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 |
|---|---|---|---|---|
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $275.20 | $344.00 | $65.00 – $6,190.00 | 19 |
| Cath stripping venous s&i CPT 75901 | $1,003.20 | $1,254.00 | $134.93 – $134.93 | 1 |
| Cauterization chemical granulation tissue CPT 17250 | $183.20 | $229.00 | $32.27 – $335.83 | 20 |
| Cdna analysis for variants CPT 81403 | $605.60 | $757.00 | $92.60 – $840.81 | 19 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $46.00 | $57.50 | $0.80 – $2.91 | 10 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $103.40 | $129.25 | $2.44 – $8.40 | 10 |
| Cefotaxime sodium injection HCPCS J0698 | $1,864.80 | $2,331.00 | $22.78 – $35.00 | 2 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $1,494.40 | $1,868.00 | $4.99 – $848.31 | 24 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $39.80 | $49.75 | $3.14 – $11.20 | 10 |
| Ceftazidime and avibactam HCPCS J0714 | $2,446.60 | $3,058.25 | $123.50 – $1,407.00 | 24 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $29.60 | $37.00 | $1.72 – $6.86 | 10 |
| Cell count body fluid CPT 89050 | $20.00 | $25.00 | $4.50 – $21.43 | 23 |
| Cell count w differential body fluid CPT 89051 | $23.20 | $29.00 | $5.66 – $25.42 | 23 |
| #cf-97variants CPT 81220 | $739.20 | $924.00 | $445.28 – $2,526.96 | 20 |
| Change cystostomy tube; complex 51710 CPT 51710 | $1,457.60 | $1,822.00 | $35.00 – $95.20 | 7 |
| Change cystostomy tube simple CPT 51705 | $1,261.60 | $1,577.00 | $35.00 – $411.06 | 20 |
| Change g-tube to g-j perc CPT 49446 | $2,888.00 | $3,610.00 | $157.30 – $427.86 | 7 |
| Change nephroureteral cath CPT 50387 | $3,511.20 | $4,389.00 | $102.36 – $278.43 | 7 |
| Change of windpipe airway 31502 CPT 31502 | $1,248.00 | $1,560.00 | $116.11 – $5,627.00 | 18 |
| Chest apical lordotic proj CPT 71047 | $416.00 | $520.00 | $23.63 – $497.84 | 22 |
| Chest CT scan (with and without contrast) CPT 71270 | $562.00 | $2,645.00 | $129.38 – $1,006.60 | 23 |
| Chest CT scan (with contrast) CPT 71260 | $470.00 | $2,362.00 | $109.38 – $1,006.60 | 23 |
| Chest CT scan (without contrast) CPT 71250 | $285.00 | $1,610.00 | $103.73 – $602.31 | 23 |
| Chest X-ray CPT 71046 | $322.40 | $403.00 | $18.57 – $497.84 | 22 |
| Chest X-ray (single view) CPT 71045 | $292.80 | $366.00 | $10.14 – $497.84 | 22 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $479.20 | $599.00 | $70.01 – $1,006.60 | 21 |
| Chloride CPT 82435 | $19.20 | $24.00 | $4.65 – $21.56 | 23 |
| Chloride 24 hour urine CPT 82436 | $24.00 | $30.00 | $5.81 – $26.11 | 23 |
| Chloroprocaine hcl injection HCPCS J2401 | $179.40 | $224.25 | $24.00 – $84.00 | 10 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $243.40 | $304.25 | $25.27 – $101.64 | 10 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $8,569.60 | $10,712.00 | $236.25 – $642.60 | 2 |
| Cholesterol CPT 82465 | $18.40 | $23.00 | $4.39 – $20.43 | 23 |
| Cholesterol (Lipid) Test CPT 80061 | $40.00 | $70.00 | $13.52 – $60.79 | 24 |
| Chromatography CPT 83021 | $75.20 | $94.00 | $18.24 – $81.99 | 23 |
| Chromo high res and frag x - sendout CPT 81243 | $236.80 | $296.00 | $45.63 – $258.96 | 20 |
| Chromosome analysis 15-20 cell count CPT 88262 | $521.60 | $652.00 | $126.74 – $585.65 | 23 |
| Chromosome karyotype study CPT 88280 | $139.20 | $174.00 | $33.80 – $151.95 | 23 |
| Cilastatin sodium injection HCPCS J0743 | $98.00 | $122.50 | $14.48 – $68.53 | 10 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $86.00 | $107.50 | $4.82 – $19.38 | 10 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $433.60 | $542.00 | $160.00 – $435.20 | 7 |
| Circumcision (newborn) CPT 54150 | $392.80 | $491.00 | $98.75 – $268.60 | 7 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $876.80 | $1,096.00 | $263.61 – $1,495.98 | 23 |
| Clearance of airways CPT 31720 | $456.80 | $571.00 | $41.25 – $343.75 | 20 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $137.40 | $171.75 | $1.73 – $6.11 | 10 |
| Cllr miami j sm HCPCS L0174 | $248.80 | $311.00 | $177.98 – $541.59 | 16 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $1,480.00 | $1,850.00 | $231.25 – $629.00 | 7 |
| Closed tx humerus fx without manip 23600 CPT 23600 | $952.80 | $1,191.00 | $145.63 – $405.44 | 20 |
