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 |
|---|---|---|---|---|
| Injection, isavuconazonium HCPCS J1833 | not published | not published | $0.65 – $2.12 | 13 |
| Injection jaw joint x-ray CPT 21116 | $455.10 | $615.00 | $23.97 – $70.41 | 10 |
| Injection jugular CPT 36299 | not published | $0.01 | not published | 0 |
| Injection, khapzory, 0.5 mg HCPCS J0642 | not published | not published | $1.06 – $1.76 | 6 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $3.70 – $12.04 | 15 |
| Injection of HIV prep drug HCPCS G0012 | not published | not published | $15.15 – $227.18 | 13 |
| Injection of sinus tract CPT 20500 | $4,165.46 | $5,629.00 | $12.00 – $4,728.29 | 15 |
| Injection,onabotulinumtoxina HCPCS J0585 | $592.41 | $2,278.50 | $4.20 – $13.65 | 15 |
| Injection, pentamidine iseth HCPCS S0080 | $151.87 | $584.12 | $99.65 – $127.50 | 3 |
| Injection, peramivir HCPCS J2547 | not published | not published | $1.08 – $3.52 | 13 |
| Injection, piperacillin sodi HCPCS S0081 | not published | not published | $1.78 – $2.73 | 2 |
| Injection px peyronie ds CPT 54200 | $64.48 | $248.00 | $76.76 – $776.33 | 13 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $1,129.98 | $1,527.00 | $27.68 – $1,282.65 | 13 |
| Injection, renflexis HCPCS Q5104 | $685.59 | $2,636.87 | $16.19 – $52.61 | 15 |
| Injection, ruconest HCPCS J0596 | not published | not published | $23.74 – $77.15 | 15 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $88.92 | $342.00 | $294.03 – $2,210.54 | 13 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,947.68 | $2,632.00 | $55.44 – $2,210.54 | 15 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,947.68 | $2,632.00 | $22.05 – $2,210.54 | 15 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $2,503.42 | $3,383.00 | $96.34 – $2,841.83 | 15 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,877.38 | $2,537.00 | $51.20 – $94.20 | 10 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $2,503.42 | $3,383.00 | $89.84 – $2,841.83 | 15 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,877.38 | $2,537.00 | $43.66 – $80.84 | 10 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,503.42 | $3,383.00 | $75.61 – $2,841.83 | 15 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $78.00 | $300.00 | $93.08 – $2,210.54 | 15 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $2,434.60 | $3,290.00 | $85.39 – $2,210.54 | 15 |
| Injection, siltuximab HCPCS J2860 | not published | not published | $104.64 – $340.11 | 15 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $830.28 | $1,122.00 | $18.50 – $942.26 | 15 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $1,037.48 | $1,402.00 | $6.41 – $942.26 | 15 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $30.16 | $116.00 | $6.41 – $942.26 | 15 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $130.24 | $176.00 | $11.04 – $17.47 | 3 |
| Injection, ticarcillin disod HCPCS S0040 | not published | not published | $13.60 – $20.88 | 2 |
| Injection torsemide 10 mg/ml HCPCS J3265 | not published | not published | $2.19 – $4.66 | 2 |
| Injection treatment of eye CPT 66020 | $94.12 | $362.00 | $84.00 – $7,280.16 | 15 |
| Injection treatment of eye CPT 66030 | $79.56 | $306.00 | $84.00 – $7,280.16 | 15 |
| Injection treatment of nerve CPT 64605 | $312.52 | $1,202.00 | $117.60 – $6,233.30 | 15 |
| Injection treatment of nerve CPT 64610 | $352.30 | $1,355.00 | $158.03 – $6,233.30 | 15 |
| Injection treatment of nerve CPT 64681 | $161.20 | $620.00 | $192.35 – $2,841.83 | 15 |
| Injection treatment of nose CPT 30200 | $43.94 | $169.00 | $52.45 – $1,625.54 | 13 |
| Inject sacroiliac joint CPT 27096 | $2,582.60 | $3,490.00 | $11.16 – $131.61 | 10 |
| Inject/treat eye socket CPT 67500 | $47.06 | $181.00 | $43.45 – $954.19 | 15 |
| Inject/treat eye socket CPT 67505 | $51.74 | $199.00 | $45.36 – $954.19 | 15 |
| Inject/treat eye socket CPT 67515 | $33.54 | $129.00 | $38.87 – $954.19 | 15 |
| Inj, eculizumab-aagh, 2 mg HCPCS Q5151 | not published | not published | $20.26 – $65.84 | 13 |
| Inj, eculizumab-aeeb, 2 mg HCPCS Q5152 | not published | not published | $26.80 – $87.12 | 13 |
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $21.80 – $70.85 | 15 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $13.64 – $44.35 | 15 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $246.58 – $801.44 | 15 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $37.11 – $120.61 | 15 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $1,947.68 | $2,632.00 | $85.83 – $2,210.54 | 15 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $2,503.42 | $3,383.00 | $68.09 – $2,841.83 | 15 |
