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 |
|---|---|---|---|---|
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $46,983.60 | $58,729.50 | $6,539.40 – $27,510.40 | 25 |
| Test stress cardiovascular tracing only CPT 93017 | $1,796.60 | $2,245.75 | $51.15 – $300.75 | 25 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $3,669.80 | $4,587.25 | $97.57 – $597.12 | 25 |
| Thrombectmy crnry perq mechanical CPT 92973 | $7,599.40 | $9,499.25 | $209.20 – $209.20 | 1 |
| Thrombin time CPT 85670 | $17.60 | $22.00 | $5.71 – $33.59 | 27 |
| Thyroglobulin antibody CPT 86800 | $163.80 | $204.75 | $15.75 – $92.42 | 27 |
| Thyroid (TSH) Test CPT 84443 | $40.00 | $295.00 | $16.63 – $97.63 | 27 |
| Thyroid Ultrasound CPT 76536 | $792.40 | $990.50 | $83.99 – $602.31 | 27 |
| Tissue exam koh skin/hair/nails CPT 87220 | $135.20 | $169.00 | $4.23 – $20.71 | 27 |
| Tissue transglutaminase iga CPT 86364 | $38.20 | $47.75 | $5.77 – $89.21 | 23 |
| Tlh w/t/o 250 g or less CPT 58571 | not published | not published | $853.60 – $18,724.00 | 8 |
| Tomosynthesis breast screen bilateral CPT 77063 | $103.00 | $128.75 | $21.37 – $135.59 | 27 |
| Tonsillectomy (age 12+) CPT 42826 | not published | not published | $853.60 – $11,091.00 | 8 |
| Total Hip Replacement CPT 27130 | not published | not published | $853.60 – $34,157.00 | 8 |
| Total Knee Replacement CPT 27447 | not published | not published | $853.60 – $34,157.00 | 8 |
| Toxoplasma antibody igg CPT 86777 | $133.40 | $166.75 | $14.25 – $83.66 | 27 |
| Toxoplasma antibody igm CPT 86778 | $532.40 | $665.50 | $14.27 – $83.70 | 27 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $77.60 | $97.00 | $0.07 – $0.07 | 1 |
| Transferrin CPT 84466 | $50.00 | $167.75 | $12.63 – $74.19 | 27 |
| Transfusion blood/blood component(s) CPT 36430 | $2,680.40 | $3,350.50 | $30.62 – $422.23 | 25 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $256.60 | $320.75 | $28.27 – $124.49 | 25 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $232.00 | $290.00 | $10.78 – $12.74 | 7 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $427.00 | $533.75 | $101.70 – $196.43 | 21 |
| Treat ulnar fracture CPT 24685 | not published | not published | $853.60 – $18,724.00 | 8 |
| Treponema pallidum antibody CPT 86780 | $150.00 | $187.50 | $13.11 – $75.50 | 27 |
| Trichomonas assay w/optic CPT 87808 | $383.40 | $479.25 | $13.54 – $74.14 | 27 |
| Triglycerides CPT 84478 | $132.20 | $165.25 | $5.68 – $33.43 | 27 |
| Troponin quantitative CPT 84484 | $63.00 | $78.75 | $10.86 – $60.47 | 27 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $855.40 | $1,069.25 | $79.64 – $602.31 | 27 |
| Ultrasound breast complete CPT 76641 | $547.80 | $684.75 | $91.18 – $602.31 | 27 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $531.60 | $664.50 | $75.28 – $497.84 | 27 |
| Ultrasound chest CPT 76604 | $564.20 | $705.25 | $81.43 – $602.31 | 27 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $701.80 | $877.25 | $94.07 – $602.31 | 27 |
| Ultrasound guidance for vascular access CPT 76937 | $644.20 | $805.25 | $28.08 – $111.22 | 8 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $1,328.80 | $1,661.00 | $79.20 – $776.50 | 8 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $728.40 | $910.50 | $26.17 – $602.31 | 27 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $376.00 | $470.00 | $60.46 – $173.33 | 8 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $909.20 | $1,136.50 | $79.51 – $602.31 | 27 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $867.60 | $1,084.50 | $70.40 – $602.31 | 27 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $831.80 | $1,039.75 | $96.35 – $602.31 | 27 |
| Ultrasound retroperitoneal limited CPT 76775 | $856.60 | $1,070.75 | $83.73 – $602.31 | 27 |
| Ultrasound scrotum and contents CPT 76870 | $792.40 | $990.50 | $81.40 – $602.31 | 27 |
| Ultrasound spinal canal and contents CPT 76800 | $512.80 | $641.00 | $102.30 – $602.31 | 27 |
| Ultrasound transvaginal non obstetric CPT 76830 | $831.80 | $1,039.75 | $84.15 – $602.31 | 26 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $853.60 – $18,724.00 | 8 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $700.50 | $6,708.25 | $343.57 – $2,816.82 | 27 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $633.50 | $4,830.75 | $343.57 – $2,227.50 | 27 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $454.00 | $4,158.25 | $232.54 – $1,813.75 | 27 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $853.60 – $3,462.59 | 25 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $853.60 – $3,462.59 | 25 |
