UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
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 |
|---|---|---|---|---|
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $6.60 | $11.00 | $0.09 – $0.16 | 6 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,196.40 | $1,994.00 | $63.06 – $69.37 | 6 |
| Dextran 40 infusion HCPCS J7100 | $645.60 | $807.00 | $145.26 – $726.30 | 13 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $32.40 | $40.50 | $1.41 – $1.56 | 5 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $29.00 | $36.25 | $6.48 – $32.40 | 13 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $60.40 | $75.50 | $1.81 – $1.99 | 5 |
| Dextrose 5 % IV bolus HCPCS J7070 | $26.80 | $33.50 | $3.11 – $3.42 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $222.40 | $307.00 | $21.00 – $35.79 | 8 |
| Diabetes (HbA1c) Test CPT 83036 | $200.00 | $276.00 | $7.00 – $11.93 | 8 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $701.79 – $993.28 | 2 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $3,052.80 | $4,207.00 | $22.00 – $68.35 | 8 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $338.40 | $466.00 | $90.23 – $139.57 | 2 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $584.00 | $805.00 | $116.26 – $221.29 | 7 |
| Diagnostic Mammogram (one breast) CPT 77065 | $383.20 | $528.00 | $90.89 – $174.53 | 7 |
| Dialysis one evaluation CPT 90945 | $1,536.00 | $2,117.00 | $44.80 – $212.24 | 2 |
| Dialysis repeated eval CPT 90947 | $1,405.60 | $1,937.00 | $44.80 – $417.44 | 2 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $79.20 | $132.00 | $0.08 – $0.08 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $127.20 | $212.00 | $7.35 – $8.08 | 5 |
| Dicyclomine injection HCPCS J0500 | $494.40 | $618.00 | $11.36 – $12.49 | 5 |
| Diffusing capacity CPT 94729 | $498.40 | $687.00 | $42.39 – $72.88 | 8 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $34.00 | $42.50 | $9.05 – $9.96 | 5 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $16,441.80 | $27,403.00 | $5,168.23 – $5,685.05 | 6 |
| Digoxin total therapeutic drug level CPT 80162 | $152.00 | $210.00 | $11.00 – $18.75 | 8 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $924.80 | $1,156.00 | $60.00 – $66.00 | 5 |
| Dilate esophagus 1/mult pass CPT 43450 | $4,264.00 | $5,877.00 | $64.90 – $416.00 | 8 |
| Dilation of cervical canal 57800 CPT 57800 | $4,291.20 | $5,914.00 | $45.65 – $1,045.76 | 8 |
| Dilation of rectal stricture 45910 CPT 45910 | $3,933.60 | $5,421.00 | $48.40 – $993.28 | 8 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,022.40 | $1,409.00 | $11.56 – $57.83 | 12 |
| Dimenhydrinate injection HCPCS J1240 | $13.20 | $16.50 | $6.14 – $6.75 | 5 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $3,160.80 | $5,268.00 | $748.85 – $823.73 | 6 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $16.80 | $21.00 | $0.76 – $0.89 | 6 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $25.80 | $43.00 | $11.00 – $17.04 | 7 |
| Disability dlco CPT 94727 | $282.40 | $390.00 | $28.08 – $58.17 | 8 |
| Disaccharidases CPT 82657 | $107.20 | $148.00 | $17.31 – $21.91 | 2 |
| Discography cerv/thor spine CPT 72285 | $2,404.00 | $3,313.00 | $46.08 – $806.88 | 8 |
| Dna antibody native/double stranded CPT 86225 | $301.60 | $416.00 | $13.58 – $24.71 | 8 |
| Dna gardnerella CPT 87510 | $267.20 | $369.00 | $16.04 – $27.34 | 8 |
| Dna trichomonas CPT 87660 | $279.20 | $384.00 | $19.82 – $38.21 | 8 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $162.00 | $270.00 | $7.08 – $7.79 | 5 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $7,030.80 | $11,718.00 | $0.63 – $0.69 | 5 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $89.40 | $149.00 | $0.83 – $0.92 | 5 |
| Doppler echo complete CPT 93320 | $1,160.00 | $1,599.00 | $52.98 – $203.12 | 8 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,308.00 | $1,803.00 | $89.66 – $336.54 | 8 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $919.20 | $1,266.00 | $47.50 – $292.12 | 8 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | $8.40 | $14.00 | $2.52 – $12.60 | 13 |
| Dornase alfa non-comp unit HCPCS J7639 | $236.00 | $295.00 | $51.57 – $60.68 | 6 |
| Dornhoffer fixed part w/window HCPCS L8614 | $44,163.20 | $60,862.00 | $9,936.72 – $49,683.60 | 13 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $162.60 | $271.00 | $3.02 – $3.32 | 5 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $4,487.40 | $7,479.00 | $108.47 – $119.31 | 5 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $1.20 | $1.50 | $0.11 – $0.12 | 5 |
