WellSpan Evangelical Community Hospital
1 Hospital Drive, Lewisburg, PA · Wellspan · · NPI 1124076039
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 |
|---|---|---|---|---|
| 3d recon without postprocess indpndt CPT 76376 | $670.60 | $838.25 | $360.29 – $701.84 | 2 |
| Abd/low ext cath 2nd CPT 36246 | $3,828.60 | $4,785.75 | $279.50 – $330.32 | 7 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $560.00 | $5,372.50 | $171.26 – $1,772.36 | 27 |
| Abdominal CT scan (with contrast) CPT 74160 | $468.50 | $4,419.50 | $163.96 – $1,552.50 | 27 |
| Abdominal CT scan (without contrast) CPT 74150 | $273.50 | $3,654.25 | $102.30 – $1,012.95 | 27 |
| Abdominal MRI (with and without contrast) CPT 74183 | $706.00 | $6,731.25 | $343.57 – $2,805.20 | 27 |
| Abdominal MRI (without contrast) CPT 74181 | $457.00 | $4,184.25 | $232.54 – $1,809.62 | 27 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,572.00 | $3,215.00 | $92.76 – $905.50 | 25 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,123.60 | $1,404.50 | $102.30 – $602.31 | 27 |
| Abdominal Ultrasound (limited) CPT 76705 | $846.80 | $1,058.50 | $68.75 – $602.31 | 27 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $14,685.60 | $18,357.00 | $63.81 – $156.46 | 20 |
| Ablation cryo retro lymph node CPT 38999 | $381.60 | $477.00 | $118.61 – $422.23 | 20 |
| Ablation of upper extremity nerves rf CPT 64999 | $807.20 | $1,009.00 | $88.81 – $285.09 | 20 |
| Abscess drain retroperitoneal surg code CPT 49406 | $4,709.20 | $5,886.50 | $190.99 – $225.72 | 7 |
| Actinotherapy uv light CPT 96900 | $215.20 | $269.00 | $19.63 – $154.05 | 21 |
| Acute hepatitis panel CPT 80074 | $917.20 | $1,146.50 | $47.15 – $276.77 | 27 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $318.00 | $397.50 | $31.11 – $68.74 | 25 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $1,100.00 | $1,375.00 | $137.28 – $320.35 | 25 |
| Administration immunization 1 vaccine CPT 90471 | $49.40 | $61.75 | $2.15 – $68.74 | 22 |
| Administration immunization each additional vaccine CPT 90472 | $60.00 | $75.00 | $1.03 – $12.98 | 3 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $49.40 | $61.75 | $13.97 – $87.72 | 23 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $47,027.60 | $58,784.50 | $6,117.65 – $25,789.12 | 25 |
| Albumin body fluid quantitative each specimen CPT 82042 | $79.60 | $99.50 | $3.89 – $37.73 | 23 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $118.80 | $148.50 | $5.72 – $33.63 | 27 |
| Albumin serum plasma or whole blood CPT 82040 | $81.80 | $102.25 | $4.02 – $28.78 | 27 |
| Alkaline phosphatase CPT 84075 | $121.00 | $151.25 | $5.13 – $30.09 | 27 |
| Allergen alpha lactalbumin ige CPT 86008 | $59.40 | $74.25 | $17.75 – $88.12 | 27 |
| Allergen egg white ige CPT 86003 | $48.80 | $61.00 | $5.17 – $30.33 | 27 |
| Alpha-fetoprotein tumor marker CPT 82105 | $170.80 | $213.50 | $16.60 – $97.47 | 27 |
| Alt/sgpt CPT 84460 | $56.60 | $70.75 | $5.25 – $30.77 | 27 |
| Amino acid screen, urine CPT 82128 | $143.60 | $179.50 | $8.80 – $80.56 | 27 |
| Ammonia CPT 82140 | $153.40 | $191.75 | $5.50 – $84.70 | 27 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $853.60 – $9,100.00 | 8 |
| Amylase CPT 82150 | $142.40 | $178.00 | $5.50 – $37.65 | 27 |
| Analysis gene f2 20210g>a variant CPT 81240 | $739.20 | $924.00 | $59.07 – $318.53 | 26 |
| Analysis gene f5 leiden variant CPT 81241 | $1,068.60 | $1,335.75 | $72.64 – $355.77 | 26 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $162.40 | $203.00 | $30.88 – $170.15 | 27 |
| Anca screen with reflex to titer -quest CPT 86021 | $62.40 | $78.00 | $5.50 – $72.98 | 27 |
| An fluoro guide for cvp CPT 77001 | $917.80 | $1,147.25 | $66.41 – $441.07 | 8 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $5,540.00 | $6,925.00 | $424.06 – $501.16 | 7 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $4,331.20 | $5,414.00 | $385.15 – $455.18 | 7 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $4,897.60 | $6,122.00 | $518.43 – $612.69 | 7 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $13,595.00 | $16,993.75 | $320.94 – $379.29 | 7 |
| Ankle X-ray CPT 73610 | $463.20 | $579.00 | $29.45 – $497.84 | 27 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $53.60 | $67.00 | $12.75 – $201.37 | 22 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $576.00 | $720.00 | $5.50 – $89.08 | 27 |
| Antibody id rbc panel CPT 86870 | $375.00 | $468.75 | $9.30 – $1,027.44 | 26 |
| Antibody screen rbc CPT 86850 | $163.40 | $204.25 | $9.30 – $51.60 | 26 |
| Anti mog serum - sendout CPT 86362 | $514.80 | $643.50 | $9.50 – $58.43 | 27 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $49.60 | $62.00 | $10.60 – $58.43 | 26 |
