Does UPMC Wellsboro publish its standard charges and chargemaster?

Yes. UPMC Wellsboro publishes a machine-readable file with 64,123 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does UPMC Wellsboro charge for procedures?

UPMC Wellsboro (Wellsboro, PA) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · PA · CCN 391316

UPMC Wellsboro

Wellsboro, PA, 16901

25 bedsCritical Access Hospitals2

Compliance grade

100/100

Rates published

64,123

last crawl 2026-05-24

Procedures tracked

163

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All PA hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/232176963_upmc-wellsboro_standardcharges.csv? · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	3	—	—	$10,200	$16,538	1.3×	$23,838
Psychiatric diagnostic evaluation	CPT	90791	12	$251	$182.4	$33.6	$177.84	1.0×	$238.45
Psychotherapy 30 minutes	CPT	90832	14	$176	$128	$28.6	$117.38	0.79×	$167.2
Psychotherapy 45 minutes	CPT	90834	14	$176	$128	$28.8	$117.38	0.73×	$167.2
Psychotherapy 60 minutes	CPT	90837	14	$176	$128	$28.8	$117.92	0.62×	$167.2
emergency
ED visit level 1	CPT	99281	13	$588	$352.8	$14.4	$234.08	1.7×	$558.6
ED visit level 2	CPT	99282	14	$678	$492	$29.52	$295.61	1.2×	$644.1
ED visit level 3	CPT	99283	14	$1,240	$900	$36.72	$490.5	1.2×	$1,178
ED visit level 4	CPT	99284	14	$2,073	$1,504	$55	$677.11	1.0×	$1,969.35
ED visit level 5	CPT	99285	14	$2,146	$1,557.6	$55	$420.55	0.40×	$2,038.7
Critical care, first hour	CPT	99291	14	$2,994	$2,172	$74.34	$560.09	0.52×	$2,844.3
imaging
CT head without contrast	CPT	70450	14	$2,671	$1,938.4	$99.2	$1,777.51	8.6×	$2,537.45
CT head with contrast	CPT	70460	14	$3,952	$2,868	$102.4	$2,629.96	11.2×	$3,754.4
CT head with and without contrast	CPT	70470	14	$4,507	$3,270.4	$128	$2,998.96	11.2×	$4,281.65
CT neck with contrast	CPT	70491	14	$4,185	$3,036.8	$105.6	$2,784.75	10.2×	$3,975.75
MRI brain without contrast	CPT	70551	14	$3,997	$2,900.8	$344.32	$2,660.03	6.6×	$3,797.15
MRI brain with contrast	CPT	70552	14	$4,851	$3,520	$344.32	$3,227.84	6.8×	$4,608.45
MRI brain with and without contrast	CPT	70553	14	$6,340	$4,600	$344.32	$4,218.2	7.2×	$6,023
Chest X-ray single view	CPT	71045	14	$292	$212	$10.38	$194.4	2.1×	$277.4
Chest X-ray 2 views	CPT	71046	14	$967	$701.6	$19.01	$643.37	6.5×	$918.65
Chest X-ray 3 views	CPT	71047	14	$832	$603.2	$24.19	$553.13	5.8×	$790.4
CT chest without contrast	CPT	71250	14	$3,741	$2,714.4	$106.37	$2,489.1	11.6×	$3,553.95
CT chest with contrast	CPT	71260	14	$4,440	$3,222.4	$112	$2,954.94	10.5×	$4,218
CT chest with and without contrast	CPT	71270	14	$5,254	$3,812.8	$132.48	$3,496.34	12.0×	$4,991.3
MRI chest without contrast	CPT	71550	14	$4,190	$3,040	$344.32	$2,787.68	6.5×	$3,980.5
MRI chest with contrast	CPT	71551	14	$5,085	$3,689.6	$399.62	$3,383.36	4.2×	$4,830.75
MRI chest with and without contrast	CPT	71552	14	$6,643	$4,820.8	$605.3	$4,420.67	7.4×	$6,310.85
Lumbosacral spine X-ray	CPT	72100	14	$695	$504	$28.8	$462.17	4.5×	$660.25
