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 |
|---|---|---|---|---|
| Ghs ot sensory integrative tech/15min CPT 97533 | $157.60 | $217.00 | $48.34 – $62.03 | 2 |
| Ghs pacing - transcutaneous CPT 92953 | $1,735.20 | $2,391.00 | $124.43 – $459.23 | 2 |
| Ghs peritonsillar abscess i andd CPT 42700 | $998.40 | $1,376.00 | $68.20 – $993.28 | 8 |
| Ghs phenylketonurid CPT 84030 | $123.20 | $170.00 | $5.44 – $12.03 | 8 |
| Ghs plngl fx pm cl CPT 26725 | $998.40 | $1,376.00 | $84.70 – $935.68 | 8 |
| Ghs plt ct-manual CPT 85032 | $84.80 | $117.00 | $3.00 – $5.11 | 8 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $4,187.20 | $5,771.00 | $848.34 – $1,375.90 | 8 |
| Ghs ppd (tb intradermal) CPT 86580 | $26.20 | $36.00 | $5.50 – $21.19 | 8 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $287.20 | $396.00 | $9.55 – $17.04 | 8 |
| Ghs protoporphyrins fract CPT 84202 | $168.80 | $233.00 | $14.19 – $33.81 | 8 |
| Ghs removal intranasal foreign body CPT 30300 | $298.40 | $412.00 | $24.75 – $993.28 | 8 |
| Ghs removal pharyngeal foreign body CPT 42809 | $852.00 | $1,174.00 | $71.50 – $993.28 | 8 |
| Ghs reticulocyte count CPT 85044 | $42.80 | $59.00 | $4.00 – $6.82 | 8 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $345.60 | $477.00 | $10.87 – $13.75 | 2 |
| Ghs sedimentation rate CPT 85651 | $73.60 | $101.00 | $3.00 – $5.11 | 8 |
| Ghs semen analysis fert CPT 89320 | $236.00 | $326.00 | $9.61 – $12.17 | 2 |
| Ghs sensitivity (per antimicro) CPT 87184 | $135.20 | $186.00 | $7.39 – $13.63 | 8 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $712.80 | $983.00 | $101.20 – $993.28 | 8 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $712.80 | $983.00 | $101.20 – $993.28 | 8 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $945.60 | $1,303.00 | $101.20 – $993.28 | 8 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $712.80 | $983.00 | $52.25 – $993.28 | 8 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $712.80 | $983.00 | $53.35 – $944.64 | 8 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $712.80 | $983.00 | $67.65 – $702.72 | 8 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $712.80 | $983.00 | $101.20 – $993.28 | 8 |
| Ghs sleep study unattended CPT 95800 | $752.80 | $1,037.00 | $117.80 – $303.16 | 8 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $188.80 | $260.00 | $38.37 – $38.67 | 2 |
| Ghs sphenopalatine ganglion block CPT 64505 | $687.20 | $947.00 | $59.95 – $277.76 | 8 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $216.80 | $299.00 | $81.50 – $106.42 | 2 |
| Ghs strapping shoulder - 29240 CPT 29240 | $569.60 | $785.00 | $21.45 – $85.60 | 8 |
| Ghs st - re-eval for alt comm CPT 92597 | $301.60 | $416.00 | $56.63 – $177.84 | 2 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $558.40 | $770.00 | $93.80 – $218.22 | 8 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $2,181.60 | $3,636.00 | $103.40 – $993.28 | 8 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $945.60 | $1,303.00 | $129.80 – $993.28 | 8 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $998.40 | $1,376.00 | $80.30 – $993.28 | 8 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $604.00 | $833.00 | $241.78 – $993.28 | 8 |
| Ghs vaginal delivery only CPT 59409 | $1,224.80 | $1,688.00 | $1,536.00 – $1,691.16 | 2 |
| Gi inhouse confirmation CPT 87045 | $104.00 | $144.00 | $6.90 – $11.76 | 8 |
| Glassia injection HCPCS J0257 | $34.80 | $58.00 | $5.64 – $6.20 | 6 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $1,053.60 | $1,317.00 | $182.45 – $200.69 | 6 |
| Glucagon plasma - sendout CPT 82943 | $244.80 | $337.00 | $14.12 – $33.66 | 8 |
| Glucose 1 hr post dose CPT 82950 | $45.00 | $62.00 | $4.70 – $11.13 | 8 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $37.80 | $52.00 | $2.00 – $3.41 | 8 |
| Glucose blood quantitative CPT 82947 | $63.20 | $87.00 | $3.89 – $6.82 | 8 |
| Glucose body fluid CPT 82945 | $63.20 | $87.00 | $3.89 – $7.40 | 8 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $241.60 | $333.00 | $12.50 – $21.30 | 8 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $52.00 | $71.00 | $3.27 – $5.57 | 8 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $35.40 | $44.25 | $0.46 – $0.50 | 6 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $104.80 | $131.00 | $11.04 – $12.14 | 6 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $340.00 | $468.00 | $17.50 – $29.82 | 8 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $309.60 | $468.00 | $17.00 – $28.97 | 8 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $4,524.00 | $7,540.00 | $733.66 – $807.03 | 6 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $3,426.40 | $4,722.00 | $30.23 – $33.56 | 3 |
