Hospital Lewisburg, PA

Evangelical Community Hospital

Evangelical Community Hospital in Lewisburg, PA publishes cash prices for 323 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Pennsylvania median for 207 of 323 procedures and below it for 114. By typical cash price it ranks #80 of 108 Pennsylvania hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1 Hospital Drive, Lewisburg, PA 17837 Collected Oct 30, 2026 Source price file Check a bill from this hospital (570) 522-2000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 390013 · CMS hospital register NPI 1124076039

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Evangelical Community Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

ProcedureCash priceList priceInsurers payvs PennsylvaniaOff list
Abdominal CT scan without and with contrast CPT 74170 CT Scan of Abdomen Before and After Contrast $560.00 $5,372.50 $171.26–$2,596.66 70% below 90%
Abdominal X-ray, 2 views CPT 74019 X-Ray of Abdomen, 2 Views $442.00 $552.50 $28.40–$845.74 35% above 20%
Ankle X-ray, complete, 3 or more views CPT 73610 X-Ray of Ankle, Minimum of 3 Views $463.20 $579.00 $29.45–$497.84 28% above 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ultrasound Study of Arm and Leg Arteries $869.20 $1,086.50 $53.67–$1,054.99 94% above 20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Scan of Arm Without Contrast $285.50 $3,064.75 $102.30–$1,622.26 76% below 91%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Single Contrast X-Ray of Esophagus $869.80 $1,087.25 $41.25–$1,006.60 89% above 20%
Bone scan, whole body (nuclear medicine) CPT 78306 Nuclear Medicine Study of Bone and/or Joint Whole Body $3,111.00 $3,888.75 $111.63–$2,259.58 153% above 20%
Breast ultrasound, complete, one breast CPT 76641 Complete Ultrasound Scan of 1 Breast $547.80 $684.75 $91.18–$808.66 at median 20%
Breast ultrasound, limited (one breast or one area) CPT 76642 Limited Ultrasound Scan of 1 Breast $531.60 $664.50 $75.28–$497.84 15% above 20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Scan of Blood Vessels of Abdomen and Pelvis With Contrast $517.50 $6,372.25 $343.57–$7,059.75 83% below 92%
CT angiography (CTA) of the head CPT 70496 CT Scan of Blood Vessels of Head With Contrast $538.00 $5,812.75 $171.26–$2,614.93 69% below 91%
CT angiography (CTA) of the neck CPT 70498 CT Scan of Blood Vessels of Neck With Contrast $538.00 $3,713.25 $171.26–$2,614.93 68% below 86%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Scan of Blood Vessels of Chest With Contrast $531.50 $5,686.00 $171.26–$2,613.18 72% below 91%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Scan of Blood Vessels and Grafts of Heart With Contrast $407.00 $5,205.75 $329.27–$5,054.78 79% below 92%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Scan of Heart With Evaluation of Blood Vessel Calcium $85.50 $135.00 $62.52–$603.81 52% below 37%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Scan of Abdomen and Pelvis Without Contrast $242.50 $5,857.50 $185.12–$4,907.01 88% below 96%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Scan of Abdomen and Pelvis With Contrast $437.50 $7,856.50 $289.48–$7,229.27 85% below 94%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Scan of Abdomen and Pelvis Before and After Contrast $525.00 $10,098.50 $343.57–$8,417.33 82% below 95%
CT scan of the abdomen with contrast CPT 74160 CT Scan of Abdomen With Contrast $468.50 $4,419.50 $163.96–$2,217.85 72% below 89%
CT scan of the abdomen without contrast CPT 74150 CT Scan of Abdomen Without Contrast $273.50 $3,654.25 $102.30–$1,798.02 76% below 93%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Scan of Face Without Contrast $295.00 $2,319.50 $102.30–$1,553.12 74% below 87%
CT scan of the head or brain, no contrast dye CPT 70450 CT Scan Head or Brain Without Contrast $296.00 $2,337.75 $102.30–$1,501.29 73% below 87%
CT scan of the head without and with contrast CPT 70470 CT Scan of Head or Brain Before and After Contrast $569.00 $3,802.00 $171.26–$2,179.06 66% below 85%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Scan of Lower Spine Without Contrast $286.00 $3,445.50 $102.30–$1,882.73 75% below 92%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Scan of Upper Spine Without Contrast $282.00 $3,074.75 $102.30–$1,881.71 76% below 91%
CT scan of the pelvis, with contrast dye CPT 72193 CT Scan of Pelvis With Contrast $475.50 $2,958.50 $154.10–$2,110.94 72% below 84%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of Both Sides of Head and Neck Blood Flow $1,843.20 $2,304.00 $162.65–$2,237.18 128% above 20%
Chest CT scan without and with contrast CPT 71270 CT Scan of Chest Before and After Contrast $562.00 $4,783.25 $171.26–$2,644.39 65% below 88%
Chest X-ray, 2 views CPT 71046 X-Ray of Chest, 2 Views $537.60 $672.00 $26.00–$497.84 67% above 20%
Chest X-ray, single view CPT 71045 X-Ray of Chest, 1 View $475.20 $594.00 $17.03–$497.84 152% above 20%
Collarbone (clavicle) X-ray, complete CPT 73000 X-Ray of Collar Bone $388.00 $485.00 $20.70–$497.84 35% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete Ultrasound Scan Behind Abdominal Cavity $898.20 $1,122.75 $89.65–$765.85 24% above 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Measurement of Hip, Pelvis, Spine $237.00 $689.75 $66.12–$602.31 13% below 66%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA Bone Density Measurement of Forearm, Finger, Hand, or Foot $469.60 $587.00 $30.23–$497.84 160% above 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Scan of Chest Without Contrast $285.00 $3,769.00 $102.30–$1,884.98 74% below 92%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Scan of Chest With Contrast $470.00 $4,476.50 $159.67–$2,164.21 67% below 90%