| Urea nitrogen CPT 84520 | $49.00 | $61.25 | $3.91 – $22.93 | 27 |
| Urea nitrogen 24 hour urine CPT 84540 | $20.00 | $25.00 | $5.50 – $50.91 | 22 |
| Uric acid blood CPT 84550 | $15.00 | $75.00 | $4.47 – $26.23 | 27 |
| Urinalysis (with microscopy) CPT 81001 | $10.00 | $112.50 | $3.14 – $18.43 | 27 |
| Urinalysis (without microscopy) CPT 81003 | $10.00 | $106.50 | $2.23 – $13.05 | 27 |
| Urine Culture Test CPT 87086 | $25.00 | $399.50 | $7.99 – $46.92 | 27 |
| Urine pregnancy test CPT 81025 | $139.60 | $174.50 | $4.40 – $41.75 | 27 |
| Valproic acid total therapeutic drug level CPT 80164 | $259.60 | $324.50 | $13.40 – $78.73 | 27 |
| Vancomycin peak therapeutic drug level CPT 80202 | $337.00 | $421.25 | $13.40 – $78.73 | 27 |
| Varicella zoster antibody igg CPT 86787 | $161.20 | $201.50 | $12.75 – $74.86 | 27 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $54,155.80 | $67,694.75 | $4,855.20 – $21,177.60 | 25 |
| Ventilator each subsequent day CPT 94003 | $823.40 | $1,029.25 | $59.73 – $709.62 | 21 |
| Ventilator initial day CPT 94002 | $1,293.40 | $1,616.75 | $82.19 – $1,030.83 | 21 |
| Version cephalic external CPT 59412 | $8,106.60 | $10,133.25 | $1,589.77 – $1,947.16 | 2 |
| Vitamin b-12 CPT 82607 | $40.00 | $209.75 | $14.30 – $87.60 | 27 |
| Vitamin D Test CPT 82306 | $100.00 | $359.00 | $29.30 – $172.02 | 27 |
| Warde 1003990 aldosterone CPT 82088 | $697.80 | $872.25 | $28.60 – $236.81 | 27 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $459.20 | $574.00 | $12.77 – $74.07 | 27 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $429.20 | $536.50 | $24.20 – $146.74 | 27 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $181.80 | $227.25 | $13.20 – $90.11 | 27 |
| Warde 1015200 kappa light chain free CPT 83521 | $305.20 | $381.50 | $15.20 – $83.74 | 27 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $294.20 | $367.75 | $7.94 – $46.61 | 27 |
| Warde 3008005 oligoclonal bands CPT 83916 | $246.60 | $308.25 | $16.50 – $132.81 | 27 |
| Warde 3016000 west nile virus antibody CPT 86788 | $83.60 | $104.50 | $16.68 – $97.91 | 27 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $83.60 | $104.50 | $14.25 – $83.66 | 27 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $281.60 | $352.00 | $12.13 – $171.67 | 22 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $368.80 | $461.00 | $8.25 – $51.70 | 27 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $75.20 | $94.00 | $17.80 – $104.44 | 27 |
| Warde 3400683 amplification rna markers infectious disease bacterial vaginosis CPT 81513 | $398.40 | $498.00 | $71.32 – $1,103.36 | 21 |
| Warde 3400852 arsenic CPT 82175 | $173.00 | $216.25 | $9.49 – $210.28 | 23 |
| Warde 3708165 mercury urine CPT 83825 | $174.60 | $218.25 | $13.20 – $94.49 | 27 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $49.60 | $62.00 | $10.14 – $58.43 | 27 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $759.20 | $949.00 | $38.23 – $224.48 | 27 |
| Warde analysis gene hfe common variants CPT 81256 | $751.20 | $939.00 | $64.71 – $316.93 | 25 |
| Warde anti-mullerian hormone CPT 82166 | $160.80 | $201.00 | $19.31 – $187.27 | 23 |
| Warde apolipoprotein b CPT 82172 | $205.40 | $256.75 | $20.88 – $102.27 | 27 |
| Warde calcitonin CPT 82308 | $523.80 | $654.75 | $23.02 – $155.62 | 27 |
| Warde calculus (stone) infrared CPT 82365 | $339.20 | $424.00 | $11.00 – $74.94 | 27 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $392.60 | $490.75 | $21.74 – $127.60 | 27 |
| Warde complement total hemolytic CPT 86162 | $209.00 | $261.25 | $20.12 – $118.09 | 27 |
| Warde copper CPT 82525 | $314.00 | $392.50 | $12.29 – $72.12 | 27 |
| Warde cryoglobulin CPT 82595 | $85.80 | $107.25 | $6.41 – $37.61 | 27 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $44.00 | $55.00 | $10.64 – $58.62 | 27 |
| Warde folic acid rbc CPT 82747 | $195.00 | $243.75 | $17.47 – $100.10 | 27 |
| Warde growth hormone (hgh) CPT 83003 | $345.40 | $431.75 | $8.80 – $96.87 | 27 |
| Warde haloperidol therapeutic drug level CPT 80173 | $45.40 | $56.75 | $15.62 – $84.62 | 27 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $240.80 | $301.00 | $12.10 – $74.07 | 27 |
| Warde hepatitis a antibody CPT 86708 | $255.00 | $318.75 | $12.27 – $72.00 | 27 |
| Warde immunofixation electrophoresis urine CPT 86335 | $170.60 | $213.25 | $29.06 – $170.55 | 27 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $302.40 | $378.00 | $11.00 – $66.98 | 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.