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 |
|---|---|---|---|---|
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $634.40 | $793.00 | $30.00 – $675.27 | 20 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,463.20 | $1,829.00 | $52.50 – $1,170.47 | 20 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $115.20 | $144.00 | $6.05 – $44.00 | 10 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,713.60 | $2,142.00 | $148.38 – $2,259.58 | 21 |
| Quest t3 uptake CPT 84479 | $26.40 | $33.00 | $6.53 – $30.43 | 23 |
| Rabies ig ht&sol human im/sc CPT 90377 | $1,850.40 | $2,313.00 | $25.00 – $2,795.52 | 24 |
| Radiation physics consult CPT 77336 | $1,289.60 | $1,612.00 | $61.25 – $224.40 | 20 |
| Radiation therapy dose plan CPT 77300 | $1,289.60 | $1,612.00 | $26.88 – $224.40 | 20 |
| Radiation treatment aid(s) CPT 77332 | $1,360.00 | $1,700.00 | $40.63 – $224.40 | 20 |
| Radiation treatment aid(s) CPT 77334 | $2,216.80 | $2,771.00 | $68.75 – $618.71 | 20 |
| Radiation treatment delivery CPT 77412 | $1,647.20 | $2,059.00 | $55.00 – $444.48 | 20 |
| Radiology port images(s) CPT 77417 | $630.40 | $788.00 | $16.15 – $43.93 | 7 |
| Radiotherapy dose plan imrt CPT 77301 | $7,141.60 | $8,927.00 | $884.78 – $3,673.39 | 20 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $4,720.00 | $5,900.00 | $393.88 – $7,779.35 | 21 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $4,720.00 | $5,900.00 | $277.74 – $7,779.35 | 21 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $4,331.80 | $5,414.75 | $445.19 – $3,889.83 | 24 |
| Rbc count only automated CPT 85041 | $12.80 | $16.00 | $3.05 – $13.71 | 23 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Reconstruction of lower jaw CPT 21244 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Reconstruction of nose CPT 30420 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $1,181.60 | $1,477.00 | $30.00 – $282.56 | 20 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $1,409.60 | $1,762.00 | $30.00 – $397.13 | 20 |
| Red blood cells washed each unit HCPCS P9022 | $1,728.80 | $2,161.00 | $30.00 – $616.14 | 20 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $1,167.40 | $1,459.25 | $12.00 – $61.74 | 10 |
| Release finger contracture CPT 26525 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Relocation skin pocket pm CPT 33222 | $4,170.40 | $5,213.00 | $414.00 – $3,091.67 | 17 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $4,029.60 | $5,037.00 | $7.94 – $2,250.18 | 24 |
| Rem endovas vena cava filter CPT 37193 | $5,162.40 | $6,453.00 | $369.78 – $1,005.79 | 2 |
| Rem interrog evl pm/ids CPT 93296 | $234.40 | $293.00 | $24.99 – $67.97 | 20 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $2,853.60 | $3,567.00 | $162.94 – $1,044.96 | 20 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $2,996.00 | $3,745.00 | $230.11 – $6,190.00 | 9 |
| Removal cerclage without anes CPT 59899 | $192.80 | $241.00 | $150.88 – $340.01 | 15 |
| Removal cerumen impacted (both sides) CPT 69210 | $366.40 | $458.00 | $25.00 – $5,627.00 | 22 |
| Removal foreign body foot subcutaneous right CPT 28190 | $2,124.00 | $2,655.00 | $38.13 – $1,189.18 | 20 |
| Removal of adenoids CPT 42830 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Removal of adenoids CPT 42831 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Removal of adenoids CPT 42836 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Removal of breast lesion CPT 19120 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Removal of finger lesion CPT 26210 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Removal of foot lesion CPT 28080 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Removal of foot lesion CPT 28090 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Removal of heel bone CPT 28118 | not published | not published | $6,899.41 – $12,504.00 | 2 |
| Removal of implant deep CPT 20680 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Removal of intranasal lesion CPT 30117 | not published | not published | $3,132.16 – $10,638.00 | 2 |
| Removal of neck wrinkles CPT 15825 | not published | not published | $3,571.12 – $10,638.00 | 14 |
| Removal of nose polyp(s) 30115 CPT 30115 | not published | not published | $3,132.16 – $8,754.00 | 2 |
| Removal of skin wrinkles CPT 15829 | not published | not published | $3,571.12 – $14,381.00 | 14 |
