092.00 | $47.99 – $602.31 | 22 |
| Pressure max expiratory/inspiratory CPT 94799 | $400.80 | $501.00 | $117.35 – $264.44 | 15 |
| Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 | not published | not published | $1,564.83 – $8,754.00 | 2 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $1,564.83 – $5,627.00 | 2 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $796.00 | $995.00 | $125.00 – $675.27 | 17 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $291.20 | $364.00 | $13.17 – $109.48 | 20 |
| Prgrmg dev eval scrms ip CPT 93285 | $172.80 | $216.00 | $12.13 – $92.28 | 20 |
| Prgrmg eval implantable dfb CPT 93282 | $414.40 | $518.00 | $15.80 – $138.38 | 20 |
| Prgrmg eval implantable dfb CPT 93283 | $463.20 | $579.00 | $18.16 – $177.96 | 20 |
| Prgrmg eval implantable dfb CPT 93284 | $504.80 | $631.00 | $20.78 – $199.17 | 20 |
| Prgr stim/pace a/iv drug CPT 93623 | $1,677.60 | $2,097.00 | $236.25 – $642.60 | 2 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $9,149.60 | $11,437.00 | $459.85 – $17,956.72 | 3 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $1,264.80 | $1,581.00 | $65.63 – $5,627.00 | 22 |
| Pr incision & drainage abscess simple/single CPT 10060 | $1,147.20 | $1,434.00 | $29.38 – $335.83 | 20 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $1,056.00 | $1,320.00 | $117.26 – $514.13 | 20 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $1,131.20 | $1,414.00 | $38.13 – $5,627.00 | 22 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $230.40 | $288.00 | $12.38 – $33.66 | 7 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Procalcitonin CPT 84145 | $136.00 | $170.00 | $22.21 – $123.58 | 23 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $34.40 | $43.00 | $1.81 – $10.22 | 10 |
| Proctosigmoidoscopy dx 45300 CPT 45300 | not published | not published | $444.66 – $5,627.00 | 14 |
| Proctosigmoidoscopy w/bx 45305 CPT 45305 | not published | not published | $1,150.15 – $5,627.00 | 14 |
| Progesterone CPT 84144 | $86.40 | $108.00 | $17.00 – $94.70 | 23 |
| Prolactin CPT 84146 | $80.80 | $101.00 | $19.57 – $87.99 | 23 |
| Promethazine hcl injection HCPCS J2550 | $22.40 | $28.00 | $2.95 – $11.59 | 10 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $118.80 | $148.50 | $1.80 – $28.80 | 10 |
| Prostate biopsy, any mthd HCPCS G0416 | $208.80 | $261.00 | $42.50 – $1,575.43 | 19 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $285.00 | $356.25 | $8.50 – $131.20 | 10 |
| Protein c activity CPT 85303 | $232.80 | $291.00 | $13.98 – $64.97 | 23 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $40.00 | $56.00 | $10.85 – $49.81 | 23 |
| Protein s total CPT 85305 | $168.00 | $210.00 | $11.73 – $54.47 | 23 |
| Protein total 24 hour urine CPT 84156 | $15.20 | $19.00 | $3.71 – $16.66 | 23 |
| Protein total body fluid CPT 84157 | $16.80 | $21.00 | $4.04 – $18.16 | 23 |
| Protein total serum plasma whole blood CPT 84155 | $15.20 | $19.00 | $3.71 – $16.66 | 23 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $16.80 | $21.00 | $3.98 – $18.46 | 23 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Prq cardiac angio addl art CPT 92921 | $8,116.00 | $10,145.00 | $144.78 – $393.79 | 2 |
| Prq trluml c angiop 1art&/br CPT 92920 | $27,389.60 | $34,237.00 | $542.24 – $5,701.52 | 3 |
| Prq trluml revsc ch occ ant CPT 92943 | $34,973.60 | $43,717.00 | $674.98 – $11,340.57 | 3 |
| Pr removal drug delivery implant CPT 11982 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $712.80 | $891.00 | $37.50 – $217.86 | 20 |
| Pr removal intrauterine device CPT 58301 | $1,265.60 | $1,582.00 | $21.56 – $6,190.00 | 22 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $1,177.60 | $1,472.00 | $41.25 – $5,627.00 | 22 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $1,152.00 | $1,440.00 | $39.38 – $335.83 | 20 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $1,177.60 | $1,472.00 | $59.38 – $335.83 | 20 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $1,152.00 | $1,440.00 | $30.63 – $335.83 | 20 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $1,177.60 | $1,472.00 | $44.38 – $335.83 | 20 |
| Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 | not published | not published | $1,784.34 – $8,754.00 | 14 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $1,950.40 | $2,438.00 | $166.20 – $452.06 | 7 |
| PSA (Prostate) Test CPT 84153 | $45.00 | $96.00 | $18.57 – $83.49 | 23 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $140.00 | $175.00 | $13.64 – $56.80 | 20 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $165.60 | $207.00 | $13.26 – $56.80 | 20 |
| Pt evaluation high complexity patient/family CPT 97163 | $534.40 | $668.00 | $56.80 – $216.27 | 20 |
| Pt evaluation low complexity patient/family CPT 97161 | $464.00 | $580.00 | $56.80 – $216.27 | 20 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $505.60 | $632.00 | $56.80 – $216.27 | 20 |
| Pt re-evaluation patient/family CPT 97164 | $293.60 | $367.00 | $53.90 – $146.61 | 20 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $157.60 | $197.00 | $39.85 – $69.74 | 19 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $148.80 | $186.00 | $27.47 – $56.80 | 20 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $176.00 | $220.00 | $28.13 – $56.95 | 20 |
| Pt wheelchair management each 15 minutes CPT 97542 | $188.80 | $236.00 | $29.32 – $56.80 | 19 |
| Pulse ox continuous overnight monitoring CPT 94762 | $180.80 | $226.00 | $78.23 – $264.44 | 16 |
| Pulse ox multiple CPT 94761 | $109.60 | $137.00 | $4.83 – $13.12 | 7 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $206.40 | $258.00 | $16.25 – $217.86 | 20 |
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.