CT cervical spine without contrast	CPT	72125	14	$3,514	$2,550.4	$106.37	$2,338.72	11.6×	$3,338.3
CT thoracic spine without contrast	CPT	72128	14	$3,457	$2,508	$115.97	$2,299.84	11.5×	$3,284.15
CT lumbar spine without contrast	CPT	72131	14	$3,419	$2,480.8	$112.77	$2,274.89	11.2×	$3,248.05
MRI cervical spine without contrast	CPT	72141	14	$4,040	$2,932	$344.32	$2,688.64	6.8×	$3,838
MRI thoracic spine without contrast	CPT	72146	14	$4,190	$3,040	$239.62	$2,787.68	7.5×	$3,980.5
MRI lumbar spine without contrast	CPT	72148	14	$4,190	$3,040	$239.62	$2,787.68	7.4×	$3,980.5
MRI lumbar spine with and without contrast	CPT	72149	14	$5,085	$3,689.6	$344.32	$3,383.36	7.5×	$4,830.75
MRI cervical spine with and without contrast	CPT	72156	14	$6,446	$4,677.6	$344.32	$4,289.36	7.9×	$6,123.7
MRI lumbar spine with contrast	CPT	72158	14	$6,684	$4,850.4	$344.32	$4,447.82	8.1×	$6,349.8
CT pelvis without contrast	CPT	72192	14	$2,189	$1,588.8	$86.4	$1,456.93	7.3×	$2,079.55
CT pelvis with contrast	CPT	72193	14	$3,170	$2,300	$110.72	$2,109.1	7.5×	$3,011.5
Shoulder X-ray	CPT	73030	12	$512	$372	$21.12	$352.87	3.8×	$486.4
Humerus X-ray	CPT	73060	12	$945	$685.6	$14.72	$650.81	7.3×	$897.75
Hand X-ray 3 views	CPT	73130	12	$491	$356.8	$14.72	$338.43	3.6×	$466.45
MRI upper extremity joint without contrast	CPT	73221	12	$4,190	$3,040	$344.32	$2,885.65	6.9×	$3,980.5
MRI upper extremity joint with and without contrast	CPT	73223	12	$6,684	$4,850.4	$604.71	$4,603.71	7.5×	$6,349.8
Knee X-ray 1-2 views	CPT	73560	12	$1,014	$736	$21.12	$698.49	7.5×	$963.3
Ankle X-ray 3 views	CPT	73610	12	$512	$372	$23.97	$352.87	3.8×	$486.4
MRI lower extremity joint without contrast	CPT	73721	12	$4,190	$3,040	$344.32	$2,885.65	6.2×	$3,980.5
MRI lower extremity joint with and without contrast	CPT	73723	12	$6,684	$4,850.4	$604.71	$4,603.71	7.3×	$6,349.8
CT abdomen without contrast	CPT	74150	14	$3,625	$2,630.4	$99.2	$2,412.08	12.8×	$3,443.75
CT abdomen with contrast	CPT	74160	14	$4,621	$3,352.8	$115.2	$3,074.52	10.7×	$4,389.95
CT abdomen with and without contrast	CPT	74170	14	$5,794	$4,204	$142.72	$3,855.07	11.5×	$5,504.3
CT abdomen and pelvis without contrast	CPT	74176	14	$5,534	$4,015.2	$129.37	$3,681.94	10.1×	$5,257.3
CT abdomen and pelvis with contrast	CPT	74177	14	$7,422	$5,385.6	$246.69	$4,938.6	9.0×	$7,050.9
CT abdomen and pelvis with and without contrast	CPT	74178	14	$9,539	$6,921.6	$326.02	$6,347.11	11.0×	$9,062.05
MRI abdomen without contrast	CPT	74181	14	$4,190	$3,040	$344.32	$2,787.68	7.1×	$3,980.5
MRI abdomen with and without contrast	CPT	74183	14	$6,684	$4,850.4	$604.49	$4,447.82	7.8×	$6,349.8
Abdominal ultrasound complete	CPT	76700	14	$1,528	$1,108.8	$73.6	$1,016.77	6.8×	$1,451.6
Abdominal ultrasound limited	CPT	76705	14	$1,151	$835.2	$48	$765.88	5.2×	$1,093.45
Retroperitoneal ultrasound complete	CPT	76770	14	$1,221	$886.4	$62.72	$812.83	5.7×	$1,159.95
Obstetric ultrasound first trimester	CPT	76801	14	$1,151	$835.2	$49.14	$765.88	5.4×	$1,093.45
Obstetric ultrasound after first trimester	CPT	76805	14	$1,151	$835.2	$59.52	$765.88	5.0×	$1,093.45
