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 |
|---|---|---|---|---|
| Complex uroflowmetry (electronic) 51741 CPT 51741 | $266.40 | $333.00 | $30.00 – $526.31 | 20 |
| Composite drsg <= 16 sq in HCPCS A6203 | $37.60 | $47.00 | $3.76 – $10.23 | 3 |
| Concentration infection agents any type CPT 87015 | $27.20 | $34.00 | $6.75 – $30.33 | 23 |
| Condylomata destruction 56420 CPT 56420 | $1,744.80 | $2,181.00 | $63.13 – $340.01 | 20 |
| Conization/cerv/loop electrode exc 57522 CPT 57522 | not published | not published | $3,070.79 – $8,754.00 | 2 |
| Conization of cervix CPT 57520 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $2,221.00 | $2,776.25 | $392.06 – $1,340.12 | 24 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $261.60 | $327.00 | $20.01 – $2,457.87 | 23 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $193.60 | $242.00 | $9.74 – $239.98 | 10 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $410.40 | $513.00 | $9.38 – $488.22 | 23 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $211.20 | $264.00 | $12.95 – $503.94 | 23 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $143.20 | $179.00 | $19.63 – $368.15 | 20 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $6,960.00 | $8,700.00 | $34.38 – $17,462.81 | 8 |
| Control nosebleed pack+caut 30905 CPT 30905 | $1,115.20 | $1,394.00 | $99.38 – $270.30 | 20 |
| Control of nosebleed ant comp 30903 CPT 30903 | $1,067.20 | $1,334.00 | $50.63 – $5,627.00 | 22 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $1,040.80 | $1,301.00 | $33.75 – $5,627.00 | 22 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Coombs direct CPT 86880 | $238.40 | $298.00 | $7.43 – $89.07 | 23 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $653.60 | $817.00 | $7.90 – $256.94 | 23 |
| Copper intrauterine device HCPCS J7300 | $5,935.20 | $7,419.00 | $762.65 – $4,371.20 | 9 |
| Core ndl bx lng/med perq CPT 32408 | $2,059.20 | $2,574.00 | $151.50 – $412.08 | 7 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $21,965.60 | $27,457.00 | $2,412.31 – $3,216.41 | 2 |
| Coronary angio/lv gram/lt heart CPT 93458 | $21,966.40 | $27,458.00 | $2,412.31 – $3,216.41 | 2 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $25,355.20 | $31,694.00 | $2,412.31 – $3,216.41 | 2 |
| Coronary art/grft angio s&i CPT 93455 | $21,966.40 | $27,458.00 | $2,412.31 – $3,216.41 | 2 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $21,966.40 | $27,458.00 | $2,412.31 – $3,216.41 | 2 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Corrj halux rigdus w/implt CPT 28291 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Cortisol acth stimulation test - sendout CPT 80400 | $136.00 | $170.00 | $32.95 – $153.20 | 23 |
| Cortisol total am CPT 82533 | $68.00 | $85.00 | $12.00 – $74.00 | 23 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $182.20 | $227.75 | $25.37 – $116.90 | 10 |
| Co-treatment - group 15 mins, st CPT 92508 | $325.60 | $407.00 | $22.44 – $56.80 | 20 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $58.40 | $73.00 | $31.14 – $70.18 | 15 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $500.80 | $626.00 | $337.88 – $761.41 | 16 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $54.40 | $68.00 | $9.77 – $59.16 | 18 |
| C-peptide CPT 84681 | $86.40 | $108.00 | $21.02 – $97.75 | 23 |
| C-reactive protein CPT 86140 | $20.00 | $27.00 | $3.00 – $23.52 | 24 |
| C-reactive protein high sensitivity CPT 86141 | $54.40 | $68.00 | $10.53 – $58.79 | 23 |
| C-reactive protein, quantitative CPT 86406 | $44.00 | $55.00 | $10.75 – $49.57 | 23 |
| Create eardrum opening CPT 69436 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Creatine kinase CPT 82550 | $27.20 | $34.00 | $6.58 – $29.56 | 23 |
| Creatine kinase mb CPT 82553 | $48.00 | $60.00 | $10.08 – $52.44 | 23 |
| Creatinine CPT 82565 | $15.00 | $27.00 | $5.17 – $23.24 | 23 |
| Creatinine 24 hour urine CPT 82570 | $20.00 | $27.00 | $5.23 – $24.31 | 24 |
| Creatinine clearance urine CPT 82575 | $39.20 | $49.00 | $9.55 – $42.95 | 23 |
| #creutz-prot.,western blot CPT 84182 | $121.60 | $152.00 | $24.55 – $132.61 | 23 |
| Critical care 30-74 minutes CPT 99291 | $4,198.40 | $5,248.00 | $189.53 – $1,424.13 | 19 |
| Critical care each additional 30 minutes CPT 99292 | $567.20 | $709.00 | $93.00 – $252.96 | 6 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $59.20 | $74.00 | $5.00 – $64.20 | 23 |
| Cryoprecipitate each unit HCPCS P9012 | $328.80 | $411.00 | $47.68 – $98.69 | 15 |
| Crystal identification light microscopy CPT 89060 | $30.40 | $38.00 | $7.40 – $33.28 | 23 |