Diagnostic mammogram, both breasts CPT 77066 Diagnostic Mammography of Both Breasts $208.00 $1,066.25 $99.45–$1,234.67 36% below 80%
Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography of 1 Breast $222.00 $1,059.50 $78.07–$708.30 30% below 79%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Ultrasound of Leg Arteries or Artery Grafts $2,153.00 $2,691.25 $161.49–$2,613.20 161% above 20%
Duplex ultrasound of the leg veins, both legs CPT 93970 Ultrasound Study of Arm or Leg Veins With Compression and Maneuvers $2,140.60 $2,675.75 $161.33–$2,598.15 146% above 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of Heart With Blood Flow, Rate, Direction and Valve Function $2,898.80 $3,623.50 $155.12–$3,858.00 55% above 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of Heart W Blood Flow, Rate, Direction and Valve Function $2,898.80 $3,623.50 $155.12–$3,858.00 55% above 20%
Elbow X-ray, 2 views CPT 73070 X-Ray of Elbow, 2 Views $474.40 $593.00 $20.28–$497.84 55% above 20%
Elbow X-ray, complete, 3 or more views CPT 73080 X-Ray of Elbow, Minimum of 3 Views $624.00 $780.00 $20.90–$497.84 81% above 20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Scan of Cranial Cavity Without Contrast $268.00 $2,315.75 $102.30–$1,603.10 75% below 88%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-Ray of Face Bones, Minimum of 3 Views $594.20 $742.75 $37.69–$602.31 45% above 20%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-Ray of Forearm, 2 Views $414.40 $518.00 $20.70–$497.84 48% above 20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nuclear Medicine Study of Liver and Bile Duct System $2,308.00 $2,885.00 $266.27–$2,259.58 88% above 20%
Hand X-ray, 2 views CPT 73120 X-Ray of Hand, 2 Views $511.20 $639.00 $19.05–$602.31 83% above 20%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-Ray of Heel, Minimum of 2 Views $440.80 $551.00 $20.70–$497.84 67% above 20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Including Heart Rate, Breathing, Airflow, and Effort $536.40 $670.50 $78.23–$2,315.69 12% below 20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study in Sleep Lab With Continuous Airway Pressure (6 Years or Older) $8,062.00 $10,077.50 $712.32–$9,785.25 157% above 20%
Knee X-ray, 3 views CPT 73562 X-Ray of Knee, 3 Views $655.20 $819.00 $27.41–$497.84 64% above 20%
Knee X-ray, complete, 4 or more views CPT 73564 X-Ray of Knee, 4 or More Views $696.80 $871.00 $35.70–$602.31 60% above 20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Scan of Leg Without Contrast $285.50 $3,763.50 $102.30–$1,590.81 73% below 92%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited Ultrasound Scan of Abdomen $846.80 $1,058.50 $68.75–$602.31 40% above 20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Limited Ultrasound Joint/Other Extremity Structure Lacking Blood Vessels $728.40 $910.50 $26.17–$602.31 85% above 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low Dose CT Scan of Chest for Lung Cancer Screening $266.00 $3,417.25 $102.30–$731.92 33% below 92%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-Ray of Lower Leg, 2 Views $550.40 $688.00 $26.99–$497.84 65% above 20%
MR angiography (MRA) of the head without contrast CPT 70544 MRI Scan of Blood Vessels of Head Without Contrast $473.50 $3,929.25 $232.54–$2,893.90 74% below 88%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI Scan of Both Breasts $705.34 $5,083.00 $231.54–$1,882.74 64% below 86%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Scan of Leg Joint Without Contrast $462.00 $4,562.00 $232.54–$3,073.56 77% below 90%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Scan of Leg Joint Before and After Contrast $712.50 $6,750.75 $343.57–$4,755.12 80% below 89%
MRI of the abdomen without contrast CPT 74181 MRI Scan of Abdomen Without Contrast $457.00 $4,184.25 $232.54–$3,341.00 77% below 89%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Scan of Abdomen Before and After Contrast $706.00 $6,731.25 $343.57–$4,007.43 80% below 90%
MRI of the brain, no contrast dye CPT 70551 MRI Scan of Brain Without Contrast $455.00 $4,194.75 $232.54–$3,294.50 75% below 89%
MRI of the brain, with and without contrast dye CPT 70553 MRI Scan of Brain Before and After Contrast $701.50 $6,651.00 $343.57–$6,972.88 76% below 89%
MRI of the lower back, no contrast dye CPT 72148 MRI Scan of Lower Spinal Canal Without Contrast $454.00 $4,527.25 $232.54–$3,564.60 75% below 90%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Scan of Lower Spinal Canal Before and After Contrast $700.50 $7,222.00 $343.57–$6,940.94 79% below 90%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Scan of Middle Spinal Canal Without Contrast $454.00 $4,158.25 $232.54–$3,609.36 78% below 89%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Scan of Upper Spinal Canal Before and After Contrast $701.50 $6,364.75 $343.57–$7,013.25 76% below 89%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Scan of Upper Spinal Canal Without Contrast $454.00 $4,256.00 $232.54–$3,339.15 74% below 89%
MRI of the pelvis without and with contrast CPT 72197 MRI Scan of Pelvis Before and After Contrast $706.00 $7,222.00 $343.57–$4,007.43 80% below 90%
MRI of the pelvis, no contrast dye CPT 72195 MRI Scan of Pelvis Without Contrast $455.50 $4,158.25 $232.54–$2,846.26 77% below 89%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Scan of Arm Joint Without Contrast $461.50 $4,546.75 $232.54–$3,105.62 78% below 90%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-Ray of Upper Spine, 4-5 Views $710.40 $888.00 $44.68–$602.31 61% above 20%
Neck soft tissue CT scan with contrast CPT 70491 CT Scan of Soft Tissue of Neck With Contrast $461.50 $3,545.25 $151.25–$1,956.91 66% below 87%
Neck soft tissue CT scan without contrast CPT 70490 CT Scan of Soft Tissue of Neck Without Contrast $268.00 $2,896.75 $102.30–$1,604.23 75% below 91%