Transvaginal ultrasound	CPT	76830	14	$1,131	$820.8	$59.52	$752.67	5.1×	$1,074.45
Pelvic ultrasound complete	CPT	76856	14	$1,220	$885.6	$59.52	$812.1	5.7×	$1,159
Scrotal ultrasound	CPT	76870	14	$1,077	$781.6	$56.32	$716.73	5.5×	$1,023.15
Diagnostic mammography unilateral	CPT	77065	13	$528	$383.2	$86.22	$351.39	2.4×	$501.6
Diagnostic mammography bilateral	CPT	77066	13	$805	$584	$116.26	$535.53	2.8×	$764.75
Screening mammography bilateral	CPT	77067	13	$377	$273.6	$61.56	$251.74	1.6×	$358.15
EKG tracing only	CPT	93005	14	$453	$271.8	$9.81	$51.77	0.44×	$430.35
EKG interpretation only	CPT	93010	12	$71	$42.6	$9.6	$52.09	2.9×	$67.45
Transthoracic echocardiogram complete	CPT	93306	14	$3,775	$2,739.2	$125.62	$2,511.85	4.2×	$3,586.25
Transthoracic echocardiogram	CPT	93307	14	$1,414	$1,026.4	$121.6	$947.38	3.8×	$1,343.3
Stress echocardiogram	CPT	93350	14	$1,455	$1,056	$59.52	$961.74	1.9×	$1,382.25
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	3	—	—	$26,667	$30,858	1.5×	$34,320
Intracranial hemorrhage/CVA w CC	MS-DRG	065	3	—	—	$15,244	$16,997	1.6×	$19,709
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	3	—	—	$10,327	$12,383	1.6×	$15,396
Respiratory infections & inflammations w MCC	MS-DRG	177	3	—	—	$20,551	$23,879	1.5×	$26,669
COPD w MCC	MS-DRG	190	3	—	—	$13,865	$16,513	1.5×	$18,904
COPD w CC	MS-DRG	191	3	—	—	$12,251	$13,553	1.5×	$14,413
COPD w/o CC/MCC	MS-DRG	192	3	—	—	$9,687.04	$10,369	1.5×	$11,508
Simple pneumonia & pleurisy w CC	MS-DRG	194	3	—	—	$11,605	$12,907	1.5×	$13,754
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	3	—	—	$8,718.07	$9,869.95	1.5×	$10,726
AMI discharged alive w MCC	MS-DRG	280	3	—	—	$20,817	$24,347	1.6×	$27,376
AMI discharged alive w CC	MS-DRG	281	3	—	—	$13,868	$15,022	1.6×	$16,893
AMI discharged alive w/o CC/MCC	MS-DRG	282	3	—	—	$10,911	$12,647	1.6×	$15,240
Heart failure & shock w MCC	MS-DRG	291	3	—	—	$16,088	$19,149	1.5×	$21,909
Heart failure & shock w CC	MS-DRG	292	3	—	—	$10,978	$12,863	1.4×	$14,489
Heart failure & shock w/o CC/MCC	MS-DRG	293	3	—	—	$8,540.28	$9,739.56	1.6×	$11,553
Cardiac arrhythmia w MCC	MS-DRG	308	3	—	—	$14,929	$17,865	1.5×	$20,548
Cardiac arrhythmia w CC	MS-DRG	309	3	—	—	$9,401.84	$11,081	1.4×	$12,556
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	3	—	—	$7,350.53	$8,594.74	1.4×	$9,661.11
GI hemorrhage w CC	MS-DRG	378	3	—	—	$14,625	$15,767	1.6×	$17,206
GI hemorrhage w/o CC/MCC	MS-DRG	379	3	—	—	$9,512	$10,536	1.5×	$12,134
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	3	—	—	$9,857.68	$11,680	1.5×	$13,305
Fractures of femur w/o MCC	MS-DRG	533	3	—	—	$23,655	$27,888	1.8×	$34,144
Kidney/UTI w MCC	MS-DRG	689	3	—	—	$17,322	$18,655	1.6×	$20,379
Kidney/UTI w/o MCC	MS-DRG	690	3	—	—	$9,477.81	$11,682	1.4×	$13,815
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	3	—	—	$26,629	$30,319	1.6×	$33,151
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	3	—	—	$13,599	$15,720	1.5×	$17,464
lab
