AHN WEXFORD HOSPITAL
12351 PERRY HIGHWAY, WEXFORD, PA · Ahn · · NPI 1588269898
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 |
|---|---|---|---|---|
| Diabetes (HbA1c) Test CPT 83036 | $61.42 | $83.00 | $4.70 – $11.20 | 16 |
| Diabetes training group per 30 min g0109 HCPCS G0136 | not published | not published | $7.86 – $95.09 | 15 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $129.08 – $487.64 | 13 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $21.92 – $82.83 | 13 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $21.92 – $82.83 | 13 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $21.92 – $82.83 | 13 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $12.67 – $36.00 | 7 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $43.04 – $162.60 | 13 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $21.92 – $82.83 | 13 |
| Diag bronchoscope/catheter CPT 31643 | $4,849.22 | $6,553.00 | $171.58 – $5,504.56 | 15 |
| Diag laparo separate proc 49320 CPT 49320 | $242.32 | $932.00 | $47.34 – $18,623.45 | 15 |
| Diagnostic anoscopy CPT 46601 | $68.12 | $262.00 | $81.28 – $1,273.75 | 13 |
| Diagnostic anoscopy & biopsy CPT 46607 | $90.22 | $347.00 | $107.48 – $3,763.66 | 13 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $362.60 | $490.00 | $21.00 – $411.45 | 15 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $26.96 – $238.50 | 8 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $69.94 | $269.00 | $26.96 – $336.12 | 8 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $546.12 | $738.00 | $42.95 – $619.70 | 13 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $546.12 | $738.00 | $59.99 – $619.70 | 15 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $34.32 | $132.00 | $40.97 – $183.82 | 15 |
| Diagnostic Mammogram (one breast) CPT 77065 | $27.82 | $107.00 | $32.97 – $144.31 | 15 |
| Diagnostic radio unlisted proc CPT 76499 | $340.40 | $460.00 | $48.39 – $281.06 | 13 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $12,025.00 | $16,250.00 | $152.94 – $314.15 | 10 |
| Dialysis one evaluation CPT 90945 | $1,197.32 | $1,618.00 | $56.00 – $446.52 | 12 |
| Dialysis repeated eval CPT 90947 | $88.66 | $341.00 | $56.00 – $194.30 | 3 |
| Dialysis training complete CPT 90989 | not published | not published | $447.32 – $653.23 | 3 |
| Dialysis training incompl CPT 90993 | not published | not published | $96.90 – $142.33 | 3 |
| Diathermy eg microwave CPT 97024 | not published | not published | $3.26 – $7.35 | 12 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.07 – $0.10 | 6 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $30.63 | $117.82 | $5.82 – $11.16 | 6 |
| Dicyclomine injection HCPCS J0500 | $76.49 | $294.21 | $11.01 – $19.44 | 6 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.05 – $0.16 | 13 |
| Diffusing capacity CPT 94729 | $6.50 | $25.00 | $6.74 – $45.71 | 7 |
| Digital analysis of eeg CPT 95957 | $72.80 | $280.00 | $74.08 – $160.09 | 7 |
| Digit nerve surgery add-on CPT 64778 | $130.52 | $502.00 | $176.18 – $284.66 | 7 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $651.68 | $2,506.46 | $3.77 – $11.51 | 6 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $22,631.70 | $87,045.00 | $3,210.20 – $10,434.02 | 15 |
| Digoxin total therapeutic drug level CPT 80162 | $84.36 | $114.00 | $6.43 – $17.60 | 16 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $119.53 | $459.73 | $41.04 – $137.36 | 6 |
| Dilate biliary duct/ampulla CPT 47542 | $7,442.92 | $10,058.00 | $114.78 – $211.39 | 10 |
| Dilate esophagus CPT 43453 | $62.66 | $241.00 | $61.95 – $6,055.25 | 15 |
| Dilate esophagus 1/mult pass CPT 43450 | $57.72 | $222.00 | $61.95 – $2,992.72 | 15 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $9,534.90 | $12,885.00 | $317.52 – $535.34 | 3 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $9,534.90 | $12,885.00 | $158.75 – $267.67 | 3 |
| Dilate ic vasospasm init CPT 61640 | $10,011.46 | $13,529.00 | $452.06 – $762.16 | 3 |
| Dilate tear duct opening CPT 68801 | $56.68 | $218.00 | $67.59 – $1,273.75 | 13 |
| Dilate urethra stricture CPT 53600 | $46.54 | $179.00 | $21.00 – $776.33 | 15 |
| Dilate urethra stricture CPT 53601 | $39.00 | $150.00 | $21.00 – $411.45 | 15 |
| Dilate urethra stricture CPT 53605 | $46.28 | $178.00 | $21.00 – $11,009.22 | 15 |
| Dilate urethra stricture CPT 53621 | $52.00 | $200.00 | $21.00 – $776.33 | 15 |
