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 |
|---|---|---|---|---|
| Infect ag genotype na hiv-1 other region CPT 87906 | $1,682.40 | $2,318.00 | $127.22 – $246.96 | 8 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,682.40 | $2,318.00 | $254.45 – $485.05 | 8 |
| Infect ag ia optc obs influenza CPT 87804 | $458.40 | $632.00 | $11.35 – $19.34 | 8 |
| Infect ag if nos ea CPT 87299 | $256.00 | $353.00 | $12.57 – $15.91 | 2 |
| Infect ag na herpes simplex quant CPT 87530 | $532.80 | $734.00 | $33.45 – $42.34 | 2 |
| Infect ag na hpv high-risk types CPT 87624 | $392.80 | $542.00 | $34.68 – $65.12 | 8 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $1,388.00 | $1,913.00 | $94.68 – $163.26 | 8 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $754.40 | $1,040.00 | $411.91 – $781.09 | 8 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $124.80 | $172.00 | $9.36 – $11.84 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $597.60 | $823.00 | $10.79 – $13.67 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $241.60 | $333.00 | $11.84 – $20.98 | 8 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $201.60 | $278.00 | $11.23 – $14.22 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $875.20 | $1,206.00 | $10.21 – $24.15 | 8 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $82.40 | $113.00 | $10.21 – $19.46 | 8 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $273.60 | $377.00 | $23.80 – $46.52 | 8 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $636.80 | $878.00 | $9.36 – $11.84 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $174.40 | $240.00 | $9.36 – $11.84 | 2 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $140.00 | $193.00 | $11.84 – $20.76 | 8 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $1,081.60 | $1,491.00 | $23.19 – $39.52 | 8 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $333.60 | $460.00 | $23.19 – $39.52 | 8 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $346.40 | $478.00 | $36.84 – $68.54 | 8 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $704.80 | $971.00 | $325.43 – $411.91 | 2 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $307.20 | $423.00 | $27.39 – $34.68 | 2 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $453.60 | $756.00 | $34.68 – $66.86 | 8 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $307.20 | $423.00 | $32.54 – $41.19 | 2 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $460.80 | $635.00 | $23.19 – $39.52 | 8 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $100.00 | $125.00 | $35.49 – $60.48 | 9 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $460.80 | $635.00 | $34.68 – $65.27 | 8 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $336.00 | $560.00 | $74.61 – $74.61 | 1 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $529.60 | $730.00 | $325.43 – $411.91 | 2 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $104.00 | $144.00 | $100.17 – $126.79 | 2 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $1,043.20 | $1,437.00 | $33.45 – $42.34 | 2 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $620.80 | $856.00 | $39.65 – $67.57 | 8 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $941.60 | $1,298.00 | $39.65 – $67.57 | 8 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $1,288.80 | $1,777.00 | $84.10 – $197.84 | 8 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $5,408.40 | $9,014.00 | $31.09 – $1,135.97 | 7 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $135.20 | $169.00 | $20.41 – $22.45 | 5 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $4,383.60 | $7,306.00 | $19.99 – $21.99 | 5 |
| Influenza dna amp prob addl CPT 87503 | $337.60 | $465.00 | $23.38 – $39.84 | 8 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | $40.00 | $52.00 | $11.00 – $98.16 | 7 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $501.60 | $691.00 | $34.32 – $74.52 | 8 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $216.00 | $360.00 | $25.60 – $25.60 | 1 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $7,107.60 | $11,846.00 | $7.28 – $2,777.90 | 7 |
| Inj, adalimumab, 1 mg HCPCS J0139 | $256.00 | $320.00 | $91.73 – $3,365.77 | 2 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $10,166.40 | $16,944.00 | $18.08 – $19.89 | 6 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | $5,052.80 | $6,316.00 | $80.91 – $89.00 | 6 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $568.00 | $710.00 | $164.59 – $181.05 | 6 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | $17,599.20 | $29,332.00 | $39.83 – $43.81 | 6 |
| Inj., brexanolone, 1 mg HCPCS J1632 | $17,286.60 | $28,811.00 | not published | 0 |
