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 |
|---|---|---|---|---|
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $1,189.40 | $1,486.75 | $101.20 – $385.87 | 25 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $789.80 | $987.25 | $319.09 – $801.49 | 20 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $496.80 | $621.00 | $34.65 – $385.39 | 25 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $890.40 | $1,113.00 | $26.95 – $385.87 | 25 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $2,249.20 | $2,811.50 | $34.65 – $385.87 | 25 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $2,249.60 | $2,812.00 | $52.25 – $385.87 | 25 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $2,242.20 | $2,802.75 | $53.35 – $591.20 | 25 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $1,297.16 | $1,621.45 | $67.65 – $385.87 | 25 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $1,703.60 | $2,129.50 | $67.21 – $79.43 | 7 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $216.00 | $270.00 | $9.16 – $10.83 | 7 |
| Ghs myocardial strain img spckl track CPT 93356 | $466.80 | $583.50 | $102.94 – $102.94 | 1 |
| Ghs nailbed repair/nail removal CPT 11760 | $920.00 | $1,150.00 | $25.30 – $591.20 | 25 |
| Ghs ng placement w fluoro guidance CPT 43752 | $1,080.98 | $1,351.22 | $383.88 – $987.31 | 20 |
| Ghs o2 saturation CPT 82810 | $40.80 | $51.00 | $9.67 – $50.71 | 27 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,642.60 | $2,053.25 | $46.65 – $55.13 | 7 |
| Ghs plngl fx pm cl CPT 26725 | $1,004.40 | $1,255.50 | $84.70 – $231.68 | 25 |
| Ghs pr without cont pulse ox CPT 94625 | $453.20 | $566.50 | $29.70 – $225.55 | 21 |
| Ghs semen analysis fert CPT 89320 | $380.40 | $475.50 | $12.19 – $132.65 | 22 |
| Ghs sensitivity (per antimicro) CPT 87184 | $158.60 | $198.25 | $7.41 – $40.08 | 27 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $1,158.20 | $1,447.75 | $101.20 – $385.87 | 25 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $937.40 | $1,171.75 | $52.25 – $191.90 | 25 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $875.40 | $1,094.25 | $53.35 – $191.90 | 25 |
| Ghs urine, porphyrins quant CPT 84120 | $209.20 | $261.50 | $8.25 – $73.03 | 27 |
| Gi inhouse confirmation CPT 87045 | $128.80 | $161.00 | $7.59 – $54.81 | 27 |
| Glucose 1 hr post dose CPT 82950 | $54.20 | $67.75 | $4.70 – $27.58 | 27 |
| Glucose blood quantitative CPT 82947 | $63.00 | $78.75 | $3.89 – $22.81 | 27 |
| Glucose body fluid CPT 82945 | $67.20 | $84.00 | $3.89 – $22.81 | 27 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $241.60 | $302.00 | $12.74 – $74.83 | 27 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $23.20 | $29.00 | $3.60 – $19.01 | 27 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $51.40 | $64.25 | $0.70 – $2.75 | 25 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $345.80 | $432.25 | $18.39 – $108.02 | 27 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $315.20 | $394.00 | $18.33 – $107.62 | 27 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $7,846.32 | $9,807.90 | $8,397.15 – $8,397.15 | 1 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,043.60 | $2,554.50 | $137.81 – $679.53 | 25 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $4.00 | $5.00 | $0.61 – $2.69 | 7 |
| Hand X-ray CPT 73130 | $511.20 | $639.00 | $20.90 – $497.84 | 27 |
| Haptoglobin quantitative CPT 83010 | $45.00 | $234.75 | $12.45 – $73.11 | 27 |
| Hcg quantitative CPT 84702 | $55.00 | $451.50 | $14.90 – $84.30 | 27 |
| Head CT scan (with and without contrast) CPT 70470 | $569.00 | $3,802.00 | $171.26 – $1,442.85 | 27 |
| Head CT scan (without contrast) CPT 70450 | $296.00 | $2,337.75 | $102.30 – $911.68 | 27 |
| Hematocrit CPT 85014 | $25.40 | $31.75 | $2.35 – $13.77 | 27 |
| Hemodialysis one evaluation CPT 90935 | $2,029.80 | $2,537.25 | $673.14 – $2,095.68 | 20 |
| Hemoglobin CPT 85018 | $48.20 | $60.25 | $2.35 – $13.77 | 27 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | not published | not published | $853.60 – $3,889.00 | 26 |
| Heparin assay CPT 85520 | $79.80 | $99.75 | $7.18 – $63.47 | 27 |
| Hepatitis b core antibody igm CPT 86705 | $172.40 | $215.50 | $11.65 – $68.38 | 27 |
| Hepatitis b core antibody total CPT 86704 | $483.80 | $604.75 | $11.93 – $70.05 | 27 |
| Hepatitis b surface antibody CPT 86706 | $177.20 | $221.50 | $10.63 – $62.41 | 27 |
| Hepatitis c antibody CPT 86803 | $55.00 | $363.25 | $14.13 – $82.94 | 27 |
| Hepatobiliary system imaging CPT 78226 | $2,308.00 | $2,885.00 | $266.27 – $2,259.58 | 27 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $853.60 – $1,008.80 | 7 |
