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 |
|---|---|---|---|---|
| Curette/treat cornea CPT 65435 | $2,283.20 | $3,147.00 | $61.55 – $993.28 | 8 |
| Cutter lead HCPCS C1773 | $619.20 | $1,032.00 | $11.56 – $57.83 | 12 |
| Cv stress test i&r only 93018 CPT 93018 | $42.60 | $71.00 | $18.74 – $142.85 | 2 |
| Cv stress test/supervision only 93016 CPT 93016 | $42.60 | $71.00 | $28.51 – $72.53 | 2 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $54.00 | $67.50 | $1.00 – $1.65 | 6 |
| Cyclic citrullinated peptide antibody CPT 86200 | $304.00 | $419.00 | $12.80 – $24.66 | 8 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $13.20 | $22.00 | $0.48 – $0.53 | 6 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $43.20 | $72.00 | $1.10 – $1.21 | 5 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $29.00 | $36.25 | $72.58 – $79.84 | 5 |
| Cyclosporine 2 hour CPT 80158 | $542.40 | $748.00 | $17.09 – $29.12 | 8 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $8.80 | $11.00 | $0.34 – $0.88 | 6 |
| Cyclosporine oral 100 mg HCPCS J7502 | $34.00 | $46.00 | $1.72 – $2.24 | 6 |
| Cyp2c19 gene com variants CPT 81225 | $1,004.00 | $1,255.00 | $227.49 – $287.96 | 2 |
| Cyp2d6 gene com variants CPT 81226 | $240.00 | $400.00 | $352.08 – $445.64 | 2 |
| Cystatin c CPT 82610 | $332.80 | $459.00 | $15.20 – $25.90 | 8 |
| Cystic fibrosis cftr CPT 81223 | $4,001.60 | $5,002.00 | $399.20 – $680.32 | 8 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $961.60 | $1,325.00 | $27.52 – $129.10 | 8 |
| Cystometrogram w/up 51727 CPT 51727 | $2,776.80 | $3,827.00 | $179.35 – $427.10 | 8 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $214.50 – $993.28 | 8 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $168.85 – $697.60 | 8 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $237.60 – $984.85 | 8 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $297.01 – $1,533.30 | 8 |
| Cystoscopy and treatment CPT 52310 | $5,744.80 | $7,917.00 | $141.90 – $830.72 | 8 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,557.60 | $2,146.00 | $82.50 – $744.96 | 8 |
| Cystoscopy chemodenervation CPT 52287 | $1,976.00 | $2,724.00 | $143.81 – $993.28 | 8 |
| Cystoscopy & ureter catheter CPT 52005 | $2,835.20 | $3,907.00 | $127.60 – $880.64 | 8 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $667.07 – $993.28 | 2 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $836.61 – $993.28 | 2 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $585.08 – $993.28 | 2 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $954.79 – $993.28 | 2 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $824.16 – $993.28 | 2 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | not published | not published | $118.25 – $678.40 | 8 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $135.85 – $893.44 | 8 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $70.80 | $118.00 | $0.83 – $0.91 | 5 |
| Cytogenetics 25-99 CPT 88274 | $412.00 | $568.00 | $33.09 – $41.88 | 2 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $176.80 | $244.00 | $14.22 – $33.79 | 8 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $176.80 | $244.00 | $16.65 – $39.67 | 8 |
| Cyto/molecular report CPT 88291 | $326.40 | $449.00 | $12.37 – $25.40 | 2 |
| Cytopath c/v auto in fluid CPT 88174 | $334.40 | $461.00 | $23.88 – $40.70 | 8 |
| Cytopath fl nongyn filter CPT 88106 | $169.60 | $234.00 | $3.20 – $72.39 | 8 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $172.00 | $237.00 | $52.81 – $218.54 | 8 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $104.00 | $137.00 | $26.30 – $50.36 | 8 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $81.60 | $107.00 | $16.00 – $27.27 | 8 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $62.20 | $85.00 | $5.12 – $77.31 | 8 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $280.80 | $387.00 | $8.32 – $91.11 | 8 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $85.60 | $118.00 | $113.83 – $122.78 | 2 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $450.40 | $621.00 | $39.16 – $130.00 | 2 |
| Cytopath smear other source CPT 88160 | $66.40 | $91.00 | $3.20 – $72.74 | 8 |