| Inj, bupivacaine liposome HCPCS J0666 | $7.60 | $9.50 | $1.47 – $1.62 | 6 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $27.60 | $46.00 | $0.90 – $4.50 | 13 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $5.80 | $7.25 | $2.42 – $2.66 | 6 |
| Inj ceftolozane tazobactam HCPCS J0695 | $487.80 | $813.00 | $9.07 – $9.97 | 6 |
| Inj, clevidipine butyrate HCPCS C9248 | $839.40 | $1,399.00 | $10.08 – $50.40 | 13 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $1,172.00 | $1,615.00 | $42.56 – $168.45 | 2 |
| Inj., copanlisib, 1 mg HCPCS J9057 | $21,182.40 | $35,304.00 | not published | 0 |
| Inj dx for sinogram CPT 20501 | $2,348.80 | $3,237.00 | $38.50 – $91.61 | 8 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $1,172.00 | $1,615.00 | $61.44 – $201.22 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | $95.40 | $159.00 | $52.47 – $57.72 | 6 |
| Injection, cangrelor HCPCS C9460 | $41,627.40 | $69,379.00 | $19.98 – $19.98 | 1 |
| Injection, caplacizumab-yhdp HCPCS C9047 | $2,329.60 | $2,912.00 | not published | 0 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $355.20 | $489.00 | $54.76 – $116.19 | 8 |
| Injection, daratumumab 10 mg HCPCS J9145 | $9,445.80 | $15,743.00 | $71.37 – $78.51 | 6 |
| Injection epidural blood patch or clot CPT 62273 | $1,470.60 | $2,451.00 | $52.80 – $993.28 | 8 |
| Injection for arthrography wrist (both sides) CPT 25246 | $1,172.00 | $1,615.00 | $44.80 – $170.87 | 2 |
| Injection for bladder x-ray CPT 51600 | $3,513.60 | $4,843.00 | $35.20 – $92.55 | 8 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $1,172.00 | $1,615.00 | $133.29 – $993.28 | 2 |
| Injection, fulvestrant HCPCS J9395 | $4,423.20 | $7,372.00 | $6.73 – $7.40 | 6 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $39.20 | $49.00 | $12.32 – $13.55 | 6 |
| Injection into brain canal CPT 61055 | $1,323.20 | $1,824.00 | $116.05 – $993.28 | 8 |
| Injection, isavuconazonium HCPCS J1833 | $1,378.20 | $2,297.00 | $1.01 – $1.01 | 1 |
| Injection jaw joint x-ray CPT 21116 | $1,172.00 | $1,615.00 | $27.50 – $144.29 | 8 |
| Injection,onabotulinumtoxina HCPCS J0585 | $2,783.40 | $4,639.00 | $6.50 – $7.15 | 6 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $614.40 | $846.00 | $303.48 – $303.48 | 1 |
| Injection, renflexis HCPCS Q5104 | $1,624.80 | $2,708.00 | $27.00 – $29.70 | 5 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,501.60 | $2,070.00 | $503.10 – $503.10 | 1 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,054.40 | $1,453.00 | $67.10 – $993.28 | 8 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,778.40 | $2,451.00 | $23.10 – $149.53 | 8 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $616.20 | $1,027.00 | $35.20 – $97.72 | 8 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $998.40 | $1,376.00 | $34.17 – $116.19 | 8 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $791.20 | $1,090.00 | $37.92 – $116.19 | 8 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $168.80 | $245.00 | $37.98 – $189.90 | 12 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | $1,790.40 | $2,984.00 | $384.85 – $423.33 | 6 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,524.80 | $2,101.00 | $78.27 – $993.28 | 8 |
| Inj, epinephrine (belcher) HCPCS J0173 | $6.60 | $11.00 | not published | 0 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | $141.60 | $177.00 | $22.02 – $24.22 | 6 |
| Inj for ext venography CPT 36005 | $1,056.80 | $1,456.00 | $48.02 – $169.33 | 8 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | $1,327.20 | $2,212.00 | not published | 0 |
| Inj givosiran 0.5 mg HCPCS J0223 | $237.60 | $396.00 | $117.36 – $129.10 | 6 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $37.20 | $62.00 | $61.44 – $67.58 | 6 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $652.80 | $1,088.00 | $2.61 – $2.87 | 6 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $205.60 | $257.00 | $23.61 – $25.97 | 5 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | $52.80 | $88.00 | $23.39 – $23.39 | 1 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $31.80 | $53.00 | $3.95 – $4.35 | 5 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $991.20 | $1,652.00 | $2.18 – $2.18 | 1 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | $558.40 | $806.00 | $248.50 – $273.35 | 6 |
| Inj multihance HCPCS A9577 | $612.60 | $1,021.00 | $1.74 – $4.63 | 5 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $1,264.80 | $2,108.00 | $30.32 – $33.36 | 5 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | $152.40 | $254.00 | $46.32 – $50.95 | 6 |
| Inj proc ankle arthr CPT 27648 | $1,172.00 | $1,615.00 | $27.50 – $129.86 | 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.