| Heterophile antibodies screening CPT 86308 | $90.20 | $112.75 | $5.13 – $30.09 | 27 |
| Hip X-ray CPT 73502 | $528.80 | $661.00 | $34.47 – $497.84 | 27 |
| Homocysteine CPT 83090 | $372.20 | $465.25 | $17.74 – $98.03 | 27 |
| Homogenization tissue CPT 87176 | $24.00 | $30.00 | $5.82 – $34.19 | 27 |
| Hydration IV infusion each additional hour CPT 96361 | $295.80 | $369.75 | $9.90 – $44.56 | 25 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $1,035.40 | $1,294.25 | $34.79 – $203.48 | 25 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $135.60 | $169.50 | $32.37 – $135.68 | 7 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $15.80 | $19.75 | $0.35 – $1.44 | 7 |
| Hysterosalpingography s&i CPT 74740 | $1,817.40 | $2,271.75 | $232.54 – $1,342.45 | 22 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $853.60 – $1,008.80 | 7 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $145.60 | $182.00 | $34.74 – $484.79 | 22 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $473.80 | $592.25 | $56.22 – $187.62 | 9 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $886.60 | $1,108.25 | $97.34 – $1,027.44 | 27 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $459.60 | $574.50 | $75.55 – $488.22 | 27 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $85.00 | $238.00 | $20.60 – $120.91 | 27 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $85.00 | $247.75 | $20.60 – $120.91 | 27 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $49.60 | $62.00 | $8.80 – $69.65 | 27 |
| Immunofixation electrophoresis serum CPT 86334 | $236.60 | $295.75 | $22.12 – $129.83 | 27 |
| Implant neuroelectrodes CPT 64555 | $19,865.00 | $24,831.25 | $157.40 – $3,132.86 | 2 |
| Impl neurostim electr perc CPT 63650 | $19,151.20 | $23,939.00 | $410.25 – $484.84 | 7 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $5,488.80 | $6,861.00 | $25.85 – $6,676.00 | 8 |
| Incision of tendon sheath CPT 25000 | not published | not published | $853.60 – $9,100.00 | 8 |
| Incision tendon sheath CPT 26055 | not published | not published | $853.60 – $6,676.00 | 8 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $342.00 | $427.50 | $5.99 – $145.96 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $257.20 | $321.50 | $6.91 – $94.13 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $288.00 | $360.00 | $11.86 – $64.00 | 27 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $487.80 | $609.75 | $13.40 – $116.66 | 27 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $983.80 | $1,229.75 | $10.23 – $60.02 | 27 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $496.00 | $620.00 | $23.84 – $135.80 | 27 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $770.20 | $962.75 | $5.99 – $136.43 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $480.80 | $601.00 | $5.99 – $144.83 | 23 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $49.60 | $62.00 | $11.86 – $64.00 | 27 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $402.40 | $503.00 | $25.51 – $203.98 | 27 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $362.00 | $452.50 | $25.51 – $203.98 | 27 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $420.20 | $525.25 | $36.90 – $200.08 | 27 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,333.60 | $1,667.00 | $412.61 – $4,534.79 | 22 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $584.60 | $730.75 | $17.55 – $486.33 | 23 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $140.00 | $509.00 | $34.74 – $203.98 | 27 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $362.00 | $452.50 | $25.51 – $203.98 | 27 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $100.00 | $192.00 | $39.04 – $248.80 | 26 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $100.00 | $638.98 | $124.15 – $691.61 | 26 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $186.20 | $232.75 | $25.51 – $457.14 | 27 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $307.40 | $384.25 | $34.74 – $190.53 | 27 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $515.20 | $644.00 | $208.39 – $6,032.91 | 23 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $1,055.60 | $1,319.50 | $42.41 – $576.67 | 22 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $1,078.20 | $1,347.75 | $42.41 – $248.91 | 27 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $778.20 | $972.75 | $84.25 – $494.48 | 27 |
| Initiation & management bipap/cpap initial day CPT 94660 | $394.40 | $493.00 | $42.83 – $964.97 | 22 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $32,563.20 | $40,704.00 | $4,118.10 – $17,376.00 | 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.