| Cytopath smear oth prep screen & interp CPT 88161 | $120.80 | $167.00 | $11.26 – $70.68 | 8 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $76.80 | $128.00 | $3.45 – $3.79 | 5 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $2,879.40 | $4,799.00 | $328.34 – $361.17 | 6 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $7,113.00 | $11,855.00 | $15.61 – $17.17 | 6 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $2,063.40 | $3,439.00 | $0.03 – $24.27 | 6 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $104.40 | $174.00 | $55.57 – $61.12 | 6 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $17,923.80 | $29,873.00 | $2.93 – $3.22 | 6 |
| Darbepoetin alfa, esrd use HCPCS J0882 | $2,151.00 | $3,585.00 | $2.93 – $3.22 | 6 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $483.00 | $805.00 | $256.09 – $281.70 | 6 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $622.20 | $1,037.00 | $21.70 – $23.87 | 6 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $538.76 – $929.28 | 2 |
| Dch glucoscan CPT 82948 | $14.40 | $20.00 | $2.00 – $4.99 | 8 |
| Dch pulmonary stress test CPT 94621 | $188.80 | $260.00 | $81.36 – $198.64 | 8 |
| Dch validity tests CPT 81002 | $62.20 | $85.00 | $3.44 – $6.08 | 8 |
| Deamidated gliadin antibody iga CPT 86258 | $80.40 | $134.00 | $9.41 – $11.91 | 2 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $1,592.00 | $2,195.00 | $32.23 – $775.68 | 8 |
| Debridement (>20 cm) charge pt CPT 97598 | $312.80 | $432.00 | $12.72 – $94.55 | 8 |
| Debridement bone <= 20 sq cm CPT 11044 | $2,103.20 | $2,898.00 | $36.30 – $775.68 | 8 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | not published | not published | $38.95 – $80.89 | 2 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | not published | not published | $67.84 – $133.38 | 2 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $825.60 | $1,376.00 | $36.30 – $775.68 | 8 |
| Debride nail1-5 11720 CPT 11720 | $471.00 | $785.00 | $17.13 – $59.26 | 8 |
| Debride nail6 or more 11721 CPT 11721 | $206.40 | $344.00 | $22.00 – $99.88 | 8 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $728.40 | $1,214.00 | $18.50 – $46.42 | 2 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $1,778.40 | $2,451.00 | $769.79 – $993.28 | 2 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $728.40 | $1,214.00 | $36.30 – $775.68 | 8 |
| Decalcification CPT 88311 | $469.60 | $647.00 | $7.92 – $141.08 | 8 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $5,326.20 | $8,877.00 | $1.22 – $1.34 | 5 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $790.40 | $1,089.00 | $27.57 – $55.33 | 8 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $321.20 – $1,251.46 | 8 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $43.20 | $72.00 | $9.01 – $9.91 | 5 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $2,262.60 | $3,771.00 | $4.45 – $4.89 | 6 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $78.60 | $108.00 | $13.00 – $38.37 | 8 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $10,269.00 | $17,115.00 | $29.38 – $1,809.19 | 7 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $712.80 | $983.00 | $25.85 – $792.32 | 7 |
| Dermagraft HCPCS Q4106 | $2,778.40 | $3,829.00 | $42.18 – $42.18 | 1 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $2,755.80 | $4,593.00 | $3.52 – $3.88 | 6 |
| Desoxycorticosterone CPT 82633 | $481.60 | $664.00 | $30.62 – $72.96 | 8 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | $1,172.00 | $1,615.00 | $56.58 – $262.74 | 8 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | $1,489.60 | $2,053.00 | $72.34 – $308.87 | 8 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $847.20 | $1,412.00 | $22.00 – $1,181.44 | 8 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $147.00 | $245.00 | $56.51 – $993.28 | 8 |
| Destruction 2-14 lesions 17003 CPT 17003 | $118.20 | $197.00 | $4.67 – $22.58 | 8 |
| Destruction benign lesions < 14 lesions CPT 17110 | $847.20 | $1,412.00 | $53.90 – $825.60 | 8 |
| Developmental screen/score/document 96110 CPT 96110 | $20.40 | $28.00 | $7.69 – $11.91 | 7 |
| Device ablt adv novasure HCPCS C1886 | $7,153.60 | $9,858.00 | $796.50 – $3,982.50 | 12 |
| Device intraute mirena HCPCS J7298 | $4,133.60 | $5,167.00 | $1,133.82 – $1,133.82 | 1 |
| Device sut capio slim opn HCPCS C2631 | $1,632.80 | $2,250.00 | $367.38 – $1,836.90 | 12 |
| Device tiss remov myosure reach HCPCS C1782 | $3,273.60 | $4,512.00 | $470.70 – $2,353.50 | 12 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $161.60 | $212.00 | $22.63 – $58.59 | 8 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | $1,432.80 | $2,388.00 | $102.94 – $113.23 | 6 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $5.40 | $9.00 | $0.02 – $0.10 | 6 |
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.