| Graft axiofill 1000mg HCPCS J3590 | $8,212.20 | $13,687.00 | $994.50 – $4,972.50 | 13 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $15,834.40 | $21,822.00 | $1,839.06 – $9,195.30 | 13 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $25,992.80 | $35,822.00 | $183.42 – $917.10 | 13 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $5,246.40 | $7,230.00 | $17.41 – $87.08 | 13 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $3,241.60 | $4,468.00 | $101.03 – $111.13 | 2 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $7,673.60 | $10,820.00 | $52.75 – $58.03 | 2 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $4,445.60 | $6,127.00 | $15.16 – $75.83 | 13 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $2,112.60 | $3,521.00 | $44.46 – $222.30 | 13 |
| Granisetron hcl injection HCPCS J1626 | $27.00 | $45.00 | $0.19 – $0.20 | 5 |
| Great toe with reduction 28495 CPT 28495 | $998.40 | $1,376.00 | $83.05 – $993.28 | 8 |
| G-tube reposition CPT 43761 | $2,128.00 | $2,933.00 | $103.87 – $281.11 | 8 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,640.80 | $3,639.00 | $137.81 – $1,036.64 | 8 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $9,038.40 | $12,456.00 | $30.42 – $152.10 | 13 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $1,221.60 | $1,683.00 | $3.02 – $15.07 | 13 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $228.00 | $314.00 | $28.98 – $144.90 | 12 |
| Gw stiffened micro access kit HCPCS C1894 | $1,028.80 | $1,418.00 | $1.62 – $244.34 | 13 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $160.00 | $200.00 | $4.40 – $12.31 | 6 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $9.00 | $11.25 | $0.77 – $0.88 | 6 |
| Hand-held pefr meter a4614 HCPCS A4614 | $30.40 | $42.00 | $24.32 – $48.63 | 2 |
| Hands-On Manual Therapy (each 15 minutes) CPT 97140 | $157.60 | $217.00 | $23.13 – $40.85 | 8 |
| Hand X-ray CPT 73130 | $356.80 | $491.00 | $14.72 – $68.14 | 2 |
| Hand X-ray (2 views, both hands) CPT 73120 | $682.40 | $941.00 | $12.80 – $61.64 | 2 |
| Haptoglobin quantitative CPT 83010 | $188.00 | $259.00 | $12.00 – $20.45 | 8 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $1,539.20 | $2,121.00 | $50.42 – $172.10 | 8 |
| Hcg qualitative CPT 84703 | $124.00 | $171.00 | $7.43 – $17.49 | 8 |
| Hcg quantitative CPT 84702 | $364.80 | $503.00 | $14.88 – $27.98 | 8 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $230.40 | $317.00 | $51.84 – $259.20 | 12 |
| Hc nm fusion spect CT unlisted CPT 78999 | $452.80 | $624.00 | $303.48 – $303.48 | 1 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $2,367.20 | $3,262.00 | $227.12 – $377.38 | 7 |
| Head CT scan (with and without contrast) CPT 70470 | $3,270.40 | $4,507.00 | $128.00 – $752.39 | 8 |
| Head CT scan (with contrast) CPT 70460 | $2,868.00 | $3,952.00 | $102.40 – $617.55 | 8 |
| Head CT scan (without contrast) CPT 70450 | $1,938.40 | $2,671.00 | $99.20 – $524.21 | 8 |
| Heart image spect CPT 78494 | $1,996.80 | $2,752.00 | $218.56 – $544.17 | 8 |
| Heart infarct image CPT 78466 | $1,323.20 | $1,824.00 | $71.68 – $309.74 | 8 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | $354.40 | $488.00 | $14.72 – $60.06 | 2 |
| Hematocrit CPT 85014 | $95.20 | $131.00 | $2.35 – $5.50 | 8 |
| Hematopoietic nuclear tx CPT 79403 | $746.40 | $1,029.00 | $113.09 – $514.76 | 8 |
| Hemodialysis one evaluation CPT 90935 | $2,340.80 | $3,226.00 | $211.20 – $272.47 | 2 |
| Hemoglobin CPT 85018 | $45.60 | $76.00 | $2.35 – $5.50 | 8 |
| Hemoglobin fetal qualitative CPT 83033 | $276.00 | $399.00 | $6.53 – $11.13 | 8 |
| Hemoglobin f (fetal) chemical CPT 83030 | $289.60 | $399.00 | $5.00 – $10.62 | 8 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $274.40 | $378.00 | $3.00 – $8.11 | 8 |
| Hemoglobin plasma CPT 83051 | $74.00 | $102.00 | $3.50 – $7.22 | 8 |
| Hemoglobin urine CPT 83069 | $63.20 | $87.00 | $3.08 – $3.90 | 2 |
| Hemophilus influenza antibdy CPT 86684 | $168.00 | $232.00 | $15.65 – $36.56 | 8 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $5,744.80 | $7,917.00 | $50.60 – $993.28 | 8 |
| Heparin assay CPT 85520 | $405.60 | $559.00 | $6.53 – $12.93 | 8 |
| Heparin bolus from bag HCPCS J1644 | $46.20 | $77.00 | $0.21 – $0.23 | 5 |
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.