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 |
|---|---|---|---|---|
| Factor viii recomb novoeight HCPCS J7182 | $3.40 | $4.25 | $1.54 – $1.69 | 6 |
| Fallopian tube recnl CPT 58345 | $972.80 | $1,341.00 | $767.64 – $2,207.67 | 2 |
| Family therapy without pt 50min 90846 CPT 90846 | $128.00 | $176.00 | $16.64 – $196.32 | 2 |
| Family therapy with patient 50 min 90847 CPT 90847 | $128.00 | $176.00 | $16.64 – $222.70 | 2 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $0.40 | $0.50 | $0.01 – $0.01 | 5 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $52.80 | $88.00 | $29.98 – $32.98 | 6 |
| Fat/lipids feces qualitative CPT 82705 | $241.60 | $333.00 | $5.04 – $12.00 | 8 |
| Fatty acids nonesterified CPT 82725 | $185.60 | $256.00 | $13.18 – $22.46 | 8 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $226.20 | $377.00 | $14.55 – $18.42 | 2 |
| Feno poc CPT 95012 | $273.60 | $377.00 | $26.52 – $26.73 | 2 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $218.40 | $364.00 | $1.10 – $1.21 | 5 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $5,580.60 | $9,301.00 | $1.11 – $1.22 | 6 |
| Ferritin CPT 82728 | $256.80 | $372.00 | $12.00 – $20.45 | 8 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $3,963.60 | $6,606.00 | $0.32 – $0.36 | 5 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $1,152.00 | $1,588.00 | $74.36 – $239.47 | 8 |
| Fetal fibronectin CPT 82731 | $1,029.60 | $1,419.00 | $20.00 – $63.66 | 8 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $431.20 | $594.00 | $7.64 – $18.22 | 8 |
| Fetal non stress test CPT 59025 | $451.20 | $622.00 | $6.04 – $98.98 | 8 |
| Fibrin degradation d dimer quantitative CPT 85379 | $179.20 | $247.00 | $10.06 – $18.06 | 8 |
| Fibrin degradation products CPT 85362 | $111.20 | $153.00 | $6.81 – $16.22 | 8 |
| Fibrinogen activity CPT 85384 | $160.80 | $222.00 | $9.61 – $16.89 | 8 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $61.80 | $103.00 | $3.00 – $15.30 | 8 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $80.80 | $111.00 | $5.00 – $8.52 | 8 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $582.00 | $970.00 | $0.30 – $0.33 | 5 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $2,461.20 | $4,102.00 | $1.00 – $1.10 | 6 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $2,032.80 | $3,388.00 | $0.46 – $533.48 | 6 |
| Finasteride, 5 mg HCPCS S0138 | $20.60 | $25.75 | $0.07 – $0.07 | 1 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,320.00 | $1,820.00 | $84.41 – $993.28 | 8 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $877.60 | $1,210.00 | $44.78 – $73.09 | 8 |
| Fine needle asp without image guide 10021 CPT 10021 | $722.40 | $1,204.00 | $68.46 – $993.28 | 8 |
| Finger X-ray (both hands) CPT 73140 | $356.80 | $491.00 | $11.52 – $51.81 | 2 |
| Fixation of knee joint CPT 27570 | not published | not published | $109.45 – $889.60 | 8 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $957.59 – $993.28 | 2 |
| Flecainide (tambocor)-sendout CPT 80181 | $228.80 | $315.00 | $14.55 – $18.42 | 2 |
| Fl exam g/colon tube w contrast CPT 49465 | $2,151.20 | $2,964.00 | $26.11 – $255.42 | 8 |
| Flexible Sigmoidoscopy CPT 45330 | $797.60 | $1,047.00 | $58.47 – $431.36 | 8 |
| Flow cytometry interp 16 or more CPT 88189 | $452.80 | $624.00 | $88.68 – $202.76 | 8 |
| Flow cytometry marker each additional CPT 88185 | $334.40 | $461.00 | $18.26 – $41.76 | 8 |
| Flow cytometry one marker technical component CPT 88184 | $1,882.40 | $2,595.00 | $37.14 – $84.96 | 8 |
| #flow interp 9 - 15 markers CPT 88188 | $348.00 | $480.00 | $67.31 – $153.90 | 8 |
| Floxuridine injection HCPCS J9200 | $555.60 | $926.00 | $4,128.02 – $4,540.82 | 6 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $42.00 | $70.00 | $2.26 – $15.36 | 6 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $1,258.80 | $2,098.00 | $68.20 – $75.02 | 6 |
| Fluidotherapy charges pt CPT 97022 | $143.20 | $197.00 | $15.32 – $29.79 | 8 |
| Fluorescent antibody titer dna CPT 86256 | $244.80 | $337.00 | $9.11 – $15.53 | 8 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $1,542.40 | $2,125.00 | $36.08 – $107.16 | 8 |
| Fluoroguide needle placement CPT 77002 | $1,542.40 | $2,125.00 | $45.66 – $110.25 | 8 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $647.20 | $891.00 | $14.72 – $129.30 | 8 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $318.60 | $531.00 | $1.99 – $2.19 | 5 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $718.20 | $1,197.00 | $7.30 – $12.45 | 6 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,175.20 | $1,619.00 | $102.33 – $993.28 | 8 |
