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 |
|---|---|---|---|---|
| Wrist X-ray CPT 73110 | $374.40 | $516.00 | $14.72 – $68.14 | 2 |
| Wrist X-ray (2 views, both wrists) CPT 73100 | $710.40 | $979.00 | $14.72 – $61.64 | 2 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | not published | not published | $1,727.55 – $2,117.12 | 2 |
| Xcapsl ctrc rmvl insj 1+ CPT 66991 | not published | not published | $696.24 – $993.28 | 2 |
| Xcpsl ctrc rmvl cplx insj 1+ CPT 66989 | not published | not published | $873.61 – $993.28 | 2 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $195.25 – $1,606.12 | 8 |
| Xfer tis s/a/l 10 sq cm/< CPT 14020 | not published | not published | $165.00 – $1,034.50 | 8 |
| X-ray abdomen >=3 views CPT 74021 | $406.40 | $560.00 | $24.54 – $51.52 | 8 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $868.80 | $1,197.00 | $21.12 – $245.64 | 2 |
| X-ray bone length studies CPT 77073 | $584.00 | $805.00 | $26.80 – $61.56 | 8 |
| X-ray bone survey infant CPT 77076 | $843.20 | $1,162.00 | $35.92 – $107.25 | 8 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $868.80 | $1,197.00 | $47.71 – $87.46 | 8 |
| X-ray exam entire spi 6/> vw CPT 72084 | $1,174.40 | $1,618.00 | $57.57 – $104.43 | 8 |
| X-ray exam of arm infant CPT 73092 | $617.60 | $852.00 | $14.08 – $61.64 | 2 |
| X-ray exam of femur 1 CPT 73551 | $287.20 | $396.00 | $18.41 – $35.33 | 2 |
| X-ray exam of jaw joint CPT 70328 | $804.80 | $1,109.00 | $21.12 – $65.94 | 8 |
| X-ray exam of jaw joint CPT 70332 | $656.00 | $904.00 | $35.20 – $245.64 | 8 |
| X-ray exam of mastoids CPT 70120 | $480.80 | $663.00 | $21.12 – $75.62 | 2 |
| X-ray exam of middle ear CPT 70134 | $574.40 | $792.00 | $28.80 – $106.83 | 8 |
| X-ray exam of salivary gland CPT 70380 | $606.40 | $836.00 | $26.88 – $77.99 | 8 |
| X-ray exam si joints CPT 72200 | $257.60 | $355.00 | $21.12 – $66.91 | 8 |
| X-ray exam thorac spine4/>vw CPT 72074 | $821.60 | $1,132.00 | $27.52 – $104.31 | 8 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $652.80 | $900.00 | $19.16 – $58.08 | 2 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $500.80 | $690.00 | $35.43 – $65.55 | 2 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $951.20 | $1,310.00 | $38.52 – $73.26 | 8 |
| X-ray joint survey 1 view CPT 77077 | $417.60 | $575.00 | $29.85 – $79.15 | 8 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $617.60 | $852.00 | $21.12 – $61.64 | 2 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $504.00 | $695.00 | $26.88 – $102.65 | 8 |
| X-ray mandible ltd <4 views CPT 70100 | $454.40 | $626.00 | $21.12 – $68.25 | 8 |
| X-ray measurement of pelvis CPT 74710 | $504.00 | $630.00 | $24.32 – $53.68 | 7 |
| X-ray nose to rectum for foreign body child CPT 76010 | $294.40 | $405.00 | $11.14 – $67.46 | 8 |
| X-ray optic foramina CPT 70190 | $354.40 | $488.00 | $26.88 – $80.43 | 8 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $875.20 | $1,206.00 | $28.80 – $265.21 | 8 |
| X-ray ribs 2 views left CPT 71100 | $368.80 | $508.00 | $21.12 – $77.85 | 8 |
| X-ray sella turcica CPT 70240 | $598.40 | $824.00 | $14.72 – $60.91 | 8 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,411.20 | $1,945.00 | $21.12 – $162.71 | 8 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $1,143.20 | $1,575.00 | $35.20 – $179.84 | 8 |
| X-ray small intestine follow-through study CPT 74248 | $480.00 | $662.00 | $46.07 – $109.17 | 8 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $466.40 | $643.00 | $14.72 – $87.60 | 8 |
| X-ray surgical specimen CPT 76098 | $216.00 | $298.00 | $13.59 – $55.18 | 8 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $479.20 | $660.00 | $24.20 – $50.41 | 8 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $114,488.00 | $157,779.00 | not published | 0 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $135.00 | $225.00 | $1.51 – $1.66 | 5 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $229.80 | $383.00 | $6.83 – $7.51 | 5 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | $74.40 | $124.00 | $7.88 – $8.67 | 6 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $4,651.80 | $7,753.00 | $5.06 – $5.56 | 5 |
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.