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 |
|---|---|---|---|---|
| Lactoferrin fecal quant CPT 83631 | $212.00 | $292.00 | $19.40 – $37.39 | 8 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $33,573.60 | $55,956.00 | $34.05 – $37.45 | 6 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $993.28 – $1,521.52 | 2 |
| Laparo proc abdm/per/oment 49329 CPT 49329 | not published | not published | $4,069.64 – $4,069.64 | 1 |
| Laparoscopy aspiration CPT 49322 | not published | not published | $777.81 – $993.28 | 2 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | $993.28 – $1,370.62 | 2 |
| Laparoscopy lysis CPT 58660 | not published | not published | $993.28 – $1,343.38 | 2 |
| Laparoscopy remove adnexa CPT 58661 | not published | not published | $993.28 – $1,365.27 | 2 |
| Laparoscopy tubal block 58671 CPT 58671 | not published | not published | $783.85 – $993.28 | 2 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $818.32 – $994.55 | 2 |
| Large Joint Injection or Fluid Draw (both sides) CPT 20610 | $1,473.60 | $2,456.00 | $25.85 – $993.28 | 8 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $5,113.60 | $7,048.00 | $129.80 – $954.88 | 8 |
| Lead capillary CPT 83655 | $404.80 | $558.00 | $10.00 – $17.04 | 8 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $1,635.20 | $2,253.00 | $55.26 – $276.30 | 13 |
| Left compres band >=3" <5"/yd HCPCS A6449 | $3.00 | $5.00 | $1.79 – $3.33 | 2 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $2,029.60 | $2,797.00 | $152.76 – $399.68 | 8 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $3,240.80 | $4,467.00 | $105.60 – $641.23 | 2 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $2,852.80 | $3,931.00 | $101.17 – $553.07 | 2 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,449.60 | $1,998.00 | $146.18 – $416.37 | 8 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $360.00 | $505.00 | $81.00 – $405.00 | 13 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $606.40 | $836.00 | $76.50 – $382.50 | 13 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $350.40 | $483.00 | $78.84 – $394.20 | 13 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $87.60 | $146.00 | $3.22 – $3.54 | 5 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $6,275.40 | $10,459.00 | $176.45 – $6,206.00 | 7 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $1,045.80 | $1,743.00 | $1,730.32 – $1,903.36 | 6 |
| Levalbuterol non-comp con HCPCS J7612 | $12.60 | $21.00 | $0.27 – $0.30 | 3 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $276.00 | $460.00 | $0.04 – $0.04 | 5 |
| Levetiracetam therapeutic drug level CPT 80177 | $400.00 | $551.00 | $13.09 – $24.66 | 8 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $37.00 | $46.25 | $2.54 – $2.79 | 5 |
| Liberta rc ipg HCPCS C1820 | $7,270.40 | $10,019.00 | $1,635.84 – $8,179.20 | 13 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $0.16 | $0.20 | $0.00 – $0.00 | 5 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $942.08 – $1,013.57 | 2 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $136.40 – $541.22 | 8 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $370.20 | $617.00 | $3.57 – $3.93 | 5 |
| Lipase CPT 83690 | $168.80 | $233.00 | $5.00 – $8.52 | 8 |
| Lipoprotein blood quant CPT 83704 | $476.80 | $657.00 | $26.70 – $33.79 | 2 |
| Lipoprotein direct measurement hdl CPT 83718 | $76.60 | $106.00 | $7.00 – $11.93 | 8 |
| Lipoprotein direct measurement ldl CPT 83721 | $199.20 | $274.00 | $10.37 – $20.45 | 8 |
| Lip surgery procedure CPT 40799 | $121.80 | $203.00 | $162.28 – $162.28 | 1 |
| Lithium therapeutic drug level CPT 80178 | $100.00 | $138.00 | $6.54 – $13.63 | 8 |
| Liver elastography 91200 CPT 91200 | $581.60 | $801.00 | $24.22 – $51.54 | 8 |
| Liver Function Test CPT 80076 | $280.80 | $387.00 | $8.08 – $15.39 | 8 |
| Liver imag w/vasclr flow CPT 78202 | $1,826.40 | $2,517.00 | $64.00 – $454.57 | 8 |
| Liver/spleen imag static only CPT 78215 | $1,582.40 | $2,181.00 | $59.52 – $331.65 | 8 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,882.40 | $2,595.00 | $78.72 – $382.02 | 8 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $358.05 – $932.62 | 8 |