| Removal of testis CPT 54530 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Removal of thyroid CPT 60240 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Removal of toe lesions CPT 28092 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Removal of toe lesions CPT 28108 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Removal/replacement ppm generator dual lead system CPT 33228 | $18,232.80 | $22,791.00 | $351.68 – $10,465.33 | 3 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $410.40 | $513.00 | $38.75 – $5,627.00 | 22 |
| Remove anal fist subq CPT 46270 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Remove ear canal lesion(s) CPT 69145 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Remove ext hem groups 2+ CPT 46250 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Remove femur lesion/bursa CPT 27062 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Remove in/ex hem groups 2+ CPT 46260 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Remove intact mammary implant CPT 19328 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Remove int/ext hem 1 group CPT 46255 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Remove mandible cyst complex CPT 21046 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Remove nasal foreign body CPT 30310 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Remove pilonidal cyst compl CPT 11772 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Remove pilonidal cyst exten CPT 11771 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Remove prostate regrowth CPT 52630 | not published | not published | $4,909.76 – $8,754.00 | 2 |
| Remove renal tube w/fluoro CPT 50389 | $1,044.80 | $1,306.00 | $56.48 – $153.61 | 7 |
| Remove spine eltrd perq aray CPT 63661 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Remove spine eltrd plate CPT 63662 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Remove spine lamieieiotina >2 crvcl 63015 CPT 63015 | not published | not published | $15,634.00 – $15,634.00 | 1 |
| Remove spine lamina 1/2 crvl CPT 63001 | not published | not published | $15,634.00 – $15,634.00 | 1 |
| Remove spine lamina >2 lmbr CPT 63017 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Remove thyroid duct lesion CPT 60280 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Remove thyroid lesion 60200 CPT 60200 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Remove tonsils and adenoids CPT 42820 | not published | not published | $5,713.34 – $10,638.00 | 2 |
| Remove tonsils and adenoids CPT 42821 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Remove ventilating tube CPT 69424 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Renal function panel CPT 80069 | $36.00 | $45.00 | $8.77 – $39.41 | 23 |
| Repair achilles tendon CPT 27650 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Repair biceps tendon CPT 23430 | not published | not published | $12,504.00 – $17,761.11 | 2 |
| Repair bladder defect CPT 57288 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Repair eardrum structures CPT 69631 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Repair extns tendon finger without grft ea CPT 26418 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Repair foot dislocation CPT 28615 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Repair ing hernia sliding CPT 49525 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $2,312.80 | $2,891.00 | $460.33 – $1,252.08 | 7 |
| Repair nasal stenosis CPT 30465 | not published | not published | $5,713.34 – $17,510.00 | 2 |
| Repair of achilles tendon CPT 27654 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Repair of ankle ligament CPT 27698 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Repair of ankle ligaments CPT 27696 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Repair of foot tendon CPT 28200 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Repair of leg tendon each CPT 27659 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Repair of nasal septum CPT 30520 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Repair of shoulder CPT 23420 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Repair palate pharynx/uvula CPT 42145 | not published | not published | $5,713.34 – $14,381.00 | 2 |
| Repair pm/icd lead sgl CPT 33218 | $4,884.80 | $6,106.00 | $455.53 – $6,150.97 | 17 |
| Repair radius or ulna CPT 25400 | not published | not published | $10,638.00 – $10,638.00 | 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.