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 |
|---|---|---|---|---|
| Inj proc elbow arthro CPT 24220 | $1,172.00 | $1,615.00 | $44.80 – $107.50 | 2 |
| Inj proc for lymphang CPT 38790 | $574.40 | $792.00 | $80.92 – $993.28 | 8 |
| Inj proc myelogram lumbar CPT 62284 | $1,323.20 | $1,824.00 | $87.49 – $762.88 | 8 |
| Inj proc sialogram CPT 42550 | $1,172.00 | $1,615.00 | $37.95 – $993.28 | 8 |
| Inj prohance multipack HCPCS A9576 | $46.20 | $77.00 | $1.42 – $3.97 | 5 |
| Inj retro urethrocysto CPT 51610 | $4,464.00 | $6,152.00 | $37.95 – $142.23 | 8 |
| Inj tedizolid phosphate HCPCS J3090 | $1,282.20 | $2,137.00 | $1.96 – $2.16 | 6 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $36,300.60 | $60,501.00 | $359.19 – $395.11 | 6 |
| Inj testosterone cypionate HCPCS J1071 | $40.80 | $68.00 | $0.03 – $14.14 | 6 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | $424.00 | $530.00 | $127.45 – $140.20 | 6 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $12.60 | $15.75 | $4.42 – $4.86 | 5 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $3.00 | $5.00 | $2,698.05 – $2,967.86 | 6 |
| Insert cath pleura with image CPT 32557 | $2,467.20 | $3,400.00 | $993.28 – $1,283.30 | 2 |
| Insert cath pleura without image CPT 32556 | $1,020.00 | $1,406.00 | $791.18 – $993.28 | 2 |
| Insert drug delivery implant CPT 11981 | $1,437.00 | $2,395.00 | $83.30 – $993.28 | 8 |
| Insert intrauterine device iud CPT 58300 | $733.60 | $1,011.00 | $18.98 – $29.40 | 7 |
| Insertion catheter bladder non indwelling CPT 51701 | $298.40 | $412.00 | $28.00 – $107.25 | 8 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $3,349.80 | $5,583.00 | $124.53 – $993.28 | 8 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $3,204.80 | $4,416.00 | $96.13 – $993.28 | 8 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,532.00 | $2,112.00 | $76.74 – $993.28 | 8 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $4,508.00 | $6,213.00 | $993.28 – $2,374.80 | 2 |
| Insert pessary/other device CPT 57160 | $907.20 | $1,251.00 | $16.66 – $100.83 | 8 |
| Insitu hybridization manual CPT 88368 | $412.80 | $688.00 | $81.10 – $326.01 | 8 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $619.20 | $854.00 | $14.77 – $145.17 | 8 |
| Ins mark abd/pel for right perq CPT 49411 | $4,976.80 | $6,859.00 | $173.93 – $993.28 | 8 |
| Ins picad w subq port 5yr> CPT 36571 | $2,063.20 | $2,843.00 | $993.28 – $2,755.22 | 2 |
| Inst fibrinolysis agent ini day CPT 32561 | $1,327.20 | $1,829.00 | $73.84 – $141.76 | 2 |
| Ins tun cvad 2 cath w/subq port(s) CPT 36566 | $5,640.60 | $9,401.00 | $993.28 – $2,004.57 | 2 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $5,788.20 | $9,647.00 | $993.28 – $1,258.41 | 2 |
| Insulin total CPT 83525 | $200.00 | $276.00 | $11.00 – $18.75 | 8 |
| Interferon alfa-2b inj HCPCS J9214 | $1,111.20 | $1,852.00 | not published | 0 |
| Interfyl, 1 mg HCPCS Q4171 | $6,389.60 | $8,805.00 | $10.09 – $11.10 | 2 |
| Int hrhc lig 1 hroid without img CPT 46945 | $4,520.00 | $6,230.00 | $50.60 – $993.28 | 8 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | $1,291.20 | $1,780.00 | $42.35 – $993.28 | 8 |
| Intrapul surf admin endo tube CPT 94610 | $73.60 | $101.00 | $60.65 – $94.01 | 2 |
| Intrinsic factor antibody CPT 86340 | $246.40 | $339.00 | $14.90 – $35.50 | 8 |
| Intro long gi tube CPT 44500 | $3,526.20 | $5,877.00 | $21.64 – $54.32 | 8 |
| Intro long gi tube w/mult fluo CPT 74340 | $464.80 | $641.00 | $290.47 – $290.47 | 1 |
| Intubation endotracheal emergency procedure CPT 31500 | $868.80 | $1,197.00 | $79.20 – $993.28 | 8 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $1,979.20 | $2,728.00 | $445.32 – $2,226.60 | 12 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $41.40 | $69.00 | $0.45 – $0.50 | 4 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $78.60 | $131.00 | $0.15 – $0.17 | 4 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $33,224.40 | $55,374.00 | $183.48 – $201.83 | 6 |
| Ipratropium bromide non-comp HCPCS J7644 | $7.20 | $12.00 | $0.10 – $0.43 | 6 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $1,091.20 | $1,364.00 | $1.75 – $1.93 | 5 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $210.60 | $351.00 | $66.00 – $72.60 | 6 |
| Iron CPT 83540 | $58.20 | $80.00 | $6.39 – $14.40 | 8 |
| Iron binding capacity CPT 83550 | $121.60 | $168.00 | $5.00 – $8.64 | 8 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $555.60 | $926.00 | $0.23 – $12.21 | 6 |