| Loop ostmy bridg ster HCPCS A4421 | $78.60 | $108.00 | $1.54 – $1.54 | 1 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $31.20 | $52.00 | $1.09 – $1.51 | 6 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $306.40 | $422.00 | $93.93 – $195.97 | 8 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $4,323.20 | $5,958.00 | $174.08 – $899.77 | 8 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $3,090.40 | $4,259.00 | $120.32 – $744.90 | 8 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $2,480.80 | $3,419.00 | $112.77 – $641.23 | 8 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,850.40 | $6,684.00 | $344.32 – $2,380.18 | 8 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,689.60 | $5,085.00 | $344.32 – $1,350.45 | 8 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,040.00 | $4,190.00 | $239.62 – $1,227.91 | 8 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $504.00 | $695.00 | $28.80 – $85.30 | 8 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $859.20 | $1,184.00 | $28.80 – $117.28 | 8 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $1,000.80 | $1,380.00 | $26.88 – $144.66 | 8 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $782.40 | $1,078.00 | $21.12 – $64.96 | 2 |
| Lso flex no ri stays pre ots HCPCS L0628 | $284.80 | $393.00 | $67.51 – $115.89 | 2 |
| L/s ratio fetal lung CPT 83661 | $489.60 | $675.00 | $21.73 – $37.49 | 8 |
| Lumbar diskogram s&i CPT 72295 | $2,380.80 | $3,281.00 | $46.08 – $762.04 | 8 |
| Lung Function Test Before and After an Inhaler CPT 94060 | $636.80 | $878.00 | $14.59 – $152.13 | 8 |
| Lung function test (mbc/mvv) CPT 94200 | $109.60 | $151.00 | $6.91 – $76.51 | 8 |
| Lung Function Test (Spirometry) CPT 94010 | $276.00 | $380.00 | $11.52 – $92.23 | 8 |
| Lung perfusion imaging CPT 78580 | $580.00 | $799.00 | $60.80 – $382.38 | 8 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $380.40 | $634.00 | $207.13 – $227.84 | 6 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $83.40 | $139.00 | $41.98 – $46.18 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $1,417.60 | $1,954.00 | $166.40 – $433.29 | 8 |
| Lymphocyte transformation mitogen CPT 86353 | $761.60 | $1,050.00 | $48.45 – $115.46 | 8 |
| Macroscopic exam arthropod CPT 87168 | $90.40 | $125.00 | $3.33 – $4.22 | 2 |
| Macroscopic exam parasite CPT 87169 | $62.20 | $85.00 | $3.37 – $4.26 | 2 |
| Magnesium CPT 83735 | $151.20 | $208.00 | $6.62 – $12.36 | 8 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $74.40 | $124.00 | $0.48 – $0.53 | 5 |
| Mammosite ced HCPCS C1728 | $13,311.20 | $18,345.00 | $2,995.02 – $14,975.10 | 12 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $174.04 – $993.28 | 8 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $88.80 | $148.00 | $3.06 – $15.30 | 13 |
| Marker biop eviva buckle ss HCPCS A4648 | $404.80 | $558.00 | $91.08 – $455.40 | 13 |
| Mastectomy partial CPT 19301 | not published | not published | $552.76 – $993.28 | 2 |
| Mastoids complete CPT 70130 | $580.00 | $799.00 | $35.20 – $110.85 | 2 |
| M.avium-intra dna amp prob CPT 87561 | $570.40 | $786.00 | $27.39 – $34.68 | 2 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $383.20 | $528.00 | $14.29 – $28.97 | 8 |
| Mayo aathr protein s free CPT 85306 | $443.20 | $611.00 | $15.14 – $36.09 | 8 |
| Mayo activated protein c resistance assay CPT 85307 | $306.40 | $422.00 | $15.14 – $28.87 | 8 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $248.80 | $343.00 | $30.12 – $38.12 | 2 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $158.40 | $218.00 | $11.55 – $14.60 | 2 |
| Mayo alpha 1 antitrypsin CPT 82103 | $238.40 | $329.00 | $13.29 – $28.97 | 8 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $864.00 | $1,080.00 | $94.96 – $120.21 | 2 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $1,680.00 | $2,100.00 | $90.59 – $170.51 | 8 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $2,514.40 | $3,143.00 | $109.60 – $186.78 | 8 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $11,640.60 | $19,401.00 | $905.73 – $1,146.45 | 2 |
| Mayo androstenedione CPT 82157 | $186.40 | $257.00 | $25.00 – $42.60 | 8 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $168.00 | $232.00 | $14.43 – $34.37 | 8 |
| Mayo antithrombin iii antigen CPT 85301 | $704.80 | $971.00 | $10.69 – $25.48 | 8 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $280.80 | $387.00 | $14.88 – $35.45 | 8 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $351.20 | $484.00 | $28.07 – $47.84 | 8 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $20.40 | $28.00 | $10.06 – $19.17 | 8 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $212.00 | $292.00 | $12.75 – $30.39 | 8 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $121.60 | $168.00 | $13.03 – $31.07 | 8 |
| Mayo brcmg brucella antibody igm CPT 86622 | $144.00 | $198.00 | $8.82 – $18.25 | 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.