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 |
|---|---|---|---|---|
| Obstetric panel inc HIV tstg CPT 80081 | $230.00 | $298.50 | $74.11 – $405.85 | 27 |
| Obstetrics panel CPT 80055 | $190.00 | $249.00 | $13.20 – $231.83 | 26 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $1.40 | $1.75 | $0.28 – $1.15 | 7 |
| Oscillation chest wall mechanical per session CPT 94669 | $598.80 | $748.50 | $195.67 – $196.43 | 19 |
| Osmolality blood CPT 83930 | $137.60 | $172.00 | $3.30 – $38.41 | 27 |
| Osmolality urine CPT 83935 | $132.20 | $165.25 | $3.30 – $39.60 | 27 |
| Ot evaluation high complexity patient/family CPT 97167 | $322.40 | $403.00 | $47.20 – $427.09 | 25 |
| Ot evaluation low complexity patient/family CPT 97165 | $280.00 | $350.00 | $47.20 – $427.09 | 25 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $301.80 | $377.25 | $47.20 – $427.09 | 25 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $141.80 | $177.25 | $43.32 – $192.89 | 25 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $140.20 | $175.25 | $25.94 – $149.24 | 25 |
| Ot re-evaluation patient/family CPT 97168 | $171.20 | $214.00 | $44.76 – $294.15 | 25 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $144.80 | $181.00 | $32.79 – $160.60 | 25 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $73.60 | $92.00 | $20.12 – $98.53 | 20 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $135.20 | $169.00 | $27.47 – $160.09 | 25 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $168.00 | $210.00 | $30.56 – $149.69 | 25 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $126.20 | $157.75 | $30.44 – $155.59 | 25 |
| Parathormone (pth) intact CPT 83970 | $231.20 | $289.00 | $40.87 – $239.88 | 27 |
| Partial removal of thyroid CPT 60220 | not published | not published | $853.60 – $18,724.00 | 8 |
| Part removal of metatarsal CPT 28110 | not published | not published | $853.60 – $9,100.00 | 8 |
| Pelvic CT scan (with contrast) CPT 72193 | $475.50 | $2,958.50 | $154.10 – $1,382.91 | 27 |
| Pelvic CT scan (without contrast) CPT 72192 | $281.00 | $2,325.25 | $102.30 – $1,013.23 | 27 |
| Pelvic MRI (with and without contrast) CPT 72197 | $706.00 | $7,222.00 | $343.57 – $2,805.20 | 27 |
| Pelvic MRI (without contrast) CPT 72195 | $455.50 | $4,158.25 | $232.54 – $1,808.39 | 27 |
| Pelvic Ultrasound (complete) CPT 76856 | $897.20 | $1,121.50 | $84.15 – $602.31 | 26 |
| Pelvic Ultrasound (limited) CPT 76857 | $870.60 | $1,088.25 | $35.20 – $602.31 | 27 |
| Pet CT skull-mid thgh initial CPT 78815 | $7,410.00 | $9,262.50 | $1,403.19 – $8,570.95 | 27 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $26,096.40 | $32,620.50 | $7,521.90 – $7,521.90 | 1 |
| Ph body fluid CPT 83986 | $58.20 | $72.75 | $2.20 – $17.36 | 27 |
| Phenobarbital therapeutic drug level CPT 80184 | $223.20 | $279.00 | $15.15 – $74.19 | 27 |
| Phenytoin total therapeutic drug level CPT 80185 | $161.20 | $201.50 | $13.12 – $77.05 | 27 |
| Phlebotomy therapeutic CPT 99195 | $110.00 | $678.00 | $11.00 – $124.49 | 25 |
| Phleb veins 1 extrm >20 stab CPT 37766 | not published | not published | $853.60 – $11,091.00 | 8 |
| Phosphorus CPT 84100 | $15.00 | $109.75 | $4.69 – $27.58 | 27 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $2,043.20 | $2,554.00 | $77.78 – $679.53 | 25 |
| Place right device/marker pros CPT 55876 | $4,212.13 | $5,265.16 | $102.83 – $2,616.83 | 21 |
| Platelet aggregation each agent teg CPT 85576 | $206.20 | $257.75 | $24.66 – $124.85 | 27 |
| Platelet automated CPT 85049 | $57.60 | $72.00 | $3.30 – $25.99 | 27 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $2,210.40 | $2,763.00 | $77.29 – $679.53 | 25 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $855.20 | $1,069.00 | $37.38 – $44.17 | 7 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $304.00 | $380.00 | $44.07 – $300.75 | 25 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $264.00 | $330.00 | $25.81 – $126.41 | 27 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $8,062.00 | $10,077.50 | $712.32 – $982.60 | 25 |
| Potassium 24 hour urine CPT 84133 | $60.60 | $75.75 | $4.68 – $24.99 | 27 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $22.80 | $28.50 | $0.08 – $2.72 | 7 |
| Potassium serum/plasma/whole blood CPT 84132 | $52.00 | $65.00 | $4.71 – $26.67 | 27 |
| Pr application of long arm splint CPT 29105 | $676.80 | $846.00 | $36.85 – $152.39 | 25 |
| Pr application splint static short arm CPT 29125 | $663.60 | $829.50 | $28.60 – $124.49 | 25 |
| Pr correction hammertoe CPT 28285 | not published | not published | $853.60 – $9,100.00 | 8 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | not published | not published | $853.60 – $1,008.80 | 7 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $1,771.00 | $2,213.75 | $34.69 – $191.90 | 25 |