Basic metabolic panel (BMP)	CPT	80048	14	$311	$225.6	$8.36	$206.88	6.4×	$295.45
Electrolyte panel	CPT	80051	14	$218	$158.4	$6.92	$145.25	6.1×	$207.1
Comprehensive metabolic panel	CPT	80053	14	$359	$260.8	$10.43	$239.15	5.4×	$341.05
Lipid panel	CPT	80061	14	$380	$276	$13.24	$253.09	6.6×	$361
Renal function panel	CPT	80069	14	$260	$188.8	$8.58	$173.13	6.3×	$247
Hepatic function panel	CPT	80076	14	$387	$280.8	$8.08	$257.49	9.7×	$367.65
Urinalysis non-automated	CPT	81002	14	$85	$62.2	$2.65	$17.85	2.6×	$80.75
Urinalysis automated	CPT	81003	14	$63	$45.8	$2.22	$42	3.0×	$59.85
Glucose quantitative	CPT	82947	14	$87	$63.2	$3.89	$57.95	3.3×	$82.65
Hemoglobin A1c	CPT	83036	14	$276	$200	$7	$184.92	6.9×	$262.2
Thyroid stimulating hormone (TSH)	CPT	84443	14	$748	$542.4	$16.6	$263.15	5.6×	$710.6
Complete blood count with automated differential	CPT	85025	14	$159	$115.2	$6	$105.64	4.0×	$151.05
Complete blood count without differential	CPT	85027	14	$134	$97.6	$6.39	$89.5	4.1×	$127.3
Urine culture bacterial	CPT	87086	14	$364	$264	$7.98	$242.09	10.4×	$345.8
Urine culture identification	CPT	87088	14	$128	$92.8	$8	$85.1	3.8×	$121.6
Tissue exam by pathologist level IV	CPT	88305	14	$417	$302.4	$11.52	$277.3	2.7×	$396.15
maternity
Fetal non-stress test	CPT	59025	14	$622	$451.2	$6.04	$413.75	2.2×	$590.9
Vaginal delivery only	CPT	59409	12	$1,688	$1,224.8	$275.58	$1,194.18	0.54×	$1,691.16
office
Office visit, new patient, 15-29 min	CPT	99202	14	$418	$250.8	$13.14	$72	0.83×	$397.1
Office visit, new patient, 30-44 minutes	CPT	99203	14	$545	$327	$15.3	$92.45	0.76×	$517.75
Office visit, new patient, 45-59 min	CPT	99204	14	$702	$421.2	$21.96	$163.5	0.94×	$666.9
Office visit, new patient, 60-74 min	CPT	99205	14	$983	$589.8	$23.76	$177.25	0.80×	$933.85
Office visit, established patient, 5 min	CPT	99211	14	$333	$199.8	$4.68	$52.65	0.82×	$316.35
Office visit, established patient, 10-19 min	CPT	99212	14	$418	$250.8	$11.84	$62.05	0.78×	$397.1
Office visit, established patient, 20-29 minutes	CPT	99213	14	$418	$250.8	$13.14	$83.6	0.73×	$397.1
Office visit, established patient, 30-39 minutes	CPT	99214	14	$545	$327	$14.22	$74.7	0.49×	$517.75
Office visit, established patient, 40-54 min	CPT	99215	14	$702	$421.2	$19.08	$99.9	0.53×	$666.9
preventive
Upper GI endoscopy diagnostic	CPT	43235	14	$5,877	$4,264	$137.74	$3,910.09	4.3×	$5,583.15
Upper GI endoscopy with biopsy	CPT	43239	14	$5,877	$4,264	$163.44	$3,910.09	4.1×	$5,583.15
Sigmoidoscopy diagnostic	CPT	45330	14	$1,047	$797.6	$58.47	$701.49	0.83×	$994.65
Sigmoidoscopy with biopsy	CPT	45331	14	$5,261	$3,816.8	$70.04	$3,500.01	3.9×	$4,997.95
Colonoscopy diagnostic	CPT	45378	14	$2,625	$2,000	$198.55	$1,758.75	2.0×	$2,493.75
Colonoscopy with biopsy	CPT	45380	14	$5,421	$3,933.6	$108.9	$1,149.25	0.95×	$5,149.95
Colonoscopy with polyp removal	CPT	45385	14	$5,421	$3,933.6	$294.89	$3,607.11	3.0×	$5,149.95
surgery
Total shoulder arthroplasty	CPT	23472	2	—	—	$993.28	$2,645.32	0.64×	$4,297.36
Total hip replacement	CPT	27130	12	$26,792	$19,441	$821.34	$11,050	2.5×	$25,452
