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 |
|---|---|---|---|---|
| Repair rotator cuff acute CPT 23410 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Repair rotator cuff chronic CPT 23412 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $1,176.00 | $1,470.00 | $311.16 – $860.70 | 20 |
| Repair shoulder capsule CPT 23460 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Repair toe dislocation CPT 28645 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Replace duod/jej tube perc CPT 49451 | $1,540.00 | $1,925.00 | $87.91 – $1,584.63 | 20 |
| Replace g/c tube perc CPT 49450 | $1,808.80 | $2,261.00 | $63.88 – $1,584.63 | 20 |
| Reposition pm/icd lead CPT 33215 | $4,572.00 | $5,715.00 | $360.00 – $3,147.50 | 3 |
| Rerepair ing hernia blocked CPT 49521 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rerepair ing hernia reduce CPT 49520 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Resect inferior turbinate CPT 30140 | not published | not published | $5,713.34 – $8,754.00 | 2 |
| Resp virus 6-11 targets CPT 87632 | $907.20 | $1,134.00 | $220.24 – $989.99 | 23 |
| Resuscitation cardiopulmonary CPT 92950 | $1,253.60 | $1,567.00 | $233.55 – $526.31 | 15 |
| Resuscitation delivery/birthing room CPT 99465 | $2,302.40 | $2,878.00 | $113.73 – $1,106.00 | 16 |
| Reticulated platelet assay CPT 85055 | $148.80 | $186.00 | $29.93 – $162.26 | 23 |
| Reticulocyte direct measurement automated CPT 85046 | $63.20 | $79.00 | $5.63 – $25.29 | 23 |
| Revasc intra lithotrip-stent HCPCS C9765 | $22,022.40 | $27,528.00 | $13,467.54 – $17,956.72 | 2 |
| Revasc intravasc lithotripsy HCPCS C9764 | $10,652.80 | $13,316.00 | $8,505.43 – $11,340.57 | 2 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $5,476.00 | $6,845.00 | $589.13 – $8,505.43 | 2 |
| Revise arm/leg nerve CPT 64708 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Revise kneecap with implant CPT 27438 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Revise lower leg tendon CPT 27691 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Revise spine eltrd plate CPT 63664 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Revision of bladder neck CPT 52500 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Revision of calf tendon CPT 27687 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Revision of cervix CPT 57720 | $4,396.80 | $5,496.00 | $243.75 – $663.00 | 3 |
| Revision of cervix CPT 59320 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Revision of collar bone CPT 23485 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Revision of foot fascia 28250 CPT 28250 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Revision of foot tendon CPT 28238 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Revision of knee joint CPT 27446 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Rev-rem impl neurostim gen-rec CPT 63688 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Rheumatoid factor quantitative CPT 86431 | $23.20 | $29.00 | $5.73 – $26.28 | 23 |
| Rho d immune globulin inj HCPCS J2790 | $456.00 | $570.00 | $82.58 – $276.13 | 10 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $42,608.80 | $53,261.00 | $381.23 – $22,446.19 | 3 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $59,126.40 | $73,908.00 | $395.83 – $32,061.58 | 3 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $19,912.00 | $24,890.00 | $366.64 – $22,446.19 | 3 |
| Rmvl icd pulse gen only CPT 33241 | $4,956.80 | $6,196.00 | $215.23 – $6,150.97 | 16 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $1,156.80 | $1,446.00 | $160.21 – $1,044.96 | 17 |
| Rmvl perm pm pulse gen CPT 33233 | $13,512.80 | $16,891.00 | $291.28 – $8,275.98 | 3 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $32,476.00 | $40,595.00 | $366.28 – $19,071.16 | 3 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $13,512.80 | $16,891.00 | $337.09 – $8,275.98 | 3 |
| Rmvl subq card rhythm mntr CPT 33286 | $1,464.00 | $1,830.00 | $90.36 – $1,189.18 | 16 |