| Prealbumin CPT 84134 | $140.80 | $176.00 | $14.44 – $84.78 | 27 |
| Prednisone 1 mg tablet HCPCS J7512 | $1.00 | $1.25 | $0.01 – $4.51 | 7 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $846.80 | $1,058.50 | $85.25 – $602.31 | 27 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $909.60 | $1,137.00 | $92.50 – $602.31 | 27 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $876.20 | $1,095.25 | $57.75 – $385.87 | 25 |
| Pr incision & drainage abscess simple/single CPT 10060 | $882.60 | $1,103.25 | $25.85 – $191.90 | 25 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $1,078.60 | $1,348.25 | $103.19 – $293.79 | 25 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | not published | not published | $384.36 – $1,956.00 | 26 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $406.00 | $507.50 | $10.89 – $12.87 | 7 |
| Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 | not published | not published | $853.60 – $9,100.00 | 8 |
| Procalcitonin CPT 84145 | $141.20 | $176.50 | $24.43 – $131.99 | 27 |
| Progesterone CPT 84144 | $330.40 | $413.00 | $18.70 – $121.23 | 27 |
| Prolactin CPT 84146 | $373.80 | $467.25 | $19.19 – $112.64 | 27 |
| Prostatectomy (turp) CPT 52601 | not published | not published | $853.60 – $11,091.00 | 8 |
| Protein c activity CPT 85303 | $319.40 | $399.25 | $13.70 – $80.36 | 27 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $40.00 | $266.00 | $10.63 – $62.41 | 27 |
| Protein s total CPT 85305 | $673.40 | $841.75 | $11.49 – $67.38 | 27 |
| Protein total 24 hour urine CPT 84156 | $85.00 | $106.25 | $3.63 – $21.29 | 27 |
| Protein total body fluid CPT 84157 | $173.80 | $217.25 | $3.96 – $21.29 | 27 |
| Protein total serum plasma whole blood CPT 84155 | $89.40 | $111.75 | $3.63 – $21.29 | 27 |
| Prq trluml c angiop 1art&/br CPT 92920 | $10,267.20 | $12,834.00 | $542.24 – $9,243.71 | 3 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $318.80 | $398.50 | $33.00 – $124.49 | 25 |
| Pr removal intrauterine device CPT 58301 | $1,231.40 | $1,539.25 | $18.98 – $293.79 | 25 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $961.80 | $1,202.25 | $36.30 – $385.87 | 25 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $821.20 | $1,026.50 | $34.65 – $191.90 | 25 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $826.60 | $1,033.25 | $52.25 – $191.90 | 25 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $772.60 | $965.75 | $26.95 – $191.90 | 25 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $858.40 | $1,073.00 | $39.05 – $191.90 | 25 |
| PSA (Prostate) Test CPT 84153 | $45.00 | $305.75 | $18.21 – $106.86 | 27 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $128.40 | $160.50 | $13.64 – $159.07 | 25 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $128.00 | $160.00 | $13.26 – $158.56 | 25 |
| Pt application of modality traction mechanical CPT 97012 | $126.80 | $158.50 | $13.64 – $137.77 | 25 |
| Pt evaluation high complexity patient/family CPT 97163 | $322.40 | $403.00 | $47.20 – $416.51 | 25 |
| Pt evaluation low complexity patient/family CPT 97161 | $280.00 | $350.00 | $47.20 – $416.51 | 25 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $301.80 | $377.25 | $47.20 – $416.51 | 25 |
| Pt re-evaluation patient/family CPT 97164 | $143.80 | $179.75 | $47.20 – $286.21 | 25 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $265.80 | $332.25 | $39.45 – $193.59 | 25 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $63.00 | $78.75 | $27.47 – $127.12 | 25 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $161.60 | $202.00 | $28.13 – $137.76 | 24 |
| Pt wheelchair management each 15 minutes CPT 97542 | $127.20 | $159.00 | $29.32 – $143.63 | 25 |
| Pulse ox continuous overnight monitoring CPT 94762 | $331.40 | $414.25 | $78.23 – $162.35 | 21 |
| Pulse ox multiple CPT 94761 | $331.40 | $414.25 | $4.25 – $5.02 | 7 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $122.40 | $153.00 | $14.30 – $124.49 | 25 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $667.80 | $834.75 | $26.40 – $385.87 | 25 |
| Quest t3 uptake CPT 84479 | $364.20 | $455.25 | $6.41 – $37.61 | 27 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $853.60 – $34,157.00 | 8 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $853.60 – $34,157.00 | 8 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $1,821.80 | $2,277.25 | $143.39 – $597.12 | 25 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $3,966.40 | $4,958.00 | $202.50 – $239.32 | 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.