| Antinuclear antibodies CPT 86038 | $207.00 | $258.75 | $11.97 – $70.25 | 27 |
| Antinuclear antibodies titer CPT 86039 | $46.40 | $58.00 | $11.05 – $64.87 | 27 |
| Antistreptolysin o titer CPT 86060 | $30.40 | $38.00 | $7.23 – $42.43 | 27 |
| Antithrombin iii activity CPT 85300 | $256.60 | $320.75 | $10.34 – $57.46 | 27 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $853.60 – $1,008.80 | 7 |
| Application long leg splint 29505 CPT 29505 | $608.60 | $760.75 | $40.70 – $152.39 | 25 |
| Application lower leg splint 29515 CPT 29515 | $608.60 | $760.75 | $38.50 – $152.39 | 25 |
| Application multi layer compression below knee (both sides) CPT 29581 | $661.00 | $826.25 | $27.80 – $152.39 | 25 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $109.40 | $136.75 | $11.11 – $197.48 | 25 |
| Apply rigid leg cast 29445 CPT 29445 | $1,406.80 | $1,758.50 | $111.62 – $256.50 | 25 |
| Aquaporin-4 antibody cba each CPT 86052 | $117.60 | $147.00 | $10.60 – $58.43 | 27 |
| Aquatic exercise - group charge CPT 97150 | $114.80 | $143.50 | $16.71 – $157.43 | 25 |
| Arterial blood draw/perc 36620 CPT 36620 | $804.40 | $1,005.50 | $52.34 – $61.85 | 7 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $4,031.80 | $5,039.75 | $41.25 – $1,207.51 | 8 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $4,310.40 | $5,388.00 | $41.25 – $1,330.51 | 8 |
| Arthrd ant ntrbdy cervical CPT 22551 | not published | not published | $853.60 – $34,157.00 | 8 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $1,953.80 | $2,442.25 | $23.65 – $285.09 | 25 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $1,834.60 | $2,293.25 | $46.59 – $668.84 | 25 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $1,369.20 | $1,711.50 | $54.80 – $285.09 | 25 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $1,723.80 | $2,154.75 | $25.85 – $1,956.00 | 26 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $1,284.60 | $1,605.75 | $40.76 – $285.09 | 25 |
| Arthrodesis triple CPT 28715 | not published | not published | $853.60 – $34,157.00 | 8 |
| Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) CPT 29824 | not published | not published | $853.60 – $11,091.00 | 8 |
| Arthrp ntrcrpl/crp/mtcrp ssp CPT 25448 | not published | not published | $853.60 – $18,724.00 | 8 |
| Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 | not published | not published | $853.60 – $18,724.00 | 8 |
| Aspirate pleura without imaging 32554 CPT 32554 | $3,669.80 | $4,587.25 | $77.98 – $597.12 | 25 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $2,785.60 | $3,482.00 | $65.76 – $679.53 | 25 |
| Assay dir meas fr estradiol CPT 82681 | $88.00 | $110.00 | $27.66 – $216.12 | 22 |
| Ast/sgot CPT 84450 | $55.00 | $68.75 | $5.13 – $30.05 | 27 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $993.20 | $1,241.50 | $191.15 – $1,008.80 | 25 |
| Azathioprine 50 mg tablet HCPCS J7500 | $2.80 | $3.50 | $0.05 – $6.85 | 7 |
| Baclofen eval charges CPT 97750 | $149.20 | $186.50 | $31.63 – $154.93 | 24 |
| Bacterial meningitis antigen CPT 86403 | $48.00 | $60.00 | $11.42 – $59.22 | 27 |
| Bacterial vaginosis pcr CPT 87801 | $292.00 | $365.00 | $42.68 – $407.92 | 27 |
| #bac vag cand-c. albicans naa CPT 87481 | $269.00 | $336.25 | $34.74 – $203.98 | 27 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $112.60 | $140.75 | $25.20 – $147.82 | 27 |
| Bilateral n block inj occipital 64405 CPT 64405 | $3,848.20 | $4,810.25 | $38.50 – $285.09 | 25 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $1,162.60 | $1,453.25 | $14.30 – $285.09 | 25 |
| Bilicheck CPT 88720 | $24.80 | $31.00 | $4.97 – $29.17 | 27 |
| Bilirubin direct CPT 82248 | $101.40 | $126.75 | $4.97 – $29.17 | 27 |
| Bilirubin total CPT 82247 | $10.00 | $115.00 | $4.97 – $29.17 | 27 |
| Biopsy needle lymph node superficial CPT 38505 | $2,908.00 | $3,635.00 | $74.17 – $87.66 | 7 |
| Biopsy of prostate CPT 55700 | $6,034.80 | $7,543.50 | $98.45 – $6,676.00 | 8 |
| Biopsy/removal lymph nodes CPT 38525 | not published | not published | $853.60 – $11,091.00 | 8 |
| Biopsy skin incisional single lesion CPT 11106 | $1,510.20 | $1,887.75 | $54.13 – $591.20 | 25 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $717.80 | $897.25 | $31.57 – $234.89 | 25 |
| Bld prd mix CPT 86965 | $653.60 | $817.00 | $164.85 – $488.22 | 21 |
| Block tap inj(s) w/wo img uni CPT 64486 | $1,865.20 | $2,331.50 | $63.55 – $878.84 | 2 |
| Blood Clotting (PT/INR) Test CPT 85610 | $15.00 | $119.75 | $4.25 – $22.85 | 27 |
| Blood Clotting (PTT) Test CPT 85730 | $30.00 | $164.75 | $5.95 – $34.87 | 27 |
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.