Neck soft tissue X-ray CPT 70360 X-Ray of Soft Tissue of Neck $405.20 $506.50 $19.25–$497.84 45% above 20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nuclear Medicine Studies of Heart Muscle at Rest and With Stress and Spect $5,698.80 $7,123.50 $374.88–$7,779.35 45% above 20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nuclear Medicine Study From Skull Base to Mid-Thigh With CT Scan $7,410.00 $9,262.50 $1,403.19–$8,570.95 2% above 20%
Pelvic CT scan without contrast CPT 72192 CT Scan of Pelvis Without Contrast $281.00 $2,325.25 $102.30–$1,855.17 74% below 88%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited Ultrasound Scan of Pelvis $870.60 $1,088.25 $35.20–$602.31 95% above 20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete Ultrasound Scan of Pelvis $897.20 $1,121.50 $84.15–$632.81 54% above 20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Scan of Pregnant Uterus (14 Weeks or More), Single or 1st Fetus $846.80 $1,058.50 $85.25–$890.71 38% above 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound of Pregnant Uterus (Less Than 14 Weeks), Single/1st Fetus $909.60 $1,137.00 $92.50–$897.78 62% above 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited Ultrasound of Pregnant Uterus $867.60 $1,084.50 $70.40–$602.31 63% above 20%
Rib X-ray, one side, 2 views CPT 71100 X-Ray of Ribs on Side of Body, 2 Views $410.40 $513.00 $29.15–$497.84 22% above 20%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-Ray of Ribs on Side of Body, Minimum of 3 Views $537.60 $672.00 $29.15–$602.31 31% above 20%
Screening mammogram, both breasts CPT 77067 Screening Mammography $225.00 $672.00 $82.23–$1,008.61 13% below 67%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-Ray of Shoulder, Minimum of 2 Views $657.60 $822.00 $27.41–$497.84 94% above 20%
Sinus X-ray, complete, 3 or more views CPT 70220 X-Ray of Paranasal Sinus, Minimum of 3 Views $599.80 $749.75 $37.27–$497.84 41% above 20%
Skull X-ray, fewer than 4 views CPT 70250 X-Ray of Skull, 1-3 Views $485.60 $607.00 $34.97–$602.31 36% above 20%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study in Sleep Lab (6 Years or Older) $7,018.40 $8,773.00 $381.22–$8,518.58 103% above 20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Imaging for Evaluation of Swallowing Function $1,097.80 $1,372.25 $50.60–$1,006.60 86% above 20%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-Ray of Thigh Bone, Minimum 2 Views $483.20 $604.00 $27.08–$497.84 21% above 20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Scan of Middle Spine Without Contrast $286.50 $3,246.75 $102.30–$1,882.43 76% below 91%
Toe X-ray, 2 or more views CPT 73660 X-Ray of Toe, Minimum of 2 Views $365.20 $456.50 $15.40–$497.84 30% above 20%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound of Uterus, Ovaries, Tubes, Cervix and Pelvic Area Through Vagina $831.80 $1,039.75 $84.15–$641.20 49% above 20%
Transvaginal ultrasound during pregnancy CPT 76817 Vaginal Ultrasound of Pregnant Uterus $831.80 $1,039.75 $96.35–$927.89 50% above 20%
Ultrasound of the abdomen, complete CPT 76700 Complete Ultrasound Scan of Abdomen $1,123.60 $1,404.50 $102.30–$761.15 43% above 20%
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound Scan of Scrotum $792.40 $990.50 $81.40–$640.79 29% above 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound Scan of Head and Neck Soft Tissue $792.40 $990.50 $83.99–$607.91 38% above 20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Single Contrast X-Ray of Upper Digestive Tract $1,178.40 $1,473.00 $71.50–$1,006.60 87% above 20%
Upper arm X-ray (humerus), 2 views CPT 73060 X-Ray of Upper Arm, Minimum of 2 Views $412.00 $515.00 $20.90–$497.84 49% above 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Ultrasound Study of One Arm or Leg Veins With Compression and Maneuvers $1,798.60 $2,248.25 $102.30–$2,183.05 181% above 20%
Wrist X-ray, 2 views CPT 73100 X-Ray of Wrist, 2 Views $617.20 $771.50 $20.70–$497.84 125% above 20%
Wrist X-ray, complete, 3 or more views CPT 73110 X-Ray of Wrist, Minimum of 3 Views $649.60 $812.00 $20.90–$497.84 102% above 20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-Ray of Hip, 2-3 Views $528.80 $661.00 $34.47–$497.84 49% above 20%
X-ray of the abdomen, 1 view CPT 74018 X-Ray of Abdomen, 1 View $354.60 $443.25 $23.25–$497.84 27% above 20%
X-ray of the ankle, 2 views CPT 73600 X-Ray of Ankle, 2 Views $447.60 $559.50 $20.70–$497.84 32% above 20%
X-ray of the finger(s), 2 or more views CPT 73140 X-Ray of Finger, Minimum of 2 Views $369.60 $462.00 $15.40–$497.84 53% above 20%
X-ray of the foot, 2 views CPT 73620 X-Ray of Foot, 2 Views $481.00 $601.25 $19.05–$497.84 48% above 20%
X-ray of the foot, complete, 3 or more views CPT 73630 X-Ray of Foot, Minimum of 3 Views $506.40 $633.00 $20.90–$497.84 39% above 20%
X-ray of the hand, 3 or more views CPT 73130 X-Ray of Hand, Minimum of 3 Views $511.20 $639.00 $20.90–$497.84 72% above 20%
X-ray of the knee, 1 or 2 views CPT 73560 X-Ray of Knee, 1-2 Views $578.40 $723.00 $26.99–$497.84 105% above 20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-Ray of Lower and Sacral Spine, 2-3 Views $563.60 $704.50 $35.78–$602.31 55% above 20%
X-ray of the lower back, 4 or more views CPT 72110 X-Ray of Lower and Sacral Spine, Minimum of 4 Views $961.00 $1,201.25 $40.28–$602.31 112% above 20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-Ray of Middle Spine, 2 Views $588.40 $735.50 $34.03–$602.31 61% above 20%
X-ray of the nasal bones, 3 or more views CPT 70160 X-Ray of Nose Bones, Minimum of 3 Views $385.20 $481.50 $20.90–$497.84 42% above 20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-Ray of Upper Spine, 2-3 Views $573.00 $716.25 $29.15–$497.84 72% above 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-Ray of Pelvis, 1-2 Views $399.20 $499.00 $19.25–$602.31 36% above 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-Ray of Sacrum and Tailbone, Minimum of 2 Views $523.60 $654.50 $26.99–$497.84 56% above 20%

