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 |
|---|---|---|---|---|
| Fibrin degradation d dimer quantitative CPT 85379 | $115.20 | $144.00 | $10.28 – $46.22 | 23 |
| Fibrin degradation products CPT 85362 | $87.20 | $109.00 | $6.96 – $32.37 | 23 |
| Fibrinogen activity CPT 85384 | $81.60 | $102.00 | $9.82 – $44.13 | 23 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $1,301.60 | $1,627.00 | $50.89 – $138.41 | 7 |
| Fixation of knee joint CPT 27570 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Flecainide (tambocor)-sendout CPT 80181 | $77.60 | $97.00 | $13.98 – $84.63 | 19 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $5,627.00 – $5,627.00 | 1 |
| Flow cytometry marker each additional CPT 88185 | $129.60 | $162.00 | $18.26 – $101.92 | 10 |
| Flow cytometry one marker technical component CPT 88184 | $129.60 | $162.00 | $37.14 – $1,027.44 | 23 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $77.40 | $96.75 | $2.26 – $12.53 | 10 |
| Fluidotherapy charges pt CPT 97022 | $216.80 | $271.00 | $14.64 – $56.80 | 20 |
| Fluorescent antibody titer dna CPT 86256 | $49.60 | $62.00 | $9.11 – $54.71 | 23 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $1,244.00 | $1,555.00 | $35.24 – $170.99 | 7 |
| Fluoroguide needle placement CPT 77002 | $1,275.20 | $1,594.00 | $44.59 – $188.33 | 7 |
| Fluoroscopy up to 1 hour CPT 76000 | $659.20 | $824.00 | $14.38 – $1,342.45 | 21 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,301.60 | $1,627.00 | $116.28 – $1,189.18 | 20 |
| Folic acid CPT 82746 | $45.00 | $77.00 | $12.00 – $66.74 | 23 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $177.00 | $221.25 | $30.00 – $105.00 | 10 |
| Fondaparinux sodium HCPCS J1652 | $230.80 | $288.50 | $3.62 – $15.05 | 10 |
| Fo nontorsion joint cf HCPCS L3935 | $127.20 | $159.00 | $76.99 – $413.74 | 16 |
| Foot X-ray CPT 73630 | $348.00 | $435.00 | $14.38 – $497.84 | 22 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $167.20 | $209.00 | $15.15 – $63.00 | 10 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $130.60 | $163.25 | $1.73 – $46.78 | 3 |
| Frenectomy 41115 CPT 41115 | $2,520.80 | $3,151.00 | $112.50 – $306.00 | 3 |
| Frenotomy 40806 CPT 40806 | not published | not published | $491.83 – $5,627.00 | 15 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $580.00 | $725.00 | $30.00 – $130.86 | 20 |
| Fructosamine glycated protein CPT 82985 | $69.60 | $87.00 | $16.44 – $76.09 | 23 |
| Ftl cgen abnor four anal CPT 81511 | $639.20 | $799.00 | $94.37 – $696.89 | 23 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $1,784.34 – $8,754.00 | 14 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $19.60 | $24.50 | $0.36 – $6.40 | 10 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Fusion of big toe joint CPT 28750 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Fusion of finger joint CPT 26860 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Fusion of foot bones CPT 28730 | not published | not published | $12,504.00 – $12,504.00 | 1 |
| Fxn gene detc abnor alleles CPT 81284 | $569.60 | $712.00 | $68.50 – $621.98 | 19 |
| Fxn gene full gene sequence CPT 81286 | $1,143.20 | $1,429.00 | $137.42 – $1,247.73 | 19 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $358.40 | $448.00 | $38.32 – $198.35 | 18 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $13.60 | $17.00 | $0.27 – $0.92 | 8 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $46.40 | $58.00 | $14.73 – $51.49 | 8 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $14,381.00 – $14,381.00 | 1 |
| Gallium illuccix 1 millicure HCPCS A9596 | $2,760.80 | $3,451.00 | $511.55 – $3,688.51 | 18 |
| Gammaglobulin iga CPT 82784 | $35.00 | $49.00 | $9.39 – $43.69 | 23 |
| Gammaglobulin ige CPT 82785 | $68.00 | $85.00 | $16.62 – $74.73 | 23 |
| Gamma glutamyltransferase CPT 82977 | $29.60 | $37.00 | $7.27 – $32.69 | 23 |
| Gamunex-c/gammaked HCPCS J1561 | $5,234.60 | $6,543.25 | $57.74 – $6,769.00 | 24 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | $52.00 | $65.00 | $2.71 – $7.38 | 2 |
| General health panel CPT 80050 | $70.00 | $250.00 | $43.89 – $149.23 | 9 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $41.60 | $52.00 | $2.21 – $8.65 | 10 |
| Gentamicin peak therapeutic drug level CPT 80170 | $68.00 | $85.00 | $12.00 – $74.37 | 23 |
| Ghs abscess perianal iandd CPT 46050 | $5,424.80 | $6,781.00 | $94.58 – $1,540.93 | 20 |
| Ghs bladder cath - complex-foley CPT 51703 | $651.20 | $814.00 | $93.26 – $264.44 | 20 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $2,204.00 | $2,755.00 | $43.75 – $1,170.47 | 20 |