Total knee replacement	CPT	27447	2	—	—	$993.28	$3,362.62	0.81×	$5,731.96
Knee revision arthroplasty single component	CPT	27486	2	—	—	$993.28	$3,021.04	1.8×	$5,048.8
Shoulder arthroscopy with decompression	CPT	29826	2	—	—	$695.68	$1,417.42	4.3×	$2,139.16
Shoulder arthroscopy with rotator cuff repair	CPT	29827	2	—	—	$993.28	$1,473.13	0.45×	$1,952.98
Knee arthroscopy with meniscectomy	CPT	29881	8	—	—	$597.85	$606	0.30×	$1,862.21
ACL reconstruction	CPT	29888	2	—	—	$993.28	$2,058.66	0.62×	$3,124.04
Major small/large bowel procedures w MCC	MS-DRG	329	3	—	—	$54,702	$66,855	1.6×	$78,444
Major small/large bowel procedures w CC	MS-DRG	330	3	—	—	$33,638	$37,872	1.6×	$40,911
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	3	—	—	$25,280	$27,057	1.6×	$29,742
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	3	—	—	$24,236	$27,019	1.6×	$28,869
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	3	—	—	$20,152	$21,959	1.6×	$23,708
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	3	—	—	$51,409	$60,811	1.9×	$74,678
Laparoscopic appendectomy	CPT	44970	2	—	—	$993.28	$1,030.55	0.66×	$1,067.82
Major joint replacement w MCC	MS-DRG	469	3	—	—	$42,185	$47,698	1.6×	$51,765
Major joint replacement w/o MCC	MS-DRG	470	3	—	—	$22,906	$28,027	1.5×	$32,919
Laparoscopic cholecystectomy	CPT	47562	2	—	—	$993.28	$1,203.84	0.68×	$1,414.39
Lap cholecystectomy with cholangiography	CPT	47563	2	—	—	$993.28	$1,257.4	0.67×	$1,521.52
Hip & femur procedures except major joint w MCC	MS-DRG	480	3	—	—	$43,943	$49,058	1.8×	$56,958
Hip & femur procedures except major joint w CC	MS-DRG	481	3	—	—	$31,604	$34,853	1.7×	$39,954
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	3	—	—	$24,597	$26,222	1.6×	$28,937
Lap inguinal hernia repair	CPT	49650	2	—	—	$818.32	$906.44	0.81×	$994.55
Lap salpingo-oophorectomy	CPT	58661	2	—	—	$993.28	$1,179.28	0.58×	$1,365.27
OR procedure for obesity w MCC	MS-DRG	619	3	—	—	$41,558	$46,230	1.7×	$49,277
OR procedure for obesity w CC	MS-DRG	620	3	—	—	$24,147	$25,783	1.6×	$28,535
OR procedure for obesity w/o CC/MCC	MS-DRG	621	3	—	—	$19,582	$22,899	1.5×	$25,742
Complex cataract surgery	CPT	66982	2	—	—	$1,727.55	$1,922.34	0.87×	$2,117.12
Cataract surgery with lens implant	CPT	66984	8	—	—	$662.78	$671.82	0.31×	$2,930.19
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	3	—	—	$16,581	$19,114	1.6×	$21,174
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	3	—	—	$19,354	$26,844	1.4×	$34,970

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 14)

Payer	Codes covered	Median rate
upmc health plan	151	$185.12
Blue Cross Blue Shield	151	$291.07
geisinger	151	$372.9
UnitedHealthcare	120	$395.25
upmc work partners	117	$396.39
pa health & wellness	108	$199.84
wirerope works	106	$433.4
america's choice	106	$701.55
Cigna	106	$163.7
intergroup	106	$701.55
Multiplan	106	$656.45
Aetna	106	$486.73
amerihealth caritas	95	$99.41
health partners plans (jefferson health plan)	94	$149.1

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