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 |
|---|---|---|---|---|
| Established Patient Office Visit (level 4) CPT 99214 | $1,034.40 | $1,293.00 | $50.00 – $217.81 | 18 |
| Established Patient Office Visit (level 5) CPT 99215 | $1,136.00 | $1,420.00 | $50.00 – $217.81 | 18 |
| Estradiol total CPT 82670 | $116.80 | $146.00 | $21.50 – $126.85 | 23 |
| Estrogens total-sendout CPT 82672 | $90.40 | $113.00 | $13.92 – $98.52 | 23 |
| Ethylene glycol -sendout CPT 82693 | $62.40 | $78.00 | $7.45 – $67.65 | 19 |
| Etonogestrel implant system HCPCS J7307 | $4,771.20 | $5,964.00 | $796.20 – $4,664.19 | 9 |
| Evaluation of speech fluency 92521 CPT 92521 | $412.80 | $516.00 | $50.00 – $221.25 | 19 |
| Event monitor CPT 93270 | $228.00 | $285.00 | $18.38 – $63.02 | 20 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $77.60 | $97.00 | $27.69 – $75.31 | 7 |
| Exam plvc w/anes othr thn lcl CPT 57410 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc back les sbq <3 cm 21930 CPT 21930 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc back tum deep 5 cm/> CPT 21933 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc bartholins gland/cyst CPT 56740 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | not published | not published | $1,564.83 – $8,754.00 | 2 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | not published | not published | $686.33 – $8,754.00 | 14 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | not published | not published | $686.33 – $5,627.00 | 14 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $1,564.83 – $5,627.00 | 2 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | not published | not published | $1,564.83 – $5,627.00 | 2 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | not published | not published | $2,764.17 – $5,627.00 | 2 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc forearm les sc 3 cm/> CPT 25071 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc hand les sc < 1.5 cm CPT 26115 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exchange biliary drg cath CPT 47536 | $6,028.00 | $7,535.00 | $150.23 – $408.61 | 7 |
| Exchange drainage catheter CPT 49423 | $2,845.60 | $3,557.00 | $73.50 – $199.92 | 7 |
| Exchange nephrostomy cath CPT 50435 | $3,552.80 | $4,441.00 | $102.75 – $279.48 | 7 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Excise/repair mouth lesion CPT 40812 | not published | not published | $1,430.62 – $5,627.00 | 2 |
| Excise submaxillary gland CPT 42440 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | not published | not published | $686.33 – $8,754.00 | 14 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | not published | not published | $1,564.83 – $5,627.00 | 2 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | not published | not published | $2,764.17 – $5,627.00 | 2 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $3,132.16 – $10,638.00 | 2 |
| Excision of tongue lesion CPT 41112 | not published | not published | $3,132.16 – $8,754.00 | 2 |
| Excision olecranon bursa CPT 24105 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | not published | not published | $686.33 – $8,754.00 | 14 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc malig feenl >4cm 11646 CPT 11646 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | not published | not published | $389.73 – $5,627.00 | 14 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | not published | not published | $686.33 – $5,627.00 | 14 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | not published | not published | $343.16 – $8,754.00 | 14 |
| Exc neck tum deep < 5 cm CPT 21556 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc neck tum deep 5 cm/> CPT 21554 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | not published | not published | $1,564.83 – $8,754.00 | 2 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | not published | not published | $2,764.17 – $8,754.00 | 2 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc thigh/knee tum dep 5cm/> CPT 27339 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | not published | not published | $1,150.15 – $5,627.00 | 14 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Exc vagina lesion 57135 CPT 57135 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $1,443.72 | $1,804.65 | $751.24 – $751.24 | 1 |
| Exploration maxillary sinus CPT 31256 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Explore parathyroid glands CPT 60500 | not published | not published | $17,510.00 – $17,510.00 | 1 |
| Exp w remove/deep fb/forearm/wrist 25248 CPT 25248 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| External chromosome analysis 20-25 cells CPT 88264 | $601.60 | $752.00 | $137.80 – $656.53 | 23 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $604.00 | $755.00 | $145.19 – $652.63 | 23 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $75.20 | $94.00 | $18.00 – $81.40 | 23 |
| F-18 fdg pet diag HCPCS A9552 | $1,481.60 | $1,852.00 | $1,336.29 – $1,336.29 | 1 |
| Factor ix CPT 85250 | $111.20 | $139.00 | $5.00 – $86.44 | 23 |
| Factor ix recombinant nos HCPCS J7195 | $3,835.80 | $4,794.75 | $2.18 – $3,237.50 | 24 |
| Factor viii CPT 85240 | $448.00 | $560.00 | $13.00 – $81.27 | 23 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $13.80 | $17.25 | $0.72 – $2.80 | 10 |
| Fat/lipids feces qualitative CPT 82705 | $21.60 | $27.00 | $5.15 – $23.94 | 23 |
| Fatty acids nonesterified CPT 82725 | $78.40 | $98.00 | $13.18 – $85.22 | 23 |
| #fecal-sodium CPT 84302 | $19.20 | $24.00 | $4.91 – $22.06 | 23 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $290.80 | $363.50 | $1.00 – $3.67 | 10 |
| Ferritin CPT 82728 | $40.00 | $71.00 | $12.00 – $61.88 | 24 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $864.80 | $1,081.00 | $72.61 – $602.31 | 21 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $84.00 | $105.00 | $7.81 – $36.35 | 23 |
| Fetal hemoglobin rosette CPT 85461 | $39.20 | $49.00 | $9.17 – $38.66 | 23 |
| Fetal non stress test CPT 59025 | $490.40 | $613.00 | $21.88 – $340.01 | 19 |
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.