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 |
|---|---|---|---|---|
| Oral busulfan HCPCS J8510 | $24.60 | $41.00 | $84.21 – $84.21 | 1 |
| Oral everolimus HCPCS J7527 | $115.20 | $192.00 | $1.37 – $1.51 | 5 |
| Organic acids total quant ea spec CPT 83918 | $335.20 | $462.00 | $22.75 – $38.77 | 8 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $13,431.00 | $22,385.00 | $28.68 – $31.55 | 6 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $61.00 | $76.25 | $11.19 – $12.30 | 5 |
| Oscillation chest wall mechanical per session CPT 94669 | $155.20 | $214.00 | $45.93 – $149.53 | 2 |
| Osmolality blood CPT 83930 | $134.40 | $185.00 | $3.00 – $6.54 | 8 |
| Osmolality urine CPT 83935 | $436.80 | $602.00 | $3.00 – $6.74 | 8 |
| Oth resp proc, group HCPCS G0239 | $473.60 | $686.00 | $26.52 – $26.52 | 1 |
| Ot re-evaluation patient/family CPT 97168 | $117.60 | $162.00 | $44.76 – $69.34 | 8 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $128.80 | $177.00 | $20.32 – $31.48 | 8 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $128.80 | $177.00 | $20.95 – $32.47 | 8 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $1,965.00 | $3,275.00 | $0.08 – $0.09 | 5 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $29.00 | $36.25 | $6.48 – $32.40 | 13 |
| P-32 chromic phos ther per mci HCPCS A9564 | $1,311.20 | $1,807.00 | $295.02 – $1,475.10 | 12 |
| P-32 sod phosphate ther per mci HCPCS A9563 | $268.80 | $371.00 | $60.48 – $302.40 | 12 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $300.60 | $501.00 | $0.14 – $0.15 | 5 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $6,166.20 | $10,277.00 | $10.54 – $11.60 | 6 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $9,557.40 | $15,929.00 | $15.11 – $2,283.23 | 7 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $6,940.20 | $11,567.00 | $11.00 – $719.87 | 7 |
| Palonosetron hcl HCPCS J2469 | $378.60 | $631.00 | $0.36 – $0.39 | 5 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $200.00 | $250.00 | $9.64 – $10.61 | 5 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $550.80 | $918.00 | $173.03 – $190.33 | 6 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $30.80 | $38.50 | $6.84 – $34.20 | 13 |
| Papaverin hcl injection HCPCS J2440 | $264.80 | $331.00 | $59.58 – $297.90 | 13 |
| Parathormone (pth) intact CPT 83970 | $228.00 | $314.00 | $40.80 – $72.43 | 8 |
| Parathyrd planar w/spect&ct CPT 78072 | $2,701.60 | $3,723.00 | $330.43 – $544.29 | 7 |
| Parathyroid planar imaging CPT 78070 | $2,248.00 | $3,099.00 | $80.00 – $217.82 | 8 |
| Parathyroid planar img w/tomo spect CPT 78071 | $2,248.00 | $3,099.00 | $285.53 – $477.27 | 8 |
| Parenteral 50% dextrose solu HCPCS B4164 | $130.40 | $163.00 | $22.00 – $22.00 | 1 |
| Paricalcitol HCPCS J2501 | $28.20 | $47.00 | $0.95 – $1.04 | 5 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $29.20 | $48.00 | $22.00 – $993.28 | 8 |
| Partial removal finger bone CPT 26236 | $6,609.60 | $9,109.00 | $302.50 – $1,190.29 | 8 |
| Partial removal of foot bone CPT 28288 | not published | not published | $271.15 – $993.28 | 8 |
| Partial removal of thyroid CPT 60220 | not published | not published | $993.28 – $1,804.93 | 2 |
| Partial removal of toe CPT 28160 | not published | not published | $727.99 – $1,196.80 | 2 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $6,781.60 | $9,346.00 | $2.54 – $2.80 | 2 |
| Passy muir valve metal trach HCPCS L8501 | $350.40 | $483.00 | $96.00 – $222.54 | 2 |
| Path clin consltj sf 5-20 CPT 80503 | $228.00 | $314.00 | $27.31 – $39.16 | 2 |
| Pcv21 vaccine im CPT 90684 | $252.80 | $316.00 | $11.00 – $327.89 | 6 |
| Pegaspargase injection HCPCS J9266 | $62,371.80 | $103,953.00 | $28,424.06 – $31,266.46 | 6 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $1,069.80 | $1,783.00 | $89.34 – $98.28 | 6 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $18,128.40 | $30,214.00 | $106.33 – $116.97 | 5 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $7,964.40 | $13,274.00 | $99.13 – $109.04 | 5 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $94,586.40 | $157,644.00 | $3,660.83 – $4,026.92 | 6 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | $548.00 | $685.00 | $228.16 – $250.97 | 6 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $3,064.00 | $4,223.00 | $131.20 – $862.88 | 8 |
| Pelvic CT scan (with contrast) CPT 72193 | $2,300.00 | $3,170.00 | $110.72 – $718.56 | 8 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,588.80 | $2,189.00 | $86.40 – $632.05 | 8 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,850.40 | $6,684.00 | $604.49 – $2,009.77 | 8 |