| Inj, epinephrine (belcher) HCPCS J0173 | not published | not published | $2.38 – $3.11 | 3 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $1.22 – $1.83 | 6 |
| Inj, erzofri, 1 mg HCPCS J2428 | not published | not published | $11.08 – $36.01 | 13 |
| Inj, etelcalcetide, 0.1 mg HCPCS J0606 | not published | not published | $4.01 – $5.29 | 3 |
| Inj, eteplirsen, 10 mg HCPCS J1428 | not published | not published | $163.20 – $215.06 | 3 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $122.60 – $398.48 | 15 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $11.22 – $36.48 | 15 |
| Inj, exagamglogene autotem HCPCS J3392 | not published | not published | $1,506,705.20 – $4,897,200.00 | 13 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $6.40 – $20.81 | 15 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $22.28 – $72.40 | 15 |
| Inj fe-based mr contrast,1ml HCPCS Q9953 | not published | not published | $21.89 – $80.98 | 3 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $12.24 – $39.80 | 15 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $90.73 – $294.89 | 15 |
| Inj ferric pyrophosphate cit HCPCS J1443 | not published | not published | $0.03 – $0.04 | 3 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $0.78 – $2.54 | 15 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $4.80 – $15.60 | 15 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $1.85 – $6.02 | 15 |
| Inj follitropin alfa 75 iu HCPCS S0126 | not published | not published | $246.34 – $315.17 | 3 |
| Inj follitropin beta 75 iu HCPCS S0128 | not published | not published | $221.85 – $283.84 | 3 |
| Inj for ext venography CPT 36005 | $840.64 | $1,136.00 | $40.77 – $74.53 | 10 |
| Inj for mammo ductogram CPT 19030 | $54.86 | $211.00 | $7.11 – $417.00 | 11 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $0.44 – $2.37 | 15 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $391.77 – $1,273.34 | 15 |
| Inj., fremanezumab-vfrm 1 mg HCPCS J3031 | not published | not published | $3.32 – $4.38 | 3 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $2.15 – $6.98 | 15 |
| Inj, fulvestrant (teva) HCPCS J9393 | not published | not published | $20.40 – $97.04 | 13 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $3.21 – $4.82 | 6 |
| Inj, ganciclovir (exela) HCPCS J1574 | not published | not published | $51.00 – $67.21 | 3 |
| Inj ganirelix acetat 250 mcg HCPCS S0132 | not published | not published | $191.61 – $240.12 | 3 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $4.99 – $12.19 | 6 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $75.72 – $246.10 | 15 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $1,790.06 – $5,818.19 | 15 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | not published | not published | $1.20 – $3.89 | 15 |
| Inj glycopyrrolate, glyrx-pf HCPCS J1597 | not published | not published | $1.63 – $2.15 | 3 |
| Inj golodirsen 10 mg HCPCS J1429 | not published | not published | $163.20 – $215.06 | 3 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $3.20 – $10.42 | 15 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $48.37 – $157.21 | 15 |
| Inj., haegarda 10 units HCPCS J0599 | not published | not published | $11.87 – $15.65 | 3 |
| Inj, hemgenix, per tx dose HCPCS J1411 | not published | not published | $2,381,050.79 – $7,739,060.00 | 13 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | not published | not published | $2.84 – $4.59 | 6 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $40.69 – $132.24 | 15 |
| Inj, hercessi, 10 mg HCPCS Q5146 | not published | not published | $71.87 – $118.56 | 6 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $50.07 – $162.73 | 15 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $6,783.58 | $9,167.00 | $36.93 – $72.72 | 6 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $6,783.58 | $9,167.00 | $46.85 – $80.83 | 6 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $6,783.58 | $9,167.00 | $47.73 – $86.54 | 6 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $6,783.58 | $9,167.00 | $30.16 – $49.82 | 6 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $6,783.58 | $9,167.00 | $29.02 – $49.82 | 6 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $0.98 – $3.19 | 15 |
| Inj hydroxocobalamin IV 25mg HCPCS J3424 | $953.68 | $3,668.00 | $3.35 – $10.89 | 13 |
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.