| Irradiation of blood product each unit reference CPT 86945 | $98.40 | $164.00 | $26.52 – $26.52 | 1 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $201.60 | $278.00 | $21.43 – $42.65 | 8 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | $891.20 | $1,229.00 | $29.75 – $106.61 | 8 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $149.40 | $249.00 | $81.90 – $90.09 | 6 |
| IV Fluids (each additional hour) CPT 96361 | $389.60 | $537.00 | $9.90 – $24.76 | 8 |
| IV Fluids (first hour) CPT 96360 | $1,143.00 | $1,905.00 | $34.79 – $83.37 | 8 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $344.80 | $476.00 | $12.57 – $30.84 | 8 |
| IV Medicine Infusion (additional drug) CPT 96367 | $285.60 | $476.00 | $21.16 – $51.32 | 8 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $344.80 | $476.00 | $13.52 – $32.95 | 8 |
| IV Medicine Infusion (first hour) CPT 96365 | $1,143.00 | $1,905.00 | $43.23 – $101.27 | 8 |
| IV Push Injection (each additional drug) CPT 96375 | $177.60 | $245.00 | $14.31 – $35.27 | 8 |
| IV Push Injection (first drug) CPT 96374 | $200.00 | $276.00 | $34.12 – $79.99 | 8 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $1,552.00 | $2,139.00 | $35.20 – $203.92 | 8 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $16,246.20 | $27,077.00 | $139.21 – $153.13 | 6 |
| Jak2 targeted sequence analysis CPT 81279 | $1,223.20 | $1,529.00 | $148.16 – $252.49 | 8 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $816.80 | $1,126.00 | $21.12 – $101.90 | 8 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $499.20 | $688.00 | $21.12 – $85.90 | 8 |
| Jejunstmy tube plcmt CPT 44372 | $4,128.80 | $5,690.00 | $228.25 – $993.28 | 8 |
| John cunningham antibody CPT 86711 | $3,827.20 | $5,274.00 | $15.83 – $26.98 | 8 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $211.20 | $291.00 | $5.00 – $8.52 | 8 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $24.60 | $30.75 | $0.30 – $0.57 | 7 |
| Kidney function study CPT 78725 | $1,426.40 | $1,966.00 | $82.62 – $285.49 | 8 |
| Kidney imaging morphology CPT 78700 | $2,058.40 | $2,837.00 | $53.12 – $324.34 | 8 |
| Kidney imag w/bld flow multi CPT 78709 | $1,404.00 | $1,935.00 | $237.62 – $501.14 | 8 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,877.60 | $2,587.00 | $88.32 – $466.13 | 8 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $886.40 | $1,221.00 | $62.72 – $263.82 | 8 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $844.00 | $1,163.00 | $62.72 – $197.83 | 8 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | $489.60 | $675.00 | $2.70 – $13.50 | 12 |
| Kit gene analys d816 variant CPT 81273 | $1,144.80 | $1,431.00 | $99.90 – $170.25 | 8 |
| Kit lead specify 5-6-5 HCPCS C1778 | $13,784.80 | $18,998.00 | $165.60 – $828.00 | 13 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $1,192.96 – $1,879.99 | 2 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $597.85 – $1,862.21 | 8 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $1,192.96 – $1,736.90 | 2 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $1,192.96 – $2,017.35 | 2 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $993.28 – $2,034.51 | 2 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $597.85 – $1,887.87 | 8 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $993.28 – $2,412.60 | 2 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $993.28 – $3,124.04 | 2 |
| Knee MRI (with and without contrast) CPT 73723 | $4,850.40 | $6,684.00 | $604.71 – $1,992.24 | 2 |
| Knee MRI (with contrast) CPT 73722 | $3,689.60 | $5,085.00 | $393.92 – $1,109.81 | 2 |
| Knee MRI (without contrast) CPT 73721 | $3,040.00 | $4,190.00 | $344.32 – $1,083.17 | 2 |
| Knee X-ray CPT 73564 | $576.80 | $795.00 | $28.70 – $82.10 | 2 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | $736.00 | $1,014.00 | $21.12 – $64.96 | 2 |
| Knee X-ray (3 views, both knees) CPT 73562 | $482.40 | $665.00 | $21.12 – $71.53 | 2 |
| Knee X-ray (standing, both knees) CPT 73565 | $287.20 | $396.00 | $22.22 – $62.50 | 8 |
| Kyleena, 19.5 mg HCPCS J7296 | $2,489.60 | $3,112.00 | $1,200.72 – $1,200.72 | 1 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $327.00 | $545.00 | $0.36 – $1.80 | 13 |
| Lactate dehydrogenase (ldh) CPT 83615 | $52.00 | $71.00 | $5.98 – $12.25 | 8 |
| Lactated ringers intravenous solution HCPCS J7120 | $32.40 | $40.50 | $0.00 – $2.65 | 6 |
| Lactic acid CPT 83605 | $147.20 | $203.00 | $8.00 – $13.63 | 8 |
| Lactoferrin fecal qualitative CPT 83630 | $424.80 | $586.00 | $12.31 – $20.98 | 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.