Lab tests

ProcedureCash priceList priceInsurers payvs PennsylvaniaOff list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone (Acth) Level $759.20 $949.00 $38.23–$382.16 242% above 20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver Enzyme (Sgpt), Level $56.60 $70.75 $5.25–$64.63 55% above 20%
AST (aspartate aminotransferase) enzyme test CPT 84450 Liver Enzyme (Sgot), Level $55.00 $68.75 $5.13–$42.93 52% above 20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel $917.20 $1,146.50 $47.15–$657.89 196% above 20%
Albumin blood test CPT 82040 Albumin (Protein) Level $81.80 $102.25 $4.02–$62.28 156% above 20%
Aldosterone blood test CPT 82088 Aldosterone Hormone Level $697.80 $872.25 $28.60–$405.92 235% above 20%
Alkaline phosphatase (ALP) blood test CPT 84075 Phosphatase (Enzyme) Level, Alkaline $121.00 $151.25 $5.13–$42.98 232% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 Measure of Antibody to Allergic Substance $48.80 $61.00 $5.17–$86.45 51% above 20%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein (Afp) Level, Serum $170.80 $213.50 $16.60–$154.36 55% above 20%
Ammonia blood test CPT 82140 Ammonia Level $153.40 $191.75 $5.50–$132.85 69% above 20%
Amylase blood test CPT 82150 Amylase (Enzyme) Level $142.40 $178.00 $5.50–$78.46 226% above 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Measurement of Antibody for Rheumatoid Arthritis Assessment $270.40 $338.00 $12.82–$133.97 217% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Screening Test for Autoimmune Disorder $207.00 $258.75 $11.97–$105.92 178% above 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide (Heart and Blood Vessel Protein) Level $80.00 $412.00 $38.87–$281.79 60% below 81%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bacterial Culture, Any Other Source Except Urine, Blood or Stool, Aerobic $378.80 $473.50 $7.59–$71.80 626% above 20%
Basic metabolic panel (blood test) CPT 80048 Blood Test, Basic Group of Blood Chemicals (Calcium, Total) $20.00 $287.00 $8.38–$100.48 73% below 93%
Bilirubin blood test, total CPT 82247 Bilirubin Level, Total $10.00 $115.00 $4.97–$82.66 69% below 91%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology Examination of Tissue Using a Microscope, Intermediate Complexity $256.80 $321.00 $37.40–$352.18 45% above 20%
Blood culture for bacteria CPT 87040 Bacterial Blood Culture $582.20 $727.75 $10.22–$117.48 587% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Insertion of Needle Into Vein for Collection of Blood Sample $5.00 $40.00 $9.00–$44.08 67% below 88%
Blood glucose (sugar) test CPT 82947 Blood Glucose (Sugar) Level $15.00 $78.75 $3.89–$55.51 42% below 81%
Blood lead test CPT 83655 Lead Level $187.20 $234.00 $11.00–$139.61 140% above 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Group Typing (Abo) $46.25 $46.25 $4.53–$124.49 65% below —
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Level to Assess Kidney Function, Quantitative $49.00 $61.25 $3.91–$55.20 81% above 20%
C-peptide blood test CPT 84681 C-Peptide (Protein) Level $232.80 $291.00 $20.60–$197.69 114% above 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Measurement C-Reactive Protein for Detection of Infection or Inflammation $20.00 $305.25 $3.30–$65.55 44% below 93%
C. difficile toxin gene test (stool PCR) CPT 87493 Detect for Clostridium Difficile, Amplified Probe $420.20 $525.25 $36.90–$285.83 102% above 20%
CA 19-9 blood test (tumor marker) CPT 86301 Immunologic Analysis for Detection of Tumor Antigen, Quantitative; Ca 19-9 $85.00 $247.75 $20.60–$172.73 36% below 66%
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunologic Analysis for Detection of Tumor Antigen, Quantitative; Ca 125 $85.00 $238.00 $20.60–$172.73 35% below 64%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Amplifed Dna or Rna Probe Detect of Coronavirus 2 (Covid-19) Antigen $100.00 $192.00 $39.04–$248.80 10% above 48%
Calcium blood test, total CPT 82310 Calcium Level, Total $52.60 $65.75 $5.11–$42.81 57% above 20%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen (Cea) Protein Level $65.00 $516.25 $18.70–$208.04 45% below 87%
Chickenpox (varicella) immunity blood test CPT 86787 Analysis for Antibody to Varicella-Zoster Virus (Chicken Pox) $161.20 $201.50 $12.75–$144.43 90% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Detect for Chlamydia Trachomatis, Amplified Probe $362.00 $452.50 $25.51–$452.83 84% above 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood Test, Lipids (Cholesterol and Triglycerides) $40.00 $349.75 $13.26–$128.75 55% below 89%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Cell Count, With Diff $15.00 $138.25 $6.60–$90.44 71% below 89%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Cell Count, W/O Diff $15.00 $135.50 $6.41–$53.73 65% below 89%
Comprehensive metabolic panel (blood test) CPT 80053 Blood Test, Comprehensive Group of Blood Chemicals $25.00 $331.00 $10.45–$131.82 72% below 92%
Cortisol blood test, total CPT 82533 Cortisol (Hormone) Measurement, Total $204.60 $255.75 $13.20–$180.27 99% above 20%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase (Cardiac Enzyme) Level, Total $158.80 $198.50 $6.44–$78.15 253% above 20%
Creatinine blood test CPT 82565 Blood Creatinine Level $15.00 $66.00 $5.07–$42.53 56% below 77%
Cytomegalovirus (CMV) antibody test CPT 86644 Analysis for Antibody to Cytomegalovirus (Cmv) $384.20 $480.25 $14.25–$129.47 344% above 20%
