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 |
|---|---|---|---|---|
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $4.40 | $5.50 | $0.02 – $0.12 | 6 |
| Hepatitis a antibody igm CPT 86709 | $203.20 | $280.00 | $11.13 – $25.90 | 8 |
| Hepatitis b core antibody igm CPT 86705 | $203.20 | $280.00 | $11.64 – $27.69 | 8 |
| Hepatitis b core antibody total CPT 86704 | $551.20 | $759.00 | $11.91 – $25.56 | 8 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,109.60 | $1,387.00 | $11.00 – $134.19 | 7 |
| Hepatitis b surface antibody CPT 86706 | $166.40 | $229.00 | $10.62 – $22.46 | 8 |
| Hepatitis c antibody CPT 86803 | $338.40 | $466.00 | $14.10 – $32.38 | 8 |
| Hereditary colon ca dsordrs CPT 81435 | $3,202.80 | $5,338.00 | $495.41 – $1,777.75 | 8 |
| Hernia Repair (Inguinal) CPT 49505 | not published | not published | $349.25 – $1,059.55 | 8 |
| Herpes simplex 2 ag if CPT 87273 | $173.60 | $239.00 | $11.84 – $20.76 | 8 |
| Herpes simplex type 1 antibody igg CPT 86695 | $328.00 | $453.00 | $13.03 – $31.05 | 8 |
| Herpes simplex type 2 antibody igg CPT 86696 | $111.20 | $153.00 | $19.13 – $36.47 | 8 |
| Herpes simplex virus isolation CPT 87255 | $540.80 | $746.00 | $33.46 – $64.50 | 8 |
| Heterophile antibodies screening CPT 86308 | $68.40 | $94.00 | $5.12 – $12.19 | 8 |
| Hexa gene CPT 81255 | $1,396.80 | $1,746.00 | $50.85 – $255.34 | 8 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | $452.80 | $624.00 | $26.59 – $51.16 | 8 |
| Hip and Pelvis X-ray (3 to 4 views, both hips) CPT 73522 | $500.80 | $690.00 | $32.04 – $63.21 | 8 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | $751.20 | $1,035.00 | $19.10 – $37.62 | 2 |
| Hip X-ray CPT 73502 | $790.40 | $1,089.00 | $28.62 – $52.44 | 2 |
| Histamine CPT 83088 | $424.80 | $586.00 | $13.00 – $29.19 | 8 |
| Hla ii typing ag equiv lr CPT 81375 | $912.00 | $1,520.00 | $218.16 – $410.58 | 8 |
| Hla i low res one antigen equiv ea CPT 81374 | $956.80 | $1,319.00 | $73.46 – $135.31 | 8 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $1,363.20 | $1,704.00 | $103.22 – $175.91 | 8 |
| Hla typing a b or c CPT 86813 | $967.20 | $1,332.00 | $57.32 – $133.78 | 8 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $9.00 | $15.00 | $0.22 – $0.24 | 4 |
| Ho flex frejka w/cov pre cst HCPCS L1600 | $58.80 | $81.00 | $78.08 – $222.89 | 2 |
| Home sleep test/type 4 porta HCPCS G0400 | $2,075.20 | $2,860.00 | $218.68 – $218.68 | 1 |
| Homocysteine CPT 83090 | $364.80 | $503.00 | $17.71 – $31.78 | 8 |
| Homogenization tissue CPT 87176 | $116.00 | $160.00 | $5.80 – $12.36 | 8 |
| Homovanillic acid (hva) CPT 83150 | $128.00 | $176.00 | $7.50 – $22.14 | 8 |
| Hopd covid-19 spec collect HCPCS C9803 | $24.00 | $30.00 | $19.49 – $19.49 | 1 |
| Hpv types 16 & 18 only CPT 87625 | $228.00 | $314.00 | $38.21 – $65.12 | 8 |
| H pylori (c-13) breath CPT 83013 | $458.40 | $632.00 | $60.10 – $102.42 | 8 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | $1,219.20 | $1,524.00 | $530.20 – $671.12 | 2 |
| Hrdtry brst ca-rlatd dsordrs CPT 81433 | $788.00 | $985.00 | $342.72 – $342.72 | 1 |
| Hrdtry cardmypy gene panel CPT 81439 | $9,300.80 | $11,626.00 | $456.69 – $578.07 | 2 |
| Hrdtry perph neurphy panel CPT 81448 | $7,200.00 | $12,000.00 | $456.69 – $578.07 | 2 |
| Htt gene detc abnor alleles CPT 81271 | $1,394.40 | $1,743.00 | $106.97 – $135.40 | 2 |
| Human epididymis protein 4 (he4) CPT 86305 | $200.80 | $277.00 | $20.57 – $40.65 | 8 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | $259.20 | $432.00 | $32.22 – $35.44 | 5 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $2.80 | $3.50 | $0.36 – $53.36 | 6 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $92.80 | $116.00 | $5.60 – $6.16 | 5 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $583.20 | $972.00 | $21.31 – $23.44 | 6 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $8.00 | $10.00 | $0.10 – $3.24 | 6 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $630.40 | $788.00 | $0.18 – $0.90 | 13 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $204.00 | $281.00 | $7.00 – $17.69 | 8 |
| Hymovis injection 1 mg HCPCS J7322 | $70.20 | $117.00 | $17.62 – $19.38 | 6 |
| Hysterosalpingography s&i CPT 74740 | $1,642.40 | $2,264.00 | $33.92 – $157.04 | 2 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $347.49 – $993.28 | 8 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $577.87 – $993.28 | 2 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $191.70 – $993.28 | 8 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $740.01 – $993.28 | 2 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $157.80 | $263.00 | $11.00 – $17.04 | 7 |