| Fna bx w/ct gdn ea addl CPT 10010 | $877.60 | $1,210.00 | $74.79 – $331.38 | 8 |
| Fna bx w/mr gdn 1st les CPT 10011 | $710.40 | $979.00 | $147.66 – $228.77 | 7 |
| Foam drg >16<=48 sq in w/bdr HCPCS A6213 | $23.60 | $32.00 | $14.85 – $14.85 | 1 |
| Foam drg <=16 sq in w/border HCPCS A6212 | $19.00 | $26.00 | $11.19 – $22.36 | 2 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | $9.60 | $13.00 | $8.64 – $17.26 | 2 |
| Folic acid CPT 82746 | $158.40 | $218.00 | $12.00 – $20.45 | 8 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $0.80 | $1.00 | $0.06 – $0.07 | 5 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $5,244.60 | $8,741.00 | $6.28 – $6.28 | 1 |
| Fondaparinux sodium HCPCS J1652 | $595.80 | $993.00 | $0.72 – $26.50 | 6 |
| Foot X-ray CPT 73630 | $364.80 | $608.00 | $14.72 – $68.14 | 2 |
| Foot X-ray (2 views, both feet) CPT 73620 | $759.20 | $1,046.00 | $12.80 – $61.64 | 2 |
| Forearm X-ray (both sides) CPT 73090 | $660.00 | $909.00 | $14.72 – $64.56 | 2 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,549.20 | $2,582.00 | $0.10 – $0.11 | 5 |
| Foscarnet sodium injection HCPCS J1455 | $1,974.60 | $3,291.00 | $16.08 – $17.68 | 6 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $366.60 | $611.00 | not published | 0 |
| Fracture assessment via dxa CPT 77086 | $679.20 | $936.00 | $46.45 – $67.84 | 2 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $274.45 – $1,861.10 | 8 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $294.40 | $405.00 | $33.00 – $51.13 | 7 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $366.40 | $505.00 | $33.00 – $146.41 | 8 |
| Fresh frozen plasma thawing ea un CPT 86927 | $86.40 | $119.00 | $122.78 – $122.78 | 1 |
| Fructosamine glycated protein CPT 82985 | $280.80 | $468.00 | $16.44 – $28.02 | 8 |
| Ftl cgen abnor five anal CPT 81512 | $452.00 | $623.00 | $68.71 – $188.81 | 8 |
| Ftl cgen abnor two proteins CPT 81508 | $152.00 | $210.00 | $42.39 – $53.66 | 2 |
| Full Spine X-ray (Scoliosis Survey) CPT 72082 | $868.80 | $1,197.00 | $43.96 – $80.51 | 8 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $0.40 | $0.50 | $0.02 – $0.22 | 6 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | $26.40 | $44.00 | $1.62 – $8.10 | 13 |
| Fusion of big toe joint CPT 28750 | not published | not published | $306.35 – $1,347.84 | 8 |
| G0180 home health certification HCPCS G0180 | $93.60 | $156.00 | $41.01 – $41.01 | 1 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $52.00 | $71.00 | $11.70 – $58.50 | 12 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $2.40 | $4.00 | $0.28 – $0.30 | 4 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $14.40 | $24.00 | $1.48 – $4.15 | 5 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $65.40 | $109.00 | $0.11 – $0.12 | 4 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $22.20 | $37.00 | $14.73 – $20.93 | 5 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $41.40 | $57.00 | $2.00 – $20.82 | 8 |
| Galectin-3 CPT 82777 | $94.40 | $130.00 | $14.24 – $43.73 | 8 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,944.00 | $2,680.00 | $266.27 – $446.10 | 8 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $2,366.40 | $3,261.00 | $364.11 – $564.11 | 8 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $993.28 – $1,414.39 | 2 |
| Gamma globulin 1 cc inj HCPCS J1460 | $381.00 | $635.00 | $49.03 – $53.94 | 6 |
| Gammaglobulin iga CPT 82784 | $340.00 | $468.00 | $9.19 – $21.90 | 8 |
| Gammaglobulin ige CPT 82785 | $274.40 | $378.00 | $16.27 – $29.82 | 8 |
| Gamma glutamyltransferase CPT 82977 | $134.40 | $185.00 | $7.12 – $15.95 | 8 |
| Gamunex-c/gammaked HCPCS J1561 | $20,308.80 | $33,848.00 | $48.96 – $53.86 | 6 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $735.20 | $919.00 | $39.54 – $43.50 | 5 |
| Gardner vag dna quant CPT 87512 | $351.20 | $484.00 | $32.60 – $41.27 | 2 |
| Gastroesophageal reflux study CPT 78262 | $1,960.80 | $2,703.00 | $41.60 – $376.82 | 8 |
| Gastroesophageal reflux test CPT 91034 | $2,960.00 | $4,079.00 | $168.17 – $406.67 | 8 |
| Gastro/jejuno tube, std HCPCS B4087 | $1,074.40 | $1,343.00 | $39.14 – $62.02 | 2 |
| Gated heart multiple CPT 78473 | $2,779.20 | $3,830.00 | $290.56 – $877.81 | 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.