| Closed tx septal&nose fx CPT 21337 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Closure paravalvlr leak pq CPT 33999 | $3,972.00 | $4,965.00 | $463.70 – $1,044.96 | 15 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $1,649.60 | $2,062.00 | $123.75 – $405.44 | 20 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $1,870.40 | $2,338.00 | $150.63 – $409.70 | 20 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $2,233.60 | $2,792.00 | $88.13 – $405.44 | 20 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $1,792.00 | $2,240.00 | $60.00 – $405.44 | 20 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $1,023.20 | $1,279.00 | $198.75 – $540.60 | 20 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $882.40 | $1,103.00 | $66.25 – $405.44 | 20 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $2,828.80 | $3,536.00 | $493.75 – $1,343.00 | 7 |
| Clsd tx fracture of radius 25500 CPT 25500 | $824.00 | $1,030.00 | $98.13 – $405.44 | 20 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $2,392.80 | $2,991.00 | $83.13 – $405.44 | 20 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $1,635.20 | $2,044.00 | $143.13 – $405.44 | 20 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $2,496.80 | $3,121.00 | $207.50 – $564.40 | 7 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $956.00 | $1,195.00 | $250.63 – $681.70 | 7 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $1,852.00 | $2,315.00 | $196.25 – $533.80 | 20 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $3,321.60 | $4,152.00 | $234.00 – $805.80 | 20 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $624.00 | $780.00 | $154.38 – $419.90 | 20 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $1,172.80 | $1,466.00 | $86.88 – $405.44 | 20 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $1,435.20 | $1,794.00 | $132.50 – $405.44 | 20 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $1,141.60 | $1,427.00 | $147.50 – $405.44 | 20 |
| Clsd tx/metatarsal fx without manip 28470 CPT 28470 | $1,834.40 | $2,293.00 | $105.63 – $405.44 | 20 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $2,442.40 | $3,053.00 | $127.50 – $405.44 | 20 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $2,789.60 | $3,487.00 | $246.25 – $669.80 | 7 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $1,406.40 | $1,758.00 | $70.00 – $405.44 | 20 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $1,159.20 | $1,449.00 | $36.23 – $405.44 | 20 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,842.40 | $2,303.00 | $298.75 – $812.60 | 7 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $1,697.60 | $2,122.00 | $135.00 – $405.44 | 20 |
| Cmv pcr-sendout CPT 87496 | $145.60 | $182.00 | $35.44 – $159.31 | 23 |
| Coagulation time activated teg CPT 85347 | $25.60 | $32.00 | $4.32 – $19.43 | 23 |
| Cocaine 4 % nasal solution HCPCS C9046 | $1,018.20 | $1,272.75 | $963.20 – $963.20 | 1 |
| Cold agglutinin titer CPT 86157 | $33.60 | $42.00 | $8.14 – $37.88 | 23 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $75.20 | $94.00 | $18.75 – $55.13 | 16 |
| Collar cerv patriot adlt HCPCS L0150 | $160.80 | $201.00 | $112.84 – $306.92 | 16 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $100.00 | $380.00 | $96.68 – $193.27 | 13 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $100.00 | $395.00 | $96.68 – $193.27 | 13 |
| Collection of venous blood by venipuncture CPT 36415 | $5.00 | $26.00 | $5.00 – $26.49 | 17 |
| Colonoscopy (diagnostic) CPT 45378 | not published | not published | $444.66 – $8,754.00 | 14 |
| Colonoscopy submucous njx CPT 45381 | not published | not published | $575.07 – $8,754.00 | 14 |
| Colonoscopy w/balloon dilat CPT 45386 | not published | not published | $1,150.15 – $8,754.00 | 14 |
| Colonoscopy w/injection CPT 44404 | not published | not published | $1,150.15 – $5,627.00 | 14 |
| Colonoscopy (with biopsy) CPT 45380 | not published | not published | $1,150.15 – $8,754.00 | 14 |
| Colonoscopy (with polyp removal) CPT 45385 | not published | not published | $575.07 – $8,754.00 | 14 |
| Colonoscopy w/resection CPT 45390 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Colpocleisis (le forte type) 57120 CPT 57120 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Colpopexy extraperitoneal CPT 57282 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $653.60 | $817.00 | $21.00 – $488.22 | 21 |
| Compatibility test each unit electronic CPT 86923 | $653.60 | $817.00 | $21.00 – $488.22 | 21 |
| Compatibility test each unit immediate spin technique CPT 86920 | $653.60 | $817.00 | $21.00 – $488.22 | 21 |
| Comp cystometrogram/void presssure 51728 CPT 51728 | $1,459.20 | $1,824.00 | $175.50 – $767.21 | 7 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | $2,174.40 | $2,718.00 | $180.72 – $841.06 | 7 |
| Complement antigen each component c3 CPT 86160 | $49.60 | $62.00 | $12.12 – $56.41 | 23 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | not published | not published | $597.11 – $8,754.00 | 14 |
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.