| I-123 iobenguane diag HCPCS A9582 | $9,129.60 | $12,582.00 | $2,054.16 – $10,270.80 | 12 |
| I-123 ioflupane diag HCPCS A9584 | $6,765.60 | $9,324.00 | $1,522.26 – $7,611.30 | 12 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $124.80 | $172.00 | $28.08 – $140.40 | 12 |
| I131 iodide cap, rx HCPCS A9517 | $128.80 | $177.00 | not published | 0 |
| I131 iodide sol, rx HCPCS A9530 | $95.20 | $131.00 | not published | 0 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $351.20 | $484.00 | $27.39 – $34.68 | 2 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $2,792.80 | $3,491.00 | $172.31 – $172.31 | 1 |
| Idarubicin hcl injection HCPCS J9211 | $555.60 | $926.00 | $36.67 – $40.34 | 5 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $7,427.20 | $10,235.00 | $97.35 – $993.28 | 8 |
| I&d lacrimal sac CPT 68420 | $7,494.40 | $10,328.00 | $301.31 – $993.28 | 2 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $320.61 – $993.28 | 2 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $268.20 | $447.00 | $25.20 – $27.72 | 5 |
| Igh gene rearrange amp meth CPT 81261 | $961.60 | $1,202.00 | $195.68 – $367.32 | 8 |
| Igh@ var region somatic mutation analy CPT 81263 | $2,004.60 | $3,341.00 | $291.08 – $546.42 | 8 |
| Igk rearrangeabn clonal pop CPT 81264 | $961.60 | $1,202.00 | $162.57 – $277.05 | 8 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $355.20 | $489.00 | $43.56 – $87.64 | 8 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $329.60 | $455.00 | $73.15 – $152.54 | 8 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $673.60 | $928.00 | $51.38 – $128.59 | 8 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $43.00 | $59.00 | $121.60 – $229.76 | 2 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $239.20 | $330.00 | $89.40 – $160.53 | 2 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $623.20 | $779.00 | $45.31 – $49.85 | 6 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $210.40 | $290.00 | $20.57 – $39.21 | 8 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $211.20 | $291.00 | $20.57 – $39.21 | 8 |
| Immunoassay tumor qual CPT 86294 | $190.20 | $317.00 | $19.97 – $25.27 | 2 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $280.80 | $387.00 | $8.00 – $13.63 | 8 |
| Immunodiffusion nes CPT 86329 | $148.80 | $205.00 | $13.89 – $28.97 | 8 |
| Immunofixation electrophoresis serum CPT 86334 | $265.60 | $366.00 | $22.08 – $47.72 | 8 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $102.40 | $141.00 | $15.40 – $91.87 | 8 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $102.40 | $141.00 | $19.58 – $107.35 | 8 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $8,470.40 | $11,673.00 | $36.72 – $183.60 | 13 |
| Implant neuroelectrodes CPT 64561 | $19,225.60 | $26,496.00 | $993.28 – $1,500.72 | 2 |
| Implant ureth bulk agent HCPCS L8606 | $1,323.20 | $1,824.00 | $280.98 – $1,404.90 | 13 |
| Imported lipodox inj HCPCS Q2049 | $11,220.60 | $18,701.00 | $528.86 – $528.86 | 1 |
| In-111 ibritumomab tiux dx HCPCS A9542 | $14,710.40 | $20,272.00 | $3,309.84 – $16,549.20 | 12 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $658.40 | $907.00 | $148.14 – $740.70 | 12 |
| In-111 pentetreotide HCPCS A9572 | $4,204.80 | $5,795.00 | $946.08 – $4,730.40 | 12 |
| In-111 satumomab pend HCPCS A4642 | $1,095.20 | $1,509.00 | $246.42 – $1,232.10 | 12 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $3,349.80 | $5,583.00 | $25.85 – $792.32 | 8 |
| Incision of burn scab initi CPT 16035 | $998.40 | $1,376.00 | $612.60 – $993.28 | 2 |
| Incision of metatarsal CPT 28306 | $712.80 | $1,188.00 | $338.25 – $1,454.08 | 8 |
| Incision of metatarsal CPT 28308 | $669.00 | $1,115.00 | $1,034.95 – $1,326.08 | 2 |
| Incision tendon sheath CPT 26055 | not published | not published | $220.00 – $823.04 | 8 |
| Incisn of toe tndn CPT 28010 | $366.00 | $610.00 | $144.10 – $993.28 | 8 |
| Infect ag drug suscept pheno predict CPT 87900 | $1,682.40 | $2,318.00 | $128.83 – $248.28 | 8 |
| Infect ag eia influenza a or b ea CPT 87400 | $171.20 | $236.00 | $6.09 – $13.97 | 8 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,795.20 | $2,474.00 | $254.45 – $482.46 | 8 |
| Infect ag genotype na dna hepatitis b CPT 87912 | $445.60 | $614.00 | $254.45 – $482.46 | 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.