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 |
|---|---|---|---|---|
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $6,739.20 | $9,287.00 | $491.94 – $2,459.70 | 13 |
| Sialography s&i CPT 70390 | $1,552.00 | $2,139.00 | $26.88 – $197.71 | 8 |
| Sickling rbc CPT 85660 | $98.40 | $135.00 | $3.00 – $5.45 | 8 |
| Sigmoidoscopy and biopsy CPT 45331 | $3,816.80 | $5,261.00 | $70.04 – $365.66 | 8 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $3,933.60 | $5,421.00 | $135.27 – $993.28 | 8 |
| Sigmoidoscopy for bleeding CPT 45334 | $3,933.60 | $5,421.00 | $123.20 – $993.28 | 8 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $86.52 – $993.28 | 8 |
| Sigmoidoscopy w/ablation CPT 45346 | $3,933.60 | $5,421.00 | $993.28 – $993.28 | 1 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $3,933.60 | $5,421.00 | $55.00 – $993.28 | 8 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | $7,896.80 | $10,883.00 | $993.28 – $993.28 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $3,933.60 | $5,421.00 | $134.15 – $993.28 | 8 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $3,933.60 | $5,421.00 | $147.92 – $399.71 | 8 |
| Sigmoidoscopy w/us guide bx CPT 45342 | $3,933.60 | $5,421.00 | $219.74 – $461.06 | 8 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $3,816.80 | $5,261.00 | $104.10 – $993.28 | 8 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $536.00 | $739.00 | $27.56 – $57.91 | 7 |
| Sig w/tndsc balloon dilation CPT 45340 | $3,933.60 | $5,421.00 | $109.36 – $993.28 | 8 |
| Simple cystometrogram 51725 CPT 51725 | $4,291.20 | $5,914.00 | $46.75 – $993.28 | 8 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $516.00 | $645.00 | $123.36 – $135.70 | 5 |
| Sinus CT scan (with and without contrast) CPT 70488 | $3,280.80 | $4,521.00 | $128.00 – $772.56 | 8 |
| Sinus CT scan (with contrast) CPT 70487 | $2,612.80 | $3,600.00 | $102.40 – $638.56 | 8 |
| Sinus CT scan (without contrast) CPT 70486 | $1,924.00 | $2,651.00 | $99.20 – $540.24 | 8 |
| Sinus X-ray (complete) CPT 70220 | $542.40 | $748.00 | $28.80 – $98.68 | 8 |
| Sinus X-ray (limited) CPT 70210 | $385.60 | $531.00 | $21.12 – $73.94 | 8 |
| Sirolimus, oral HCPCS J7520 | $180.00 | $225.00 | $0.87 – $1.43 | 6 |
| Skin Biopsy CPT 11102 | $362.40 | $500.00 | $35.45 – $993.28 | 8 |
| Skull X-ray (1 to 3 views) CPT 70250 | $440.00 | $607.00 | $26.88 – $84.88 | 8 |
| Skull X-ray (complete) CPT 70260 | $532.80 | $734.00 | $35.19 – $119.41 | 8 |
| Skyla, 13.5 mg HCPCS J7301 | $2,325.00 | $3,875.00 | $944.09 – $944.09 | 1 |
| Sleep study attended CPT 95807 | $6,004.00 | $8,274.00 | $360.95 – $814.94 | 8 |
| Sleep Study (Polysomnography) CPT 95810 | $6,611.20 | $9,111.00 | $346.01 – $833.78 | 8 |
| Sleep study unattended CPT 95806 | $653.60 | $901.00 | $113.55 – $732.26 | 2 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $244.00 | $336.00 | $9.29 – $9.29 | 1 |
| Sling suprapubic suburetheral HCPCS C1771 | $4,885.60 | $6,733.00 | $703.98 – $3,519.90 | 13 |
| Slitting of prepuce CPT 54001 | $4,708.80 | $6,489.00 | $52.80 – $614.40 | 8 |
| Slp eval non-spch gen comm dev CPT 92605 | $375.20 | $517.00 | $67.20 – $67.20 | 1 |
| Slp pure tone screening CPT 92551 | $22.80 | $38.00 | $8.80 – $13.63 | 7 |
| Sm-153 lexidron ther HCPCS A9604 | $15,008.80 | $20,684.00 | not published | 0 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $809.60 | $1,116.00 | $28.80 – $172.10 | 8 |
| Small bowel endoscopy CPT 44360 | $4,128.80 | $5,690.00 | $149.01 – $993.28 | 8 |
| Small bowel endoscopy CPT 44364 | $4,128.80 | $5,690.00 | $210.00 – $993.28 | 8 |
| Small bowel endoscopy CPT 44366 | $4,128.80 | $5,690.00 | $228.25 – $948.06 | 8 |
| Small bowel endoscopy CPT 44369 | $4,128.80 | $5,690.00 | $228.25 – $1,026.76 | 8 |
| Small bowel endoscopy CPT 44382 | $4,264.00 | $5,877.00 | $76.74 – $643.39 | 8 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $4,128.80 | $5,690.00 | $197.48 – $993.28 | 8 |
| Small bowel endoscopy br/wa CPT 44380 | $4,264.00 | $5,877.00 | $64.44 – $465.00 | 8 |
| Small bowel endoscopy br/wa CPT 44381 | $4,128.80 | $5,690.00 | $993.28 – $993.28 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $7,896.80 | $10,883.00 | $460.56 – $993.28 | 2 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $111.20 | $153.00 | $3.00 – $5.32 | 8 |
| Smear gram stain CPT 87205 | $111.20 | $153.00 | $4.22 – $7.67 | 8 |