D-dimer blood test (blood clot marker) CPT 85379 Coagulation Function Measurement, D-Dimer; Quantitative $186.20 $232.75 $10.08–$93.11 172% above 20%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone (Dhea-S) Hormone Level $229.80 $287.25 $22.01–$212.85 71% above 20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Testing for Presence of Drug, by Chemistry Analyzers $344.65 $430.81 $61.52–$760.93 89% above 20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Blood Test Panel, Electrolytes (Sodium Potassium, Chloride, Carbon Dioxide) $147.60 $184.50 $6.94–$106.73 180% above 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 Analysis Epstein-Barr Virus (Mononucleosis Virus), Viral Capsid $128.40 $160.50 $17.96–$169.31 12% above 20%
Estradiol blood test CPT 82670 Measurement of Total Estradiol (Hormone) $407.60 $509.50 $23.65–$300.63 145% above 20%
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin, Follicle Stimulating (Reproductive Hormone) Level $345.80 $432.25 $18.39–$175.77 190% above 20%
Fecal calprotectin (stool inflammation test) CPT 83993 Stool Calprotectin (Protein) Level $545.20 $681.50 $19.43–$189.08 322% above 20%
Ferritin blood test (iron stores) CPT 82728 Ferritin (Blood Protein) Level $40.00 $346.75 $13.20–$124.45 54% below 88%
Fibrinogen blood test CPT 85384 Fibrinogen (Factor 1) Activity Measurement $44.00 $55.00 $9.62–$102.12 33% below 20%
Folate (folic acid) blood test CPT 82746 Folic Acid Level, Serum $45.00 $202.25 $13.20–$163.98 48% below 78%
Free T3 thyroid hormone test CPT 84481 Thyroid Hormone, T3 Measurement, Free $159.60 $199.50 $16.77–$185.70 49% above 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (Thyroid Chemical), Free $35.00 $161.25 $8.80–$106.73 42% below 78%
Free testosterone test CPT 84402 Testosterone (Hormone) Level, Free $326.60 $408.25 $25.22–$281.06 105% above 20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Glutamyltransferase (Liver Enzyme) Level $141.60 $177.00 $7.13–$59.76 197% above 20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel $70.00 $764.25 $48.28–$283.08 63% below 91%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Blood Glucose (Sugar) Level After Receiving Dose of Glucose $54.20 $67.75 $4.70–$60.12 46% above 20%
Glucose tolerance test, 3 samples CPT 82951 Blood Glucose (Sugar) Tolerance Test, 3 Specimens $241.60 $302.00 $12.74–$144.52 198% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Detect for Neisseria Gonorrhoeae (Gonorrhoeae Bacteria), Amplified Probe $362.00 $452.50 $25.51–$454.68 97% above 20%
H. pylori stool antigen test CPT 87338 Detect Test for Helicobacter Pylori in Stool, Multiple-Step Method $487.80 $609.75 $13.40–$116.66 406% above 20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Detection Test by Nucleic Acid for Hiv-1 Virus, Quantification $778.20 $972.75 $84.25–$1,195.13 57% above 20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Detection Test by Immunoassay Technique for Hiv-1 and Hiv-2 $496.00 $620.00 $23.84–$187.80 250% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Level $25.00 $258.25 $7.70–$124.35 51% below 90%
Hemoglobin blood test CPT 85018 Blood Count, Hemoglobin $48.20 $60.25 $2.35–$34.82 181% above 20%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Measurement $483.80 $604.75 $11.93–$146.06 474% above 20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Measurement $177.20 $221.50 $10.63–$157.94 142% above 20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Detection Test by Immunoassay Technique for Hepatitis B Surface Antigen $983.80 $1,229.75 $10.23–$122.20 1314% above 20%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody Measurement $55.00 $363.25 $14.13–$177.82 45% below 85%
Hepatitis C viral load (HCV RNA) test CPT 87522 Detection Test by Nucleic Acid for Hepatitis C Virus, Quantification $1,078.20 $1,347.75 $42.41–$608.32 279% above 20%
High-sensitivity CRP (hs-CRP) test CPT 86141 Measure C-Reactive Protein for Detect of Infection/Inflammation $92.80 $116.00 $11.58–$117.89 18% above 20%
Homocysteine blood test CPT 83090 Homocysteine (Amino Acid) Level $372.20 $465.25 $17.74–$198.09 211% above 20%
Insulin blood test CPT 83525 Insulin Measurement, Total $204.00 $255.00 $11.32–$100.58 181% above 20%
Iron blood test (serum iron) CPT 83540 Iron Level $20.00 $76.00 $6.41–$53.79 56% below 74%
Kidney function blood test panel CPT 80069 Kidney Function Blood Test Panel $191.60 $239.50 $8.59–$134.69 180% above 20%
LH (luteinizing hormone) test CPT 83002 Gonadotropin, Luteinizing (Reproductive Hormone) Level $315.20 $394.00 $18.33–$175.05 164% above 20%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Level $149.40 $186.75 $8.80–$165.52 95% above 20%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase (Enzyme) Level $25.00 $86.50 $5.98–$50.09 32% below 71%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase (Fat Enzyme) Level $174.20 $217.75 $5.50–$81.02 271% above 20%
Liver function blood test panel CPT 80076 Liver Function Blood Test Panel $25.00 $358.00 $8.09–$100.28 68% below 93%
Lyme disease antibody test CPT 86618 Analysis for Antibody Borrelia Burgdorferi (Lyme Disease Bacteria) $56.40 $70.50 $16.86–$156.92 41% below 20%
Magnesium blood test CPT 83735 Magnesium Level $30.00 $85.50 $6.63–$55.61 28% below 65%
Measles (rubeola) antibody test CPT 86765 Analysis for Antibody to Rubeola (Measles Virus) $224.80 $281.00 $12.75–$106.53 179% above 20%
Mono test (heterophile antibody, Monospot) CPT 86308 Screening Test for Mononucleosis (Mono) $90.20 $112.75 $5.13–$42.98 142% above 20%
Mumps immunity blood test CPT 86735 Analysis for Antibody to Mumps Virus $288.20 $360.25 $6.53–$146.88 254% above 20%