| CT 3d report other modality w/workstation CPT 76377 | $691.20 | $864.00 | $18.82 – $28.34 | 2 |
| Cta abdomen without & /or w/contrast CPT 74175 | $532.50 | $2,763.00 | $173.65 – $1,012.89 | 23 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $397.50 | $2,763.00 | $173.65 – $1,156.85 | 23 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $528.50 | $2,763.00 | $173.65 – $1,006.60 | 23 |
| Cta neck without &/or w/contrast CPT 70498 | $538.00 | $2,763.00 | $173.65 – $1,006.60 | 23 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $517.50 | $3,682.00 | $348.37 – $2,106.92 | 23 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $531.50 | $2,649.00 | $173.65 – $1,040.30 | 23 |
| CT Angiogram of the Head CPT 70496 | $538.00 | $2,763.00 | $173.65 – $1,006.60 | 23 |
| CT angio hrt w/3d image CPT 75574 | $407.00 | $2,107.00 | $258.84 – $1,017.76 | 22 |
| CT angio pelvis CPT 72191 | $534.00 | $2,763.00 | $173.65 – $1,006.60 | 23 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $535.50 | $2,763.00 | $173.65 – $1,006.60 | 23 |
| CT guidance for needle placement CPT 77012 | $1,810.40 | $2,263.00 | $127.82 – $539.85 | 7 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,862.40 | $2,328.00 | $12.50 – $59.50 | 7 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $85.50 | $135.00 | $43.48 – $497.84 | 21 |
| CT hrt w/3d image CPT 75572 | $445.50 | $2,107.00 | $211.28 – $803.62 | 22 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $475.50 | $2,362.00 | $103.13 – $1,006.60 | 23 |
| CT lower extremity without contrast (both sides) CPT 73700 | $285.50 | $1,610.00 | $98.80 – $602.31 | 23 |
| CT lwr extremity w/o&w/dye CPT 73702 | $572.00 | $2,645.00 | $115.63 – $1,006.60 | 23 |
| CT neck soft tissue w/contrast CPT 70491 | $461.50 | $2,362.00 | $103.13 – $1,006.60 | 23 |
| CT neck soft tissue without contrast CPT 70490 | $268.00 | $1,610.00 | $98.75 – $602.31 | 23 |
| CT neck soft tissue without & w/contrast CPT 70492 | $557.50 | $2,645.00 | $115.63 – $1,006.60 | 23 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $557.50 | $2,645.00 | $173.65 – $1,006.60 | 23 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $461.50 | $2,362.00 | $161.25 – $1,006.60 | 23 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $268.00 | $1,610.00 | $103.73 – $602.31 | 23 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $525.00 | $3,711.00 | $318.38 – $2,106.92 | 23 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $437.50 | $3,608.00 | $240.91 – $2,106.92 | 23 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $242.50 | $2,322.00 | $126.34 – $1,342.45 | 23 |
| CT thoracic spine w/contrast CPT 72129 | $472.00 | $2,362.00 | $109.38 – $1,006.60 | 23 |
| CT thoracic spine without contrast CPT 72128 | $286.50 | $1,610.00 | $103.73 – $602.31 | 23 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $266.00 | $1,206.00 | $91.73 – $602.31 | 23 |
| CT t-spine w /wo contrast CPT 72130 | $568.50 | $2,645.00 | $170.00 – $1,006.60 | 23 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $475.50 | $2,350.00 | $103.13 – $2,106.92 | 23 |
| CT upper extremity without contrast (both sides) CPT 73200 | $285.50 | $1,610.00 | $98.80 – $602.31 | 23 |
| Culture aerobic additional method definitive id each CPT 87077 | $33.60 | $42.00 | $7.10 – $36.68 | 23 |
| Culture afb any source CPT 87116 | $44.80 | $56.00 | $7.50 – $49.03 | 23 |
| Culture anaerobic additional method definitive id each CPT 87076 | $33.60 | $42.00 | $8.16 – $36.68 | 23 |
| Culture anaerobic except blood CPT 87075 | $39.20 | $49.00 | $9.56 – $42.99 | 23 |
| Culture bact stool aero addl path ea CPT 87046 | $39.20 | $49.00 | $2.61 – $42.86 | 23 |
| Culture body fluid CPT 87070 | $36.00 | $45.00 | $6.90 – $39.13 | 23 |
| Culture fungi definitive id mold CPT 87107 | $43.20 | $54.00 | $10.42 – $46.85 | 23 |
| Culture fungi definitive id yeast CPT 87106 | $43.20 | $54.00 | $9.70 – $46.85 | 23 |
| Culture fungi other (except blood) CPT 87102 | $35.20 | $44.00 | $8.49 – $38.18 | 23 |
| Culture fungi skin/hair/nail CPT 87101 | $32.80 | $41.00 | $7.79 – $35.00 | 23 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $60.80 | $76.00 | $14.76 – $66.33 | 23 |
| Culture mycoplasma any source CPT 87109 | $64.00 | $80.00 | $15.54 – $69.87 | 23 |
| Culture quantitative aerobic other source CPT 87071 | $40.80 | $51.00 | $5.22 – $44.90 | 23 |
| Culture typing immunologic CPT 87147 | $21.60 | $27.00 | $3.00 – $23.52 | 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.