| Rmvl tv pm lead dual CPT 33235 | $24,584.80 | $30,731.00 | $456.55 – $6,150.97 | 16 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $237.40 | $296.75 | $1.84 – $28.80 | 10 |
| Rplcmt oi implt skl prq esp CPT 69717 | not published | not published | $35,016.00 – $35,016.00 | 1 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $4,720.00 | $5,900.00 | $406.85 – $7,779.35 | 21 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $5,280.00 | $6,600.00 | $797.47 – $8,570.95 | 21 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $727.20 | $909.00 | $81.42 – $221.48 | 7 |
| Rpl tun cvc wo subq port CPT 36581 | $4,105.60 | $5,132.00 | $232.36 – $632.03 | 7 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $3,408.37 – $14,381.00 | 2 |
| Rubella antibody igg CPT 86762 | $60.00 | $75.00 | $14.53 – $66.78 | 23 |
| Rubeola antibody igg CPT 86765 | $53.60 | $67.00 | $11.80 – $58.48 | 23 |
| Russell viper venom diluted CPT 85613 | $295.20 | $369.00 | $9.68 – $43.49 | 23 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,608.80 | $2,011.00 | $149.17 – $620.33 | 20 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $1,065.60 | $1,332.00 | $98.25 – $445.40 | 20 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,608.80 | $2,011.00 | $113.28 – $414.63 | 20 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $303.20 | $379.00 | $98.25 – $339.15 | 20 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $555.20 | $694.00 | $103.73 – $469.44 | 20 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $709.60 | $887.00 | $98.25 – $339.32 | 20 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,356.80 | $1,696.00 | $149.17 – $499.15 | 20 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $919.20 | $1,149.00 | $98.25 – $330.34 | 20 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $983.20 | $1,229.00 | $98.25 – $317.70 | 20 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $960.80 | $1,201.00 | $1,215.18 – $1,215.18 | 1 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $117.60 | $147.00 | $19.00 – $128.35 | 23 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $206.40 | $258.00 | $19.00 – $210.43 | 23 |
| Screening Mammogram CPT 77067 | $225.00 | $427.00 | $83.89 – $521.53 | 23 |
| Screening prostate cancer PSA HCPCS G0103 | $45.00 | $101.00 | $19.50 – $87.67 | 23 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $244.00 | $305.00 | $4.00 – $4.00 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $20.00 | $86.00 | $2.73 – $20.00 | 24 |
| Semen analysis presence/motility CPT 89321 | $49.60 | $62.00 | $9.04 – $54.71 | 18 |
| Serpina1 gene CPT 81332 | $181.60 | $227.00 | $44.09 – $198.17 | 20 |
| Set radiation therapy field CPT 77280 | $1,868.80 | $2,336.00 | $45.63 – $224.40 | 20 |
| Set radiation therapy field CPT 77290 | $2,904.00 | $3,630.00 | $90.63 – $618.71 | 20 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Shoulder MRI (with and without contrast) CPT 73223 | $712.50 | $2,544.00 | $348.37 – $2,106.92 | 23 |
| Shoulder MRI (with contrast) CPT 73222 | $645.50 | $2,250.00 | $384.69 – $4,386.56 | 23 |
| Shoulder MRI (without contrast) CPT 73221 | $461.50 | $2,225.00 | $235.78 – $1,342.45 | 23 |
| Shoulder X-ray CPT 73030 | $398.40 | $498.00 | $20.63 – $497.84 | 22 |
| Sialolithotomy 42330 CPT 42330 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Sickling rbc CPT 85660 | $33.60 | $42.00 | $3.00 – $25.02 | 23 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $889.34 – $5,627.00 | 14 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $444.66 – $5,627.00 | 14 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $1,150.15 – $5,627.00 | 14 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $1,150.15 – $5,627.00 | 14 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $631.60 | $789.50 | $123.36 – $501.41 | 10 |
| Sinus CT scan (with and without contrast) CPT 70488 | $568.00 | $2,645.00 | $125.00 – $1,006.60 | 23 |
| Sinus CT scan (with contrast) CPT 70487 | $494.00 | $2,362.00 | $100.00 – $1,006.60 | 23 |
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.