Obstetric blood test panel CPT 80055 Obstetric Blood Test Panel $190.00 $249.00 $13.20–$231.83 39% below 24%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa (Prostate Specific Antigen) Measurement, Free $45.00 $647.75 $18.21–$243.89 60% below 93%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa (Prostate Specific Antigen) Measurement, Total $45.00 $305.75 $18.21–$172.90 59% below 85%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap Test, Automated Thin Layer Preparation and Manual Rescreening $280.20 $350.25 $26.23–$219.47 243% above 20%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap Test, Automated Thin Layer Preparation; and Manual Rescreening $367.80 $459.75 $26.34–$219.47 350% above 20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Test, Manual Screening $367.80 $459.75 $17.60–$247.47 501% above 20%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (Parathyroid Hormone) Level $231.20 $289.00 $40.87–$410.02 6% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation Assessment Blood Test, Plasma or Whole Blood $30.00 $164.75 $5.95–$49.81 27% below 82%
Phosphorus (phosphate) blood test CPT 84100 Phosphate Level $15.00 $109.75 $4.69–$39.40 54% below 86%
Potassium blood test CPT 84132 Blood Potassium Level $52.00 $65.00 $4.71–$38.09 63% above 20%
Progesterone blood test CPT 84144 Progesterone (Reproductive Hormone) Level $330.40 $413.00 $18.70–$196.35 141% above 20%
Prolactin blood test CPT 84146 Prolactin (Milk Producing Hormone) Level $373.80 $467.25 $19.19–$212.23 200% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 Blood Test, Clotting Time $15.00 $119.75 $4.25–$32.64 47% below 87%
Renin blood test CPT 84244 Renin (Kidney Enzyme) Level $226.60 $283.25 $13.20–$237.94 57% above 20%
Rh blood typing CPT 86901 Blood Typing for Rh (D) Antigen $43.00 $81.25 $4.59–$122.81 25% below 47%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Level $131.60 $164.50 $5.61–$72.21 237% above 20%
Rubella antibody test (immunity check) CPT 86762 Analysis for Antibody to Rubella (German Measles Virus) $133.40 $166.75 $14.25–$122.50 58% above 20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Red Blood Cell Sedimentation Rate, to Detect Inflammation, Automated $20.00 $91.00 $2.67–$69.76 8% below 78%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Evaluation Volume, Sperm Count, Motility and Analysis $380.40 $475.50 $12.19–$132.65 328% above 20%
Sodium blood test CPT 84295 Blood Sodium Level $52.00 $65.00 $4.76–$63.40 60% above 20%
Stool ova and parasites exam CPT 87177 Smear for Parasites $368.80 $461.00 $8.25–$99.77 529% above 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool Analysis for Blood to Screen for Colon Tumors $15.00 $22.00 $3.82–$27.01 26% below 32%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Stool Analysis for Blood, by Fecal Hemoglobin Determination by Immunoassay $36.00 $240.25 $3.64–$132.02 at median 85%
Syphilis antibody test (Treponema pallidum) CPT 86780 Analysis for Antibody, Treponema Pallidum $150.00 $187.50 $13.11–$184.37 101% above 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Detection Test $60.60 $75.75 $4.23–$35.42 116% above 20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis Test, Gamma Interferon $365.20 $456.50 $61.36–$657.69 18% above 20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone (Hormone) Level, Total $221.00 $276.25 $25.55–$251.25 36% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibodies (Autoantibody) Measurement $243.40 $304.25 $8.70–$120.82 223% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood Test, Thyroid Stimulating Hormone (Tsh) $40.00 $295.00 $16.63–$185.29 60% below 86%
Total IgE blood test CPT 82785 Ige (Immune System Protein) Level $174.60 $218.25 $16.30–$184.06 68% above 20%
Total cholesterol blood test CPT 82465 Cholesterol Level $62.20 $77.75 $4.31–$58.18 105% above 20%
Total thyroxine (T4) blood test CPT 84436 Thyroxine (Thyroid Chemical), Total $101.40 $126.75 $6.80–$57.03 125% above 20%
Total triiodothyronine (T3) blood test CPT 84480 Thyroid Hormone, T3 Measurement, Total $276.00 $345.00 $8.80–$129.67 185% above 20%
Transferrin blood test CPT 84466 Transferrin (Iron Binding Protein) Level $50.00 $167.75 $12.63–$146.58 42% below 70%
Trichomonas test (NAAT) CPT 87661 Detect for Trichomonas Vaginalis (Genital Parasite), Amplified Probe $307.40 $384.25 $34.74–$615.18 67% above 20%
Triglycerides blood test CPT 84478 Triglycerides Level $132.20 $165.25 $5.68–$73.54 234% above 20%
Troponin test, quantitative CPT 84484 Troponin (Protein) Analysis, Quantitative $63.00 $78.75 $10.86–$105.19 23% below 20%
Uric acid blood test CPT 84550 Uric Acid Level, Blood $15.00 $75.00 $4.47–$61.05 53% below 80%
Urinalysis with microscope exam, automated CPT 81001 Manual Urinalysis Test With Examination Using Microscope, Automated $10.00 $112.50 $3.14–$26.33 70% below 91%
Urinalysis without microscope exam, automated CPT 81003 Automated Urinalysis Test $10.00 $106.50 $2.23–$44.04 44% below 91%
Urine culture for bacteria, with colony count CPT 87086 Bacterial Colony Count, Urine $25.00 $399.50 $7.99–$90.44 56% below 94%
Urine microalbumin (albumin) test CPT 82043 Urine Microalbumin (Protein) Level $118.80 $148.50 $5.72–$70.27 200% above 20%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test $139.60 $174.50 $4.40–$101.81 278% above 20%
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12) Level $40.00 $209.75 $14.30–$139.31 57% below 81%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D-3 Level $100.00 $359.00 $29.30–$318.66 33% below 72%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Dihydroxyvitamin D, 1, 25 Level $718.20 $897.75 $38.12–$409.20 199% above 20%
Zinc blood test CPT 84630 Zinc Level $316.20 $395.25 $11.28–$130.19 338% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, Chorionic (Reproductive Hormone) Level $55.00 $451.50 $14.90–$149.96 39% below 88%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs PennsylvaniaOff list
