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 |
|---|---|---|---|---|
| Allergen alpha lactalbumin ige CPT 86008 | $31.80 | $43.00 | $17.71 – $30.18 | 8 |
| Allergen egg white ige CPT 86003 | $216.80 | $271.00 | $5.16 – $12.29 | 8 |
| Allergy injections; 2 or more 95117 CPT 95117 | $6.80 | $9.00 | $8.96 – $42.87 | 2 |
| Allergy injection; single 95115 CPT 95115 | $10.20 | $17.00 | $4.48 – $28.62 | 2 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $2,929.80 | $4,883.00 | $604.62 – $3,023.10 | 13 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $5,792.80 | $7,983.00 | $1,303.38 – $6,516.90 | 13 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $4,781.60 | $6,590.00 | $121.29 – $121.29 | 1 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $29.80 | $37.25 | $5.46 – $6.00 | 6 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $177.60 | $245.00 | $63.66 – $120.69 | 8 |
| Alpha-fetoprotein amniotic CPT 82106 | $160.20 | $267.00 | $16.80 – $34.08 | 8 |
| Alpha-fetoprotein tumor marker CPT 82105 | $168.00 | $232.00 | $16.57 – $34.08 | 8 |
| Alprostadil for injection HCPCS J0270 | $550.20 | $917.00 | $0.18 – $0.90 | 13 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $40,758.00 | $67,930.00 | $94.45 – $177.50 | 7 |
| Alt/sgpt CPT 84460 | $161.60 | $223.00 | $5.24 – $12.27 | 8 |
| Aluminum - quest CPT 82108 | $386.40 | $532.00 | $25.18 – $60.02 | 8 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $1,680.80 | $2,316.00 | $71.24 – $148.04 | 8 |
| Ambl bp mntr w/sw a/r CPT 93788 | $207.20 | $286.00 | $90.66 – $90.66 | 1 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $26.80 | $33.50 | $0.63 – $3.03 | 6 |
| Amino acids quant 2-5 CPT 82136 | $266.40 | $368.00 | $19.38 – $39.71 | 8 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $8.00 | $10.00 | $1.71 – $1.89 | 5 |
| Aminolevulinic acid delta CPT 82135 | $216.00 | $298.00 | $12.00 – $20.45 | 8 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $70.20 | $87.75 | $10.34 – $11.38 | 5 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $224.40 | $374.00 | $0.43 – $0.47 | 5 |
| Ammonia CPT 82140 | $152.00 | $210.00 | $5.00 – $14.40 | 8 |
| Amniotic fluid scan CPT 82143 | $245.60 | $338.00 | $5.00 – $9.24 | 8 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $176.40 | $294.00 | $43.41 – $47.75 | 5 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,050.00 | $1,750.00 | $21.48 – $23.63 | 6 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $77.40 | $129.00 | $0.55 – $0.60 | 5 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $67.20 | $112.00 | $1.39 – $1.53 | 5 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $280.20 | $467.00 | $255.57 – $255.57 | 1 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $252.45 – $993.28 | 8 |
| Amputation toe interphalangeal joint CPT 28825 | $3,304.80 | $4,555.00 | $535.81 – $993.28 | 2 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $596.93 – $934.40 | 2 |
| Amylase CPT 82150 | $136.80 | $189.00 | $5.00 – $8.52 | 8 |
| Anabolic steroid 1 or 2 CPT 80327 | $222.40 | $278.00 | $23.39 – $39.86 | 7 |
| Ana ds-dna CPT 86226 | $216.00 | $298.00 | $11.96 – $28.51 | 8 |
| Anal pressure record CPT 91122 | $2,128.00 | $2,933.00 | $52.48 – $334.78 | 8 |
| Analysis gene f2 20210g>a variant CPT 81240 | $2,361.60 | $3,936.00 | $53.70 – $91.52 | 8 |
| Analysis gene f5 leiden variant CPT 81241 | $1,764.00 | $2,205.00 | $66.70 – $113.67 | 8 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $290.40 | $484.00 | $28.07 – $47.84 | 8 |
| Anastrozole 1 mg HCPCS S0170 | $13.00 | $16.25 | $0.14 – $0.14 | 1 |
| Anca screen with reflex to titer -quest CPT 86021 | $188.80 | $260.00 | $5.00 – $14.88 | 8 |
| An cholangiogram percutaneous compl CPT 47531 | $840.00 | $1,158.00 | $85.71 – $993.28 | 8 |
| An fluoro guide for cvp CPT 77001 | $1,542.40 | $2,125.00 | $59.21 – $120.25 | 8 |
| Angiotensin ii CPT 82163 | $334.40 | $461.00 | $14.50 – $24.71 | 8 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $1,796.80 | $2,246.00 | $0.16 – $0.16 | 1 |
| Anidulafungin injection HCPCS J0348 | $417.00 | $695.00 | $0.52 – $0.57 | 5 |
| Ankle X-ray CPT 73610 | $372.00 | $512.00 | $23.97 – $68.14 | 2 |