| Dpyd gene common variants CPT 81232 | $2,358.60 | $3,931.00 | $136.49 – $172.77 | 2 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,741.60 | $2,400.00 | $29.15 – $993.28 | 8 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $1,741.60 | $2,400.00 | $38.50 – $993.28 | 8 |
| Drainage external ear complex 69005 CPT 69005 | $8,618.40 | $11,878.00 | $151.23 – $648.96 | 8 |
| Drainage external ear simple 69000 CPT 69000 | $712.80 | $983.00 | $47.30 – $993.28 | 8 |
| Drainage of arm bursa 23931 CPT 23931 | $4,036.80 | $5,563.00 | $43.45 – $993.28 | 8 |
| Drainage of kidney lesion CPT 50390 | $1,352.80 | $1,865.00 | $100.70 – $993.28 | 8 |
| Drainage of rectal abscess CPT 45005 | $5,976.80 | $8,237.00 | $103.40 – $993.28 | 8 |
| Drainage of rectal abscess 45020 CPT 45020 | $6,501.60 | $8,960.00 | $165.55 – $869.12 | 8 |
| Drain blood from under nail 11740 CPT 11740 | $298.40 | $412.00 | $26.40 – $993.28 | 8 |
| Drain cath image guided visceral pq CPT 49405 | $5,596.80 | $7,713.00 | $190.71 – $1,166.03 | 8 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,524.80 | $2,101.00 | $40.70 – $993.28 | 8 |
| Drain finger abscess;simple 26010 CPT 26010 | $712.80 | $983.00 | $29.15 – $993.28 | 8 |
| Drain thigh/knee lesion 27301 CPT 27301 | $6,528.00 | $8,996.00 | $97.35 – $993.28 | 8 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $998.40 | $1,376.00 | $110.61 – $213.73 | 8 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $712.80 | $983.00 | $22.00 – $99.11 | 8 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $998.40 | $1,376.00 | $126.59 – $244.33 | 8 |
| Drng of eyelid abscess 67700 CPT 67700 | $8,618.40 | $11,878.00 | $165.27 – $1,066.24 | 2 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,267.20 | $3,125.00 | $88.00 – $896.00 | 8 |
| Drng of scrotum abscess 55100 CPT 55100 | $3,497.60 | $4,821.00 | $38.50 – $993.28 | 8 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $39.60 | $49.50 | $7.63 – $8.40 | 5 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $2,151.20 | $2,964.00 | $233.64 – $1,168.20 | 12 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $660.00 | $909.00 | $11.88 – $13.07 | 2 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $841.60 | $1,160.00 | $2.49 – $2.73 | 2 |
| Drug assay vedolizumab CPT 80280 | $431.40 | $719.00 | $30.12 – $38.12 | 2 |
| Drug asy hydroxychloroquine CPT 80220 | $196.20 | $327.00 | $14.55 – $18.42 | 2 |
| Drug test def 1-7 classes HCPCS G0480 | $480.80 | $663.00 | $63.95 – $108.98 | 7 |
| Drug test def 8-14 classes HCPCS G0481 | $316.80 | $528.00 | $98.39 – $167.68 | 7 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $383.20 | $479.00 | $61.41 – $108.81 | 8 |
| Drvvt confirm - quest CPT 85597 | $211.20 | $291.00 | $17.78 – $42.33 | 8 |
| Ductogram sgl duct CPT 77053 | $1,043.20 | $1,437.00 | $49.89 – $147.68 | 8 |
| Duplex scan bilateral study 93985 CPT 93985 | $1,728.80 | $2,382.00 | $222.68 – $349.77 | 8 |
| Duplex scan unilateral study 93986 CPT 93986 | $864.00 | $1,191.00 | $126.76 – $203.14 | 8 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $1,062.40 | $1,464.00 | $101.74 – $344.49 | 8 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $1,179.20 | $1,625.00 | $152.76 – $383.80 | 8 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $514.40 | $709.00 | $115.74 – $578.70 | 13 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $324.60 | $541.00 | $85.12 – $93.63 | 6 |
| Dxa bone density axl vrt fx CPT 77085 | $813.60 | $1,121.00 | $73.47 – $83.46 | 2 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $3,540.00 | $4,878.00 | $148.66 – $993.28 | 8 |
| Dx bronchoscope/wash 31622 CPT 31622 | $3,540.00 | $4,878.00 | $147.25 – $838.40 | 8 |
| Ear irrigation 69209 CPT 69209 | $117.00 | $195.00 | $16.06 – $993.28 | 2 |
| Ecg < 30 days transmission & analysis CPT 93271 | $312.80 | $432.00 | $82.63 – $199.75 | 8 |
| Ecg external < 48 hours recording CPT 93225 | $551.40 | $919.00 | $20.07 – $106.73 | 8 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $671.40 | $1,119.00 | $43.74 – $192.86 | 8 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $91.20 | $126.00 | $10.01 – $26.52 | 8 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $75.00 | $125.00 | $9.61 – $44.88 | 8 |
| Ecg/review interpret only CPT 93272 | $45.60 | $76.00 | $32.26 – $81.42 | 2 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,739.20 | $3,775.00 | $125.62 – $396.39 | 8 |
| Echocardiogram (Limited Follow-Up Heart Ultrasound) CPT 93308 | $483.20 | $666.00 | $27.52 – $270.02 | 8 |
| Echocardiography doppler color flow mapping CPT 93325 | $580.80 | $800.00 | $20.44 – $242.77 | 8 |
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.