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 |
|---|---|---|---|---|
| Repair shoulder capsule CPT 23455 | not published | not published | $595.10 – $2,867.06 | 8 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | not published | not published | $261.80 – $993.28 | 8 |
| Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 | $6,096.00 | $10,160.00 | $399.30 – $1,382.69 | 8 |
| Replace duod/jej tube perc CPT 49451 | $2,260.00 | $3,114.00 | $77.36 – $1,219.54 | 8 |
| Replace g/c tube perc CPT 49450 | $3,755.20 | $5,175.00 | $56.21 – $1,150.09 | 8 |
| Reptilase test CPT 85635 | $105.60 | $146.00 | $6.00 – $10.23 | 8 |
| Rerepair ing hernia reduce CPT 49520 | $8,618.40 | $11,878.00 | $475.20 – $1,259.82 | 8 |
| #resp virpnl dfa-adenovirus CPT 87260 | $196.80 | $271.00 | $11.26 – $14.27 | 2 |
| Resp virus 6-11 targets CPT 87632 | $1,237.80 | $2,063.00 | $215.52 – $399.98 | 8 |
| Reticulocyte automated CPT 85045 | $91.20 | $126.00 | $3.95 – $7.67 | 8 |
| Revefenacin inh non-com 1mcg HCPCS J7677 | $949.80 | $1,583.00 | $0.19 – $16.60 | 6 |
| Revise arm/leg nerve CPT 64708 | not published | not published | $993.28 – $1,282.23 | 2 |
| Revise hip joint replacement CPT 27134 | not published | not published | $1,280.00 – $6,363.81 | 2 |
| Revise/replace knee joint CPT 27486 | not published | not published | $993.28 – $5,048.80 | 2 |
| Revise vag graft via vagina CPT 57295 | $6,759.20 | $9,315.00 | $775.16 – $993.28 | 2 |
| Revision of knee joint CPT 27442 | not published | not published | $749.65 – $2,788.99 | 8 |
| Rheumatoid factor qualitative CPT 86430 | $90.40 | $125.00 | $6.07 – $11.93 | 8 |
| Rheumatoid factor quantitative CPT 86431 | $171.20 | $236.00 | $5.61 – $13.17 | 8 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $163.20 | $204.00 | $4.86 – $5.34 | 5 |
| Rho d immune globulin inj HCPCS J2790 | $728.80 | $911.00 | $82.58 – $90.83 | 5 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | $482.40 | $665.00 | $21.12 – $92.87 | 8 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | $779.20 | $1,074.00 | $21.12 – $116.62 | 8 |
| Rib X-ray (3 views, both sides) CPT 71110 | $561.60 | $774.00 | $21.12 – $101.22 | 8 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $0.20 | $0.25 | $0.14 – $0.16 | 5 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $26.40 | $33.00 | $14.94 – $16.44 | 6 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $4,199.40 | $6,999.00 | $10.98 – $1,239.37 | 7 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $4,351.20 | $7,252.00 | $75.22 – $82.74 | 6 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $218.40 | $364.00 | $36.69 – $40.36 | 6 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $265.80 | $443.00 | $29.38 – $32.32 | 5 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $199.80 | $333.00 | $27.84 – $30.63 | 5 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $2,633.60 | $3,630.00 | $33.55 – $51.98 | 7 |
| Rmvl ext fixj sys under anes CPT 20694 | not published | not published | $615.88 – $993.28 | 2 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $1,778.40 | $2,451.00 | $33.55 – $994.56 | 8 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | not published | not published | $198.35 – $199.10 | 2 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $197.60 | $247.00 | $30.78 – $33.85 | 6 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $44.60 | $55.75 | $11.01 – $12.11 | 6 |
| Romiplostim injection HCPCS J2796 | $8,358.00 | $13,930.00 | not published | 0 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $8,542.20 | $14,237.00 | $12.07 – $13.28 | 6 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $178.80 | $298.00 | $0.05 – $0.05 | 5 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $2,759.20 | $3,802.00 | $547.03 – $993.28 | 2 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $2,779.20 | $3,830.00 | $75.52 – $606.15 | 8 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $3,347.20 | $4,613.00 | $416.61 – $653.42 | 8 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $3,796.80 | $5,232.00 | $792.37 – $1,227.60 | 8 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $775.87 – $993.28 | 2 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $751.37 – $993.28 | 2 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $577.00 – $993.28 | 2 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | not published | not published | $344.03 – $993.28 | 2 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $478.93 – $993.28 | 2 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $575.68 – $993.28 | 2 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $993.28 – $1,138.46 | 2 |
