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 |
|---|---|---|---|---|
| Drvvt confirm - quest CPT 85597 | $81.60 | $102.00 | $17.80 – $104.48 | 27 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $6,627.80 | $8,284.75 | $3,492.28 – $3,492.28 | 1 |
| Duplex scan bilateral study 93985 CPT 93985 | $811.20 | $1,014.00 | $225.76 – $266.81 | 25 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $1,112.60 | $1,390.75 | $101.74 – $120.24 | 25 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $2,229.80 | $2,787.25 | $155.72 – $233.45 | 25 |
| Dxa bone density axl vrt fx CPT 77085 | $799.40 | $999.25 | $102.30 – $812.66 | 22 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $4,929.80 | $6,162.25 | $148.67 – $175.70 | 7 |
| Ear irrigation 69209 CPT 69209 | $210.20 | $262.75 | $10.56 – $57.37 | 25 |
| Ecg 12 lead tracing only CPT 93005 | $378.20 | $472.75 | $11.51 – $57.37 | 25 |
| Ecg external < 48 hours recording CPT 93225 | $873.40 | $1,091.75 | $20.08 – $124.49 | 25 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $983.40 | $1,229.25 | $43.74 – $57.37 | 25 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $206.40 | $258.00 | $9.61 – $37.91 | 25 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,898.80 | $3,623.50 | $155.12 – $529.55 | 25 |
| Echocardiography doppler color flow mapping CPT 93325 | $617.60 | $772.00 | $20.44 – $24.15 | 7 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $1,895.40 | $2,369.25 | $40.15 – $233.45 | 25 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $456.80 | $571.00 | $31.13 – $36.79 | 7 |
| Echo stress CPT 93350 | $2,475.60 | $3,094.50 | $84.15 – $529.55 | 25 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,001.40 | $1,251.75 | $263.44 – $529.55 | 25 |
| Echo transthoracic CPT 93303 | $2,808.80 | $3,511.00 | $172.98 – $529.55 | 25 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $717.40 | $896.75 | $154.42 – $763.04 | 25 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $1,375.20 | $1,719.00 | $24.75 – $300.75 | 25 |
| Eeg recording awake and asleep CPT 95819 | $1,430.20 | $1,787.75 | $24.75 – $300.75 | 25 |
| Egd remove lesion snare CPT 43251 | not published | not published | $853.60 – $1,008.80 | 7 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $162.40 | $203.00 | $30.88 – $170.15 | 27 |
| Electrical stimulation/unattended 97014 CPT 97014 | $114.60 | $143.25 | $11.70 – $152.42 | 23 |
| Electrolyte panel CPT 80051 | $147.60 | $184.50 | $6.94 – $40.76 | 27 |
| Endo abl/incom vein/ext/rad fre/#1 36475 CPT 36475 | not published | not published | $853.60 – $18,724.00 | 8 |
| Endoluminl ivus oct c 1st CPT 92978 | $5,707.20 | $7,134.00 | $300.06 – $300.06 | 1 |
| Endome abla/them without hystero guide 58353 CPT 58353 | not published | not published | $853.60 – $11,091.00 | 8 |
| Endoscopic injection/implant CPT 51715 | not published | not published | $853.60 – $11,091.00 | 8 |
| Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 | not published | not published | $853.60 – $9,100.00 | 8 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $903.80 | $1,129.75 | $65.56 – $77.48 | 7 |
| Epstein barr early antigen antibody CPT 86663 | $89.40 | $111.75 | $12.99 – $76.26 | 27 |
| Epstein barr nuclear antigen antibody CPT 86664 | $116.20 | $145.25 | $15.14 – $88.91 | 27 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $128.40 | $160.50 | $17.96 – $105.39 | 27 |
| ER Visit (level 1, minor) CPT 99281 | $320.20 | $400.25 | $23.10 – $307.64 | 25 |
| ER Visit (level 2) CPT 99282 | $562.40 | $703.00 | $38.50 – $553.29 | 25 |
| ER Visit (level 3) CPT 99283 | $995.00 | $1,243.75 | $66.85 – $967.38 | 25 |
| ER Visit (level 4) CPT 99284 | $1,600.60 | $2,000.75 | $112.49 – $1,487.73 | 25 |
| ER Visit (level 5, high severity) CPT 99285 | $1,752.00 | $2,190.00 | $163.71 – $2,142.01 | 25 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $853.60 – $1,008.80 | 7 |
| Established Patient Office Visit (level 1) CPT 99211 | $159.20 | $199.00 | $8.88 – $124.46 | 25 |
| Established Patient Office Visit (level 2) CPT 99212 | $212.00 | $265.00 | $35.78 – $160.65 | 25 |
| Established Patient Office Visit (level 3) CPT 99213 | $239.20 | $299.00 | $44.00 – $301.27 | 25 |
| Established Patient Office Visit (level 4) CPT 99214 | $266.40 | $333.00 | $44.00 – $443.59 | 25 |
| Established Patient Office Visit (level 5) CPT 99215 | $316.00 | $395.00 | $44.00 – $655.73 | 25 |
| Estradiol total CPT 82670 | $407.60 | $509.50 | $23.65 – $162.39 | 27 |
| Estrogens total-sendout CPT 82672 | $402.40 | $503.00 | $15.31 – $126.01 | 27 |