| Dilation/female urethra/initial 53660 CPT 53660 | $30.16 | $116.00 | $21.00 – $499.43 | 15 |
| Dilation of anal sphincter CPT 45905 | $124.80 | $480.00 | $46.20 – $3,763.66 | 15 |
| Dilation of cervical canal 57800 CPT 57800 | $35.10 | $135.00 | $41.84 – $10,149.16 | 15 |
| Dilation of rectal stricture 45910 CPT 45910 | $141.70 | $545.00 | $46.20 – $3,763.66 | 15 |
| Dilation of salivary duct CPT 42660 | $57.72 | $222.00 | $36.75 – $1,625.54 | 15 |
| Dilation of urethra CPT 53661 | $29.12 | $112.00 | $21.00 – $411.45 | 15 |
| Dilation of urethra CPT 53665 | $27.04 | $104.00 | $21.00 – $6,538.91 | 15 |
| Dilation of vagina CPT 57400 | $95.16 | $366.00 | $38.85 – $10,149.16 | 15 |
| Dilation salivary duct 42650 CPT 42650 | $43.42 | $167.00 | $36.75 – $4,728.29 | 15 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $63.18 | $243.00 | $21.00 – $2,130.58 | 15 |
| Dilator fascial 10fx20cm HCPCS C2627 | $119.42 | $459.32 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $9,698.44 | $13,106.00 | $130.01 – $11,009.22 | 15 |
| Dilat xst trc new access rcs CPT 50437 | $9,698.44 | $13,106.00 | $217.29 – $11,009.22 | 15 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $10.38 | $39.94 | $0.03 – $0.05 | 3 |
| Dimecaprol injection HCPCS J0470 | $154.04 | $592.46 | $54.55 – $75.83 | 3 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $7.30 – $11.31 | 6 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $479.98 – $1,560.08 | 15 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $0.03 | 3 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $2.74 | $10.54 | $0.73 – $2.10 | 7 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $13.80 – $95.60 | 8 |
| Dipyridamole injection HCPCS J1245 | $18.02 | $69.30 | $3.60 – $5.47 | 6 |
| Direct advanced life support CPT 99288 | not published | not published | $88.00 – $88.00 | 1 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $21.57 – $125.29 | 13 |
| Disability dlco CPT 94727 | $8.58 | $33.00 | $10.10 – $499.43 | 15 |
| Disaccharidases CPT 82657 | $140.60 | $190.00 | $10.74 – $24.17 | 13 |
| Disarticulation sho sec clsr CPT 23921 | $349.70 | $1,345.00 | $372.24 – $5,838.96 | 15 |
| Disarticulation shoulder CPT 23920 | $825.24 | $3,174.00 | $194.40 – $1,791.89 | 6 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | $1,069.90 | $4,115.00 | $208.43 – $2,325.76 | 6 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | $150.80 | $580.00 | $30.82 – $329.02 | 6 |
| Discography cerv/thor spine CPT 72285 | $7,550.22 | $10,203.00 | $25.20 – $6,233.30 | 15 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $50.28 – $189.95 | 13 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $104.00 – $450.93 | 13 |
| Dise eval slp do brth flx dx CPT 42975 | $70.72 | $272.00 | $103.38 – $5,504.56 | 13 |
| Dissect brain w/scope CPT 62161 | $1,125.54 | $4,329.00 | $195.69 – $2,455.08 | 6 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | $74.88 | $288.00 | $91.51 – $93.58 | 2 |
| Dissolve clot heart vessel CPT 92975 | $7,559.10 | $10,215.00 | $385.98 – $586.61 | 6 |
| Dist revas ligation hemo CPT 36838 | $816.66 | $3,141.00 | $158.87 – $17,255.16 | 15 |
| Div aberrant vsl w/reanast CPT 33803 | $828.88 | $3,188.00 | $151.20 – $1,811.62 | 6 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | $579.28 | $2,228.00 | $110.25 – $18,882.97 | 15 |
| Division of fallopian tube 58605 CPT 58605 | $245.96 | $946.00 | $50.12 – $540.65 | 6 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $13.88 – $23.41 | 3 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $4,046.32 | $5,468.00 | $41.69 – $460.52 | 6 |
| Dmd dup/delet analysis CPT 81161 | $784.40 | $1,060.00 | $135.15 – $840.00 | 16 |
| Dmpk gene charac alleles CPT 81239 | $214.24 | $824.00 | $133.13 – $299.56 | 13 |
| Dmpk gene detc abnor allele CPT 81234 | $385.54 | $521.00 | $66.36 – $149.33 | 13 |
| Dna antibody native/double stranded CPT 86225 | $87.32 | $118.00 | $6.66 – $23.20 | 16 |
| Dna gardnerella CPT 87510 | $126.54 | $171.00 | $9.71 – $25.66 | 16 |
| Dna probe chlamydia CPT 87490 | $17.68 | $68.00 | $11.02 – $36.35 | 16 |
| Dna probe gc CPT 87590 | $20.80 | $80.00 | $13.02 – $29.30 | 13 |
| Dna trichomonas CPT 87660 | $126.54 | $171.00 | $9.71 – $35.87 | 16 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $36.40 | $140.00 | $7.39 – $15.75 | 7 |
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.