| Ghs change cysto/gastrost CPT 43762 | $1,094.40 | $1,368.00 | $38.88 – $411.06 | 20 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $145.60 | $182.00 | $35.44 – $159.31 | 23 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $1,780.80 | $2,226.00 | $45.63 – $405.44 | 20 |
| Ghs closed reduction ankle dislocation CPT 27840 | $1,000.00 | $1,250.00 | $111.88 – $405.44 | 20 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $1,165.60 | $1,457.00 | $246.88 – $671.50 | 7 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | not published | not published | $1,784.34 – $8,754.00 | 14 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $7,144.80 | $8,931.00 | $246.25 – $669.80 | 3 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $1,556.00 | $1,945.00 | $196.25 – $533.80 | 20 |
| Ghs community re-entry 15 minutes CPT 97537 | $176.00 | $220.00 | $30.21 – $56.80 | 19 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $1,024.80 | $1,281.00 | $33.13 – $674.43 | 20 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $606.40 | $758.00 | $32.50 – $217.86 | 20 |
| Ghs diphtheria toxoid ab igg CPT 86648 | $63.20 | $79.00 | $15.36 – $71.47 | 23 |
| Ghs dislocation elbow closed treatment CPT 24600 | $512.00 | $640.00 | $128.13 – $405.44 | 20 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $2,904.00 | $3,630.00 | $152.62 – $680.00 | 20 |
| Ghs fb removal foot - deep - left CPT 28192 | not published | not published | $1,564.83 – $8,754.00 | 2 |
| Ghs fb removal from muscle - complicated CPT 20525 | not published | not published | $10,638.00 – $10,638.00 | 1 |
| Ghs fb removal - incisional CPT 10121 | not published | not published | $8,754.00 – $8,754.00 | 1 |
| Ghs fish cytogen CPT 88271 | $92.80 | $116.00 | $10.71 – $97.25 | 20 |
| Ghs flow volume loop CPT 94375 | $912.80 | $1,141.00 | $22.55 – $526.31 | 20 |
| Ghs gastric intub aspiration lavage CPT 43753 | $456.00 | $570.00 | $20.64 – $526.31 | 20 |
| Ghs histoplasma antigen CPT 87385 | $55.20 | $69.00 | $6.63 – $60.16 | 19 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | not published | not published | $1,150.15 – $10,638.00 | 14 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $6,002.40 | $7,503.00 | $140.63 – $1,189.18 | 20 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $1,149.60 | $1,437.00 | $45.00 – $1,189.18 | 20 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $2,182.40 | $2,728.00 | $51.25 – $411.06 | 20 |
| Ghs inf midline insertion CPT 36140 | $582.40 | $728.00 | $119.59 – $325.28 | 4 |
| Ghs init tx 1st degree burn CPT 16000 | $691.20 | $864.00 | $22.50 – $335.83 | 20 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | $2,128.00 | $2,660.00 | $63.75 – $1,504.72 | 20 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $2,256.80 | $2,821.00 | $91.88 – $1,504.72 | 20 |
| Ghs insertion of needle - bone CPT 36680 | $1,173.60 | $1,467.00 | $61.88 – $674.43 | 20 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $1,440.80 | $1,801.00 | $115.00 – $675.27 | 20 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $1,560.00 | $1,950.00 | $115.00 – $1,034.60 | 20 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $100.80 | $126.00 | $10.10 – $27.47 | 7 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $1,212.00 | $1,515.00 | $155.05 – $421.74 | 17 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $804.00 | $1,005.00 | $248.77 – $560.61 | 15 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $496.80 | $621.00 | $39.38 – $674.43 | 20 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $1,152.00 | $1,440.00 | $30.63 – $675.27 | 20 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $1,152.00 | $1,440.00 | $30.63 – $5,627.00 | 22 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $1,152.00 | $1,440.00 | $39.38 – $5,627.00 | 22 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $1,160.00 | $1,450.00 | $59.38 – $675.27 | 20 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $1,160.00 | $1,450.00 | $44.38 – $675.27 | 20 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $1,252.80 | $1,566.00 | $59.38 – $675.27 | 20 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $1,315.20 | $1,644.00 | $58.13 – $675.27 | 20 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $1,315.20 | $1,644.00 | $60.63 – $1,034.60 | 20 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $1,314.40 | $1,643.00 | $76.88 – $675.27 | 20 |
| Ghs mbp CPT 83873 | $71.20 | $89.00 | $15.00 – $78.09 | 23 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $236.00 | $295.00 | $23.77 – $64.67 | 7 |
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.