Cardiac catheterization with coronary angiogram one side CPT 93458 Insert Tube in Left Lower Heart Chamber and Coronary Artery $6,734.20 $8,417.75 $3,094.25–$18,076.00 24% below 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 External Shock to Heart to Regulate Heart Beat $1,863.20 $2,329.00 $95.70–$18,076.00 27% above 20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Removal of Foreskin Using Clamp or Device $717.40 $896.75 $86.90–$9,100.00 41% below 20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal of Impacted Ear Wax by Washing $210.20 $262.75 $10.56–$1,956.00 50% above 20%
Earwax removal with instruments, one ear CPT 69210 Removal of Impacted Ear Wax $493.20 $616.50 $22.00–$598.62 268% above 20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inject Substance Into Middle/Upper Spine Canal W Image Guide $4,834.00 $6,042.50 $98.12–$5,867.27 101% above 20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inject Lower or Sacral Spine Facet Joint W Image Guide, Single Level $4,737.20 $5,921.50 $79.21–$5,749.78 229% above 20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Insert Tube/Introduction of Contrast for X-Ray of Uterus/Fallopian Tubes $305.60 $382.00 $57.20–$370.92 20% below 20%
Incision and drainage of a simple or single skin abscess CPT 10060 Simple or Single Drainage of Skin Abscess $882.60 $1,103.25 $25.85–$1,956.00 73% above 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or Injection of Fluid From Large Joint $1,723.80 $2,154.75 $25.85–$2,092.26 268% above 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or Injection of Fluid From Medium Joint $1,953.80 $2,442.25 $23.65–$2,371.42 452% above 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate Repair Wound Scalp/Underarm/Trunk/Arm/Leg 2.5 Cm or Less $890.40 $1,113.00 $26.95–$1,956.00 52% above 20%
Lower-back epidural injection, with imaging guidance CPT 62323 Injection of Substance Into Lower Spine Canal Using Imaging Guidance $1,843.20 $2,304.00 $89.45–$5,032.00 12% below 20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inject Anesthetic/Steroid Sacral Spine Nerve W Image Guide, Single Level $3,272.00 $4,090.00 $104.54–$4,362.00 71% above 20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Removal of Noncancer Skin Growth of Body, Arms, or Legs, 0.5 Cm or Less $3,178.20 $3,972.75 $41.25–$3,889.00 138% above 20%
Nail removal (partial or complete), one nail CPT 11730 Simple Separation of Fingernail or Toenail From Nail Bed, First Nail $993.20 $1,241.50 $191.15–$1,956.00 111% above 20%
Occipital nerve block (injection for headaches) CPT 64405 Inject Anesthetic/Steroid in Upper Neck and Back of Head Nerve $3,848.20 $4,810.25 $38.50–$4,670.75 582% above 20%
Paracentesis with imaging guidance CPT 49083 Drainage of Fluid From Abdominal Cavity Using Imaging Guidance $2,572.00 $3,215.00 $92.76–$5,673.79 53% above 20%
Prostate biopsy CPT 55700 Biopsy of Prostate Gland $6,034.80 $7,543.50 $98.45–$7,324.74 57% above 20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruct Lower or Sacral Spine Nerve Joint W Image Guide, Single Joint $5,453.60 $6,817.00 $197.27–$8,418.86 83% above 20%
Removal of a breast lump, open surgery CPT 19120 Removal of Growth and Tissue of Breast, Duct, or Nipple $5,848.80 $7,311.00 $190.30–$8,811.00 35% below 20%
Short arm splint (forearm and hand) CPT 29125 Application of Nonmoveable Forearm to Hand Splint $663.60 $829.50 $28.60–$1,956.00 111% above 20%
Short leg splint (calf to foot) CPT 29515 Application of Short Leg Splint From Calf to Foot $608.60 $760.75 $38.50–$1,956.00 32% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 2.5cm or Less $772.60 $965.75 $26.95–$1,956.00 50% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 2.6-7.5 Cm $858.40 $1,073.00 $39.05–$1,956.00 62% above 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Repair Surface Wound of Face/Ear/Eyelid/Nose/Lip/Mouth 2.5cm or Less $821.20 $1,026.50 $34.65–$1,956.00 61% above 20%
Thoracentesis with imaging guidance CPT 32555 Aspiration of Fluid From Chest Cavity Using Imaging Guidance $3,669.80 $4,587.25 $97.57–$4,454.22 149% above 20%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection of Trigger Points, 1-2 Muscles $1,605.20 $2,006.50 $34.17–$1,956.00 197% above 20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy Breast Place Locating Device Using Ultrasound, First Growth $5,202.40 $6,503.00 $152.78–$6,676.00 45% above 20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of Skin and Tissue, 20.0 Sq Cm or Less $2,409.00 $3,011.25 $36.30–$4,238.58 124% above 20%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs PennsylvaniaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Transfollowupsion of Blood or Blood Products $2,680.40 $3,350.50 $30.62–$3,889.00 185% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation Treatment for Airway Obstruction or Sputum Production $427.00 $533.75 $101.70–$518.27 91% above 20%
Chemotherapy IV infusion, first hour CPT 96413 Administration of Chemotherapy Into Vein, 1 Hour or Less $1,100.00 $1,375.00 $137.28–$1,335.13 52% above 20%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care, First 30-74 Minutes $2,184.40 $2,730.50 $166.79–$7,483.00 16% above 20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Measurement of Brain Wave Activity (Eeg), Awake and Drowsy $1,375.20 $1,719.00 $24.75–$3,566.00 81% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine Electrocardiogram (Ecg) Using at Least 12 Leads With Tracing $378.20 $472.75 $11.51–$459.04 117% above 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Department Visit for Problem of Mild Severity $320.20 $400.25 $23.10–$1,838.00 5% above 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Department Visit for Problem of Mild to Moderate Severity $562.40 $703.00 $38.50–$1,838.00 17% above 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Department Visit for Problem of Moderate Severity $995.00 $1,243.75 $66.85–$1,838.00 34% above 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Department Visit for Problem of High Severity $1,600.60 $2,000.75 $112.49–$3,778.00 31% above 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Department Visit for Life Threatening or Functioning Severity $1,752.00 $2,190.00 $163.71–$5,657.00 10% above 20%
Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise or Drug-Induced Heart Stress Test With Electrocardiogram (Ecg) $1,796.60 $2,245.75 $51.15–$3,858.00 90% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infollowupsion Into a Vein for Hydration, 31-60 Minutes $1,035.40 $1,294.25 $34.79–$1,256.72 138% above 20%
IV infusion of a medicine, first hour CPT 96365 Infusion Into a Vein for Therapy, Prevention, or Diagnosis, 1 Hour or Less $1,100.00 $1,375.00 $43.23–$1,335.13 144% above 20%
IV push of a medicine, first drug CPT 96374 Injection of Drug or Substance Into Vein $239.80 $299.75 $34.12–$291.06 27% below 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of Drug or Substance Under Skin or Into Muscle $183.00 $228.75 $13.97–$222.12 48% above 20%
Neuromuscular re-education, 15 minutes CPT 97112 Physical Therapy Nueromuscular Reeducation, Each 15 Minutes $168.00 $210.00 $30.56–$314.00 31% above 20%
Neuromuscular re-education, 15 minutes CPT 97112 Occupational Therapy Nueromuscular Reeducation, Each 15 Minutes $168.00 $210.00 $30.56–$314.00 31% above 20%
New patient office visit, about 30 minutes CPT 99203 New Outpatient Visit Level 3 or Over 30 Minutes $239.20 $299.00 $44.00–$529.04 at median 20%
New patient office visit, about 45 minutes CPT 99204 New Outpatient Visit Level 4 or Over 45 Minutes $266.40 $333.00 $44.00–$678.69 11% below 20%
New patient office visit, about 60 minutes CPT 99205 New Outpatient Visit Level 5 or Over 60 Minutes $316.00 $395.00 $44.00–$829.47 39% below 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Lc New Patient Visit Level 2 $112.80 $141.00 $36.56–$436.14 38% below 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Outpatient Visit Level 2 or Over 15 Minutes $212.00 $265.00 $44.00–$436.14 16% above 20%
Occupational therapy evaluation, low complexity CPT 97165 Evaluation for Occupational Therapy, Typically 30 Minutes $280.00 $350.00 $47.20–$427.09 16% below 20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Evaluation for Physical Therapy, Typically 45 Minutes $322.40 $403.00 $47.20–$416.51 5% below 20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Evaluation for Physical Therapy, Typically 20 Minutes $280.00 $350.00 $47.20–$416.51 5% below 20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Evaluation for Physical Therapy, Typically 30 Minutes $301.80 $377.25 $47.20–$416.51 10% below 20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy Procedure Using Manual Technique, Each 15 Minutes $140.20 $175.25 $25.94–$314.00 7% above 20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical Therapy, Each 15 Minutes $135.20 $169.00 $27.47–$314.00 2% above 20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Occupational Therapy, Each 15 Minutes $135.20 $169.00 $27.47–$314.00 2% above 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Outpatient Visit Level 5 or Over 40 Minutes $316.00 $395.00 $44.00–$655.73 16% above 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Maternity Triage 7+ Hrs $316.00 $395.00 $44.00–$655.73 16% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Maternity Triage 3-5 Hrs $239.20 $299.00 $44.00–$301.27 29% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Lc Est Patient Visit Level 3 $239.20 $299.00 $44.00–$301.27 29% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Outpatient Visit Level 3 or Over 20 Minutes $239.20 $299.00 $44.00–$301.27 29% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Outpatient Visit Level 4 or Over 30 Minutes $266.40 $333.00 $44.00–$443.59 32% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Maternity Triage 5-7 Hrs $266.40 $333.00 $44.00–$443.59 32% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Lc Est Patient Visit Level 2 $212.00 $265.00 $35.78–$257.32 31% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Maternity Triage 1-3 Hrs $212.00 $265.00 $35.78–$257.32 31% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Outpatient Visit Level 2 or Over 10 Minutes $212.00 $265.00 $44.00–$257.32 31% above 20%
Speech and language evaluation CPT 92523 Evaluate Speech/Sound Production W Language Comprehension and Expression $389.80 $487.25 $44.00–$953.27 27% below 20%
Speech therapy session, individual CPT 92507 Treat Speech/Language/Voice/Communication/Hearing Processing Disorder $213.40 $266.75 $23.87–$343.24 30% below 20%
Spirometry before and after a bronchodilator CPT 94060 Test to Measure Expiratory Airflow Before/After Medication Administration $602.60 $753.25 $20.90–$731.41 7% below 20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy Procedure Using Functional Activities $144.80 $181.00 $32.79–$314.00 13% above 20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of Blood for a Medical Problem $110.00 $678.00 $11.00–$658.34 52% below 84%

Vaccines

ProcedureCash priceList priceInsurers payvs PennsylvaniaOff list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of Vaccine $49.40 $61.75 $2.15–$68.74 22% below 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of Vaccine, Each Additional Vaccine $60.00 $75.00 $1.03–$72.83 123% above 20%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://edge.sitecorecloud.io/269a6006063e-wellspanxmcef9f-production4406-c241/media/Project/Wellspan-Site-Tenant/wellspan-site/data/media/files/Patient-Resources/Cost/240795411_evangelical-community-hospital_standardcharges.csv