| Ankle X-ray (2 views, both ankles) CPT 73600 | $697.60 | $962.00 | $14.72 – $61.64 | 2 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $156.60 | $261.00 | $25.60 – $25.60 | 1 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $170.40 | $284.00 | $25.60 – $25.60 | 1 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $171.60 | $286.00 | $25.60 – $25.60 | 1 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $208.80 | $348.00 | $25.60 – $25.60 | 1 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $44.20 | $61.00 | $10.06 – $12.73 | 2 |
| Antibody elution rbc reference CPT 86860 | $82.40 | $113.00 | $8.45 – $39.81 | 8 |
| Antibody htlv-i CPT 86687 | $96.00 | $132.00 | $8.98 – $19.77 | 8 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $720.80 | $993.00 | $5.00 – $18.15 | 8 |
| Antibody id rbc panel CPT 86870 | $248.80 | $343.00 | $8.45 – $39.81 | 8 |
| Antibody influenza virus CPT 86710 | $111.20 | $153.00 | $10.59 – $13.39 | 2 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $111.20 | $153.00 | $12.72 – $30.32 | 8 |
| Antibody screen rbc CPT 86850 | $136.80 | $189.00 | $8.45 – $14.40 | 8 |
| Antibody tetanus CPT 86774 | $402.40 | $554.00 | $11.56 – $14.62 | 2 |
| Anticoag mgmt pt warfarin CPT 93793 | $39.00 | $65.00 | $9.00 – $15.22 | 2 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $11.40 | $14.25 | $1.49 – $1.64 | 6 |
| Antihemophilic viii/vwf comp HCPCS J7186 | $10.20 | $17.00 | $1.25 – $1.37 | 6 |
| Anti mog serum - sendout CPT 86362 | $115.80 | $193.00 | $9.64 – $16.43 | 8 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $188.80 | $260.00 | $9.64 – $16.43 | 8 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $188.80 | $260.00 | $9.64 – $16.43 | 8 |
| Antinuclear antibodies CPT 86038 | $206.40 | $285.00 | $11.95 – $25.56 | 8 |
| Antinuclear antibodies titer CPT 86039 | $110.40 | $152.00 | $11.03 – $25.56 | 8 |
| Antiphosphatidylserine antibody CPT 86148 | $476.80 | $657.00 | $12.54 – $15.88 | 2 |
| Antistreptolysin o screen CPT 86063 | $68.40 | $94.00 | $5.70 – $11.93 | 8 |
| Antistreptolysin o titer CPT 86060 | $141.60 | $195.00 | $7.00 – $11.93 | 8 |
| Antithrombin iii activity CPT 85300 | $190.40 | $263.00 | $9.40 – $16.02 | 8 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $993.28 – $1,697.92 | 2 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | $331.20 | $457.00 | $64.14 – $123.38 | 8 |
| Aortic dysfunction/dilation CPT 81410 | $8,320.00 | $10,400.00 | $393.52 – $498.11 | 2 |
| Apc gene dup/delet variants CPT 81203 | $1,848.00 | $2,547.00 | $197.66 – $771.44 | 8 |
| Apc gene full sequence CPT 81201 | $1,848.00 | $2,547.00 | $770.89 – $1,558.81 | 8 |
| Apheresis plasma CPT 36514 | $1,532.00 | $2,112.00 | $82.50 – $172.58 | 8 |
| Apl(pml-rara) quant - sendout CPT 81315 | $503.20 | $693.00 | $204.89 – $385.59 | 8 |
| Appendix Removal (Laparoscopic) CPT 44970 | not published | not published | $993.28 – $1,067.82 | 2 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $2,148.00 | $2,960.00 | $425.04 – $993.28 | 2 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $1,830.40 | $2,522.00 | $55.22 – $116.15 | 2 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $315.20 | $435.00 | $25.19 – $48.19 | 2 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $6,088.00 | $8,391.00 | $420.87 – $993.28 | 2 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $2,156.00 | $2,972.00 | $44.52 – $98.45 | 2 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $315.20 | $435.00 | $17.52 – $38.50 | 2 |
| Application finger splntstatic 29130 CPT 29130 | $569.60 | $785.00 | $82.27 – $90.66 | 2 |
| Application long leg splint 29505 CPT 29505 | $569.60 | $785.00 | $40.70 – $133.40 | 8 |
| Application lower leg splint 29515 CPT 29515 | $471.00 | $785.00 | $38.50 – $114.43 | 8 |
| Application of cylinder cast 29365 CPT 29365 | $801.60 | $1,336.00 | $66.00 – $993.28 | 8 |
| Application of forearm cast 29075 CPT 29075 | $998.40 | $1,376.00 | $50.05 – $993.28 | 8 |
| Application of long leg cast 29345 CPT 29345 | $176.40 | $294.00 | $252.52 – $993.28 | 2 |
| Application of paste boot 29580 CPT 29580 | $569.60 | $785.00 | $88.00 – $113.80 | 2 |
| Application short leg cast 29405 CPT 29405 | $103.20 | $172.00 | $55.55 – $993.28 | 8 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $170.40 | $284.00 | $219.71 – $993.28 | 2 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $1,502.40 | $2,071.00 | $203.45 – $993.28 | 2 |
| Appl mltpln uni ext fixj sys CPT 20692 | not published | not published | $982.07 – $993.28 | 2 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $92.80 | $128.00 | $6.60 – $37.09 | 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.