| Pelvic MRI (with contrast) CPT 72196 | $3,689.60 | $5,085.00 | $260.35 – $1,141.28 | 8 |
| Pelvic MRI (without contrast) CPT 72195 | $3,040.00 | $4,190.00 | $334.23 – $941.15 | 8 |
| Pelvic Ultrasound (complete) CPT 76856 | $885.60 | $1,220.00 | $59.52 – $221.76 | 8 |
| Pelvic Ultrasound (limited) CPT 76857 | $869.60 | $1,198.00 | $24.32 – $137.63 | 8 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $617.60 | $852.00 | $12.80 – $65.26 | 8 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $616.00 | $849.00 | $26.88 – $84.18 | 8 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $21,534.00 | $35,890.00 | $60.29 – $66.32 | 6 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $15,666.00 | $26,110.00 | $4.36 – $4.79 | 6 |
| Peng benzathine/procaine inj HCPCS J0558 | $581.40 | $969.00 | $19.52 – $21.48 | 6 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,494.00 | $2,490.00 | $30.01 – $33.01 | 6 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $136.80 | $228.00 | $0.79 – $0.87 | 5 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $31,936.00 | $44,012.00 | $7,185.60 – $35,928.00 | 13 |
| Penile vascular study CPT 93980 | $809.60 | $1,116.00 | $120.50 – $536.17 | 8 |
| Pentobarbital sodium inj HCPCS J2515 | $115.20 | $192.00 | $1.80 – $9.00 | 13 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $10,218.00 | $17,030.00 | $2,608.16 – $2,868.97 | 6 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $1,066.20 | $1,777.00 | $40.65 – $44.72 | 4 |
| Pericardiocentesis wwo imaging CPT 33016 | $2,977.60 | $4,103.00 | $213.32 – $330.50 | 8 |
| Perq dev breast 1st strtctc CPT 19283 | $2,168.80 | $2,989.00 | $91.72 – $370.29 | 8 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $2,128.00 | $2,933.00 | $75.02 – $993.28 | 8 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $22,539.60 | $37,566.00 | $17.02 – $18.72 | 6 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $324.60 | $541.00 | $62.10 – $68.31 | 6 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $903.20 | $1,244.00 | $45.31 – $45.31 | 1 |
| Pessary reusable rub anytype HCPCS A4561 | $122.40 | $169.00 | $18.20 – $18.20 | 1 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $22,916.00 | $32,297.00 | $16.38 – $81.90 | 13 |
| Ph body fluid CPT 83986 | $63.20 | $87.00 | $2.00 – $3.54 | 8 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $128.80 | $161.00 | $30.17 – $33.18 | 5 |
| Phenobarbital therapeutic drug level CPT 80184 | $198.40 | $273.00 | $15.12 – $27.28 | 8 |
| Phentolaine mesylate inj HCPCS J2760 | $1,968.60 | $3,281.00 | $432.02 – $475.22 | 6 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $0.60 | $1.00 | $0.00 – $0.00 | 5 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $15.00 | $25.00 | $0.45 – $0.50 | 5 |
| Phenytoin total therapeutic drug level CPT 80185 | $137.60 | $190.00 | $13.00 – $22.15 | 8 |
| Phlebotomy therapeutic CPT 99195 | $233.60 | $322.00 | $11.00 – $36.64 | 8 |
| Phone e/m phys/qhp 11-20 min CPT 99442 | $46.20 | $77.00 | $51.60 – $51.60 | 1 |
| Phone e/m phys/qhp 21-30 min CPT 99443 | $68.40 | $114.00 | $75.67 – $75.67 | 1 |
| Phone e/m phys/qhp 5-10 min CPT 99441 | $24.00 | $40.00 | $27.25 – $27.25 | 1 |
| Phosphorus CPT 84100 | $85.60 | $118.00 | $4.69 – $11.16 | 8 |
| Phosphorus 24 hour urine CPT 84105 | $90.40 | $125.00 | $5.71 – $12.19 | 8 |
| Phys blood bank serv reactj CPT 86078 | $481.60 | $664.00 | $41.56 – $130.56 | 8 |
| Physical Therapy Evaluation (high complexity) CPT 97163 | $238.40 | $329.00 | $81.42 – $111.32 | 2 |
| Physical Therapy Evaluation (low complexity) CPT 97161 | $238.40 | $329.00 | $81.42 – $111.32 | 2 |
| Physical Therapy Evaluation (moderate complexity) CPT 97162 | $238.40 | $329.00 | $32.42 – $111.32 | 2 |
| Physical Therapy Re-Evaluation CPT 97164 | $117.60 | $162.00 | $43.98 – $73.49 | 8 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $220.80 | $368.00 | $2.73 – $3.00 | 5 |
| Pinworm exam CPT 87172 | $54.60 | $75.00 | $3.33 – $4.22 | 2 |
| Pinworm examinations HCPCS Q0113 | $58.00 | $80.00 | $7.56 – $12.88 | 7 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $114.00 | $190.00 | $1.07 – $1.18 | 5 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,380.00 | $1,902.00 | $90.85 – $327.19 | 8 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $1,380.00 | $1,902.00 | $43.26 – $224.80 | 8 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,144.80 | $1,578.00 | $77.78 – $618.68 | 8 |
| Placement of seton CPT 46020 | not published | not published | $192.18 – $993.28 | 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.