| Evacuate mole of uterus CPT 59870 | not published | not published | $853.60 – $9,100.00 | 8 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $108.40 | $135.50 | $24.37 – $28.80 | 7 |
| Exc abd les sc 3 cm/> CPT 22903 | not published | not published | $853.60 – $11,091.00 | 8 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $3,178.20 | $3,972.75 | $41.25 – $679.53 | 25 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | not published | not published | $853.60 – $6,676.00 | 8 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $2,249.20 | $2,811.50 | $51.15 – $385.87 | 25 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | not published | not published | $853.60 – $5,032.00 | 8 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $3,178.20 | $3,972.75 | $59.40 – $3,889.00 | 26 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $853.60 – $9,100.00 | 8 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | not published | not published | $853.60 – $11,091.00 | 8 |
| Ext ecg>7d<15d scan a/r CPT 93247 | $1,043.00 | $1,303.75 | $124.00 – $222.24 | 25 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $171.40 | $214.25 | $17.75 – $104.20 | 27 |
| Factor viii CPT 85240 | $413.80 | $517.25 | $14.30 – $104.04 | 27 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $6.60 | $8.25 | $0.56 – $2.56 | 7 |
| Fat/lipids feces qualitative CPT 82705 | $246.60 | $308.25 | $5.05 – $29.57 | 27 |
| Fem/popl revasc w/stent CPT 37226 | $9,074.00 | $11,342.50 | $468.11 – $553.22 | 7 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $19.60 | $24.50 | $1.67 – $6.14 | 7 |
| Ferritin CPT 82728 | $40.00 | $346.75 | $13.20 – $79.16 | 27 |
| Fetal hemoglobin rosette CPT 85461 | $91.20 | $114.00 | $9.27 – $45.39 | 27 |
| Fetal non stress test CPT 59025 | $660.20 | $825.25 | $20.65 – $194.29 | 23 |
| Fibrin degradation d dimer quantitative CPT 85379 | $186.20 | $232.75 | $10.08 – $49.36 | 27 |
| Fibrin degradation products CPT 85362 | $111.80 | $139.75 | $6.82 – $40.04 | 27 |
| Fibrinogen activity CPT 85384 | $44.00 | $55.00 | $9.62 – $49.35 | 27 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $1,392.80 | $1,741.00 | $44.78 – $52.92 | 7 |
| Flow cytometry marker each additional CPT 88185 | $100.00 | $125.00 | $20.09 – $171.74 | 9 |
| Flow cytometry one marker technical component CPT 88184 | $937.80 | $1,172.25 | $40.85 – $1,027.44 | 27 |
| Fluidotherapy charges pt CPT 97022 | $106.40 | $133.00 | $14.64 – $198.61 | 25 |
| Fluorescent antibody titer dna CPT 86256 | $45.60 | $57.00 | $10.02 – $58.43 | 27 |
| Fluoroguide needle placement CPT 77002 | $1,678.00 | $2,097.50 | $60.93 – $229.58 | 8 |
| Fluoroscopy up to 1 hour CPT 76000 | $783.00 | $978.75 | $20.90 – $1,342.45 | 27 |
| Folic acid CPT 82746 | $45.00 | $202.25 | $13.20 – $85.45 | 27 |
| Foot X-ray CPT 73630 | $506.40 | $633.00 | $20.90 – $497.84 | 27 |
| Fructosamine glycated protein CPT 82985 | $257.40 | $321.75 | $16.59 – $84.34 | 27 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $35.40 | $44.25 | $0.28 – $6.40 | 7 |
| Fusion of big toe joint CPT 28750 | not published | not published | $853.60 – $18,724.00 | 8 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $1.60 | $2.00 | $0.11 – $0.38 | 7 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $853.60 – $1,008.80 | 7 |
| Gammaglobulin iga CPT 82784 | $35.00 | $165.25 | $9.21 – $54.05 | 27 |
| Gammaglobulin ige CPT 82785 | $174.60 | $218.25 | $16.30 – $95.72 | 27 |
| Gamma glutamyltransferase CPT 82977 | $141.60 | $177.00 | $7.13 – $41.83 | 27 |
| General health panel CPT 80050 | $70.00 | $764.25 | $48.28 – $118.86 | 8 |
| Ghs change cysto/gastrost CPT 43762 | $1,112.80 | $1,391.00 | $34.21 – $234.89 | 25 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $145.60 | $182.00 | $34.74 – $203.98 | 27 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $1,185.80 | $1,482.25 | $40.15 – $231.68 | 25 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $644.00 | $805.00 | $28.60 – $124.49 | 25 |
| Ghs dislocation elbow closed treatment CPT 24600 | $1,225.80 | $1,532.25 | $112.75 – $231.68 | 25 |
| Ghs excision ingrown nail CPT 11765 | $556.00 | $695.00 | $55.00 – $385.87 | 25 |
| Ghs flow volume loop CPT 94375 | $274.20 | $342.75 | $34.62 – $300.75 | 25 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $8,921.20 | $11,151.50 | $119.35 – $1,138.76 | 25 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $826.20 | $1,032.75 | $39.60 – $679.53 | 25 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $2,824.00 | $3,530.00 | $80.85 – $859.84 | 25 |
| Ghs inj tendon origin/insertion CPT 20551 | $1,928.00 | $2,410.00 | $42.64 – $285.09 | 25 |
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.