| Smear nasal eosinophil CPT 89190 | $122.40 | $169.00 | $5.72 – $11.32 | 8 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $235.20 | $324.00 | $4.50 – $7.67 | 8 |
| Smear wet mount CPT 87210 | $135.20 | $186.00 | $5.75 – $9.92 | 8 |
| Sodium 24 hour urine CPT 84300 | $74.20 | $102.00 | $5.01 – $11.45 | 8 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $26.00 | $38.00 | $0.00 – $2.14 | 6 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $22.20 | $27.75 | $1.26 – $1.39 | 5 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $32.40 | $42.00 | $0.65 – $0.71 | 5 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $26.40 | $44.00 | $0.18 – $0.90 | 13 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $147.60 | $246.00 | $2.02 – $2.23 | 5 |
| Sodium serum/plasma/whole blood CPT 84295 | $47.80 | $66.00 | $4.76 – $11.08 | 8 |
| Specific gravity body fluid CPT 84315 | $52.00 | $71.00 | $2.56 – $3.24 | 2 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $375.20 | $517.00 | $190.80 – $261.75 | 2 |
| Speech evaluation complex CPT 70371 | $1,175.20 | $1,619.00 | $61.98 – $288.27 | 8 |
| Speech Therapy Session (one-on-one) CPT 92507 | $217.60 | $300.00 | $23.87 – $81.81 | 8 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,644.80 | $2,267.00 | $80.72 – $993.28 | 8 |
| Spine X-ray (single view, one level) CPT 72020 | $374.40 | $516.00 | $18.51 – $54.78 | 8 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $656.00 | $904.00 | $320.00 – $723.38 | 2 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $130.40 | $180.00 | $40.60 – $64.30 | 2 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $24.80 | $31.00 | $5.58 – $27.90 | 13 |
| Splint func pos polyflex ii med HCPCS L3999 | $169.60 | $212.00 | $38.16 – $190.80 | 12 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $148.00 | $204.00 | $26.61 – $26.61 | 1 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $723.20 – $2,357.48 | 2 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | $2,773.60 | $3,822.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $375.20 | $517.00 | $95.96 – $131.64 | 2 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $474.40 | $654.00 | $77.54 – $144.88 | 2 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $11,702.40 | $16,127.00 | $1,446.84 – $7,234.20 | 13 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $577.60 | $796.00 | $32.58 – $162.90 | 13 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $7,876.80 | $10,855.00 | $748.44 – $3,742.20 | 13 |
| Sterile gauze <= 16 sq in HCPCS A6402 | $1.80 | $2.25 | $0.15 – $0.29 | 2 |
| Sterile needle HCPCS A4215 | $476.80 | $657.00 | $0.23 – $0.23 | 1 |
| Sterile water/saline, 10 ml HCPCS A4216 | $51.20 | $64.00 | $0.07 – $0.46 | 2 |
| Sterile water/saline, 500 ml HCPCS A4217 | $3.60 | $6.00 | $3.20 – $3.20 | 1 |
| St evaluate speech sound production CPT 92522 | $375.20 | $517.00 | $91.99 – $126.20 | 2 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $301.60 | $416.00 | $46.55 – $82.12 | 8 |
| Stomach Emptying Scan (Nuclear Medicine) CPT 78264 | $1,826.40 | $2,517.00 | $126.72 – $497.77 | 8 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $315.60 | $526.00 | $22.00 – $75.17 | 8 |
| Strapping of elbow or wrist 29260 CPT 29260 | $569.60 | $785.00 | $34.52 – $68.00 | 8 |
| Strapping of knee CPT 29530 | $295.20 | $406.00 | $28.05 – $87.63 | 8 |
| Strapping of toes 29550 CPT 29550 | $28.20 | $38.00 | $22.00 – $61.49 | 8 |
| Strep a ag ia CPT 87430 | $92.80 | $128.00 | $6.30 – $16.62 | 8 |
| Strep b dna amp probe CPT 87653 | $129.60 | $170.00 | $34.68 – $66.86 | 8 |
| Stress test pulmonary CPT 94618 | $789.60 | $1,088.00 | $11.08 – $46.22 | 8 |
| Stress tte complete CPT 93351 | $2,406.40 | $3,316.00 | $152.59 – $411.54 | 8 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $69.60 | $116.00 | $1.98 – $9.90 | 13 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $208.00 | $260.00 | $89.78 – $89.78 | 1 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $0.40 | $0.50 | $0.05 – $0.05 | 5 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $148.00 | $185.00 | $69.57 – $69.57 | 1 |
| Supp non-insulin inf cath/wk HCPCS A4221 | $66.60 | $92.00 | $23.19 – $52.16 | 2 |
| Support clav 29.6-40.5in med HCPCS L3650 | $218.40 | $301.00 | $64.08 – $114.97 | 2 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $168.51 – $993.28 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $58.20 | $80.00 | $1.92 – $26.86 | 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.