| Rsv assay w/optic CPT 87807 | $13.60 | $18.00 | $12.31 – $20.98 | 8 |
| Rubella antibody igg CPT 86762 | $157.60 | $217.00 | $14.22 – $33.47 | 8 |
| Rubeola antibody igg CPT 86765 | $265.60 | $366.00 | $11.80 – $20.11 | 8 |
| Russell viper venom diluted CPT 85613 | $751.20 | $1,035.00 | $9.47 – $19.91 | 8 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $67.20 | $112.00 | $36.28 – $39.90 | 6 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $480.80 | $663.00 | $21.12 – $77.61 | 8 |
| Salivary glnd img serial img CPT 78231 | $1,960.80 | $2,703.00 | $44.80 – $331.83 | 8 |
| Sarscov coronavirus ag ia CPT 87426 | $46.40 | $58.00 | $34.92 – $59.54 | 8 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,127.20 | $1,553.00 | $100.61 – $359.59 | 8 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,041.60 | $1,435.00 | $151.88 – $529.54 | 8 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,002.40 | $1,382.00 | $100.61 – $361.27 | 8 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $1,192.80 | $1,644.00 | $100.61 – $352.88 | 8 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $1,127.20 | $1,553.00 | $100.61 – $344.49 | 8 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $846.45 – $993.28 | 2 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | $104.00 | $137.00 | $20.68 – $20.68 | 1 |
| Screen cerv/vag thin layer HCPCS G0123 | $81.60 | $107.00 | $15.82 – $15.82 | 1 |
| Screening Colonoscopy (average risk) HCPCS G0121 | not published | not published | $648.87 – $648.87 | 1 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $2,000.00 | $2,625.00 | $648.87 – $648.87 | 1 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $292.00 | $402.00 | $18.22 – $31.05 | 7 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $172.00 | $237.00 | $19.00 – $32.38 | 7 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $251.20 | $347.00 | $19.00 – $32.38 | 7 |
| Screening Mammogram CPT 77067 | $273.60 | $377.00 | $96.03 – $178.43 | 7 |
| Screening prostate cancer PSA HCPCS G0103 | $120.00 | $168.00 | $15.08 – $15.08 | 1 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $9,627.20 | $13,268.00 | $1.44 – $7.20 | 13 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $781.60 | $1,077.00 | $56.32 – $213.89 | 8 |
| Sedimentation rate erythrocyte automated CPT 85652 | $69.60 | $95.00 | $2.67 – $5.11 | 8 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $157.60 | $217.00 | $25.93 – $36.65 | 2 |
| Semen analysis presence/motility CPT 89321 | $143.20 | $197.00 | $9.41 – $11.91 | 2 |
| Semen analysis w/count CPT 89310 | $213.60 | $294.00 | $6.72 – $8.51 | 2 |
| Serpina1 gene CPT 81332 | $351.20 | $439.00 | $43.14 – $81.07 | 8 |
| Sgmdsc w/band ligation CPT 45350 | $3,933.60 | $5,421.00 | $993.28 – $993.28 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $83.40 | $139.00 | $35.20 – $855.04 | 8 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $1,024.80 | $1,412.00 | $41.80 – $855.04 | 8 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $494.40 | $681.00 | $30.80 – $855.04 | 8 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $494.40 | $681.00 | $38.50 – $855.04 | 8 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $1,024.80 | $1,412.00 | $27.50 – $855.04 | 8 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $1,024.80 | $1,412.00 | $35.20 – $855.04 | 8 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $1,444.00 | $1,990.00 | $41.80 – $855.04 | 8 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $846.09 – $1,883.80 | 8 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $561.93 – $1,683.77 | 8 |
| Shoe post-op mens m HCPCS L3260 | $75.60 | $94.50 | $17.01 – $85.05 | 12 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $147.00 | $245.00 | $13.97 – $31.10 | 8 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | $480.80 | $663.00 | $24.32 – $81.40 | 8 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $993.28 – $1,952.98 | 2 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $368.00 | $507.00 | $21.12 – $65.79 | 2 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,850.40 | $6,684.00 | $604.71 – $1,992.24 | 2 |
| Shoulder MRI (with contrast) CPT 73222 | $3,689.60 | $5,085.00 | $393.92 – $1,109.81 | 2 |
| Shoulder MRI (without contrast) CPT 73221 | $3,040.00 | $4,190.00 | $344.32 – $1,083.17 | 2 |
| Shoulder X-ray CPT 73030 | $372.00 | $512.00 | $21.12 – $70.75 | 2 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $704.80 | $971.00 | $18.57 – $59.22 | 2 |
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.