Does DIVINE PROVIDENCE HOSPITAL publish its standard charges and chargemaster?

Yes. DIVINE PROVIDENCE HOSPITAL publishes a machine-readable file with 66,226 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 DIVINE PROVIDENCE HOSPITAL charge for procedures?

DIVINE PROVIDENCE HOSPITAL (Williamsport, 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 394048

DIVINE PROVIDENCE HOSPITAL

Williamsport, PA, 17701-

31 beds12

Compliance grade

100/100

Rates published

66,226

last crawl 2026-05-24

Procedures tracked

164

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/240795508_upmc-williamsport_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	7	—	—	$10,917	$11,676	0.91×	$23,838
Psychiatric diagnostic evaluation	CPT	90791	15	$176	$105.6	$33.6	$120.56	0.68×	$231.25
Psychotherapy 45 minutes	CPT	90834	15	$176	$105.6	$42.9	$117.92	0.73×	$165.43
emergency
ED visit level 1	CPT	99281	15	$421	$252.6	$51.6	$227.13	1.6×	$378.9
ED visit level 2	CPT	99282	15	$678	$406.8	$36.28	$323.41	1.4×	$610.2
ED visit level 3	CPT	99283	15	$1,240	$744	$62.31	$591.48	1.5×	$1,116
ED visit level 4	CPT	99284	15	$2,073	$1,243.8	$104.86	$988.82	1.5×	$1,865.7
ED visit level 5	CPT	99285	15	$2,146	$1,287.6	$152.61	$1,023.64	0.98×	$1,931.4
Critical care, first hour	CPT	99291	15	$2,994	$1,796.4	$166.79	$1,428.14	1.3×	$2,694.6
imaging
CT head without contrast	CPT	70450	15	$2,671	$1,602.6	$99.2	$1,274.07	6.2×	$2,403.9
CT head with contrast	CPT	70460	15	$3,952	$2,371.2	$102.4	$1,885.1	8.1×	$3,556.8
CT head with and without contrast	CPT	70470	15	$4,507	$2,704.2	$128	$2,149.84	8.1×	$4,056.3
CT neck with contrast	CPT	70491	15	$4,185	$2,511	$105.6	$1,996.24	7.3×	$3,766.5
MRI brain without contrast	CPT	70551	15	$3,997	$2,398.2	$232.71	$1,906.57	4.7×	$3,597.3
MRI brain with contrast	CPT	70552	15	$4,851	$2,910.6	$343.82	$2,313.93	4.8×	$4,365.9
MRI brain with and without contrast	CPT	70553	15	$6,340	$3,804	$343.82	$3,024.18	5.1×	$5,706
Chest X-ray single view	CPT	71045	15	$292	$175.2	$10.38	$139.28	1.5×	$262.8
Chest X-ray 2 views	CPT	71046	15	$967	$580.2	$19.01	$461.26	4.7×	$870.3
Chest X-ray 3 views	CPT	71047	15	$832	$499.2	$24.19	$396.86	4.1×	$748.8
CT chest without contrast	CPT	71250	15	$3,741	$2,244.6	$102.37	$1,784.46	8.3×	$3,366.9
CT chest with contrast	CPT	71260	15	$4,440	$2,664	$112	$2,117.88	7.5×	$3,996
CT chest with and without contrast	CPT	71270	15	$5,254	$3,152.4	$132.48	$2,506.16	8.6×	$4,728.6
MRI chest without contrast	CPT	71550	15	$4,190	$2,514	$232.71	$1,998.63	4.6×	$3,771
MRI chest with contrast	CPT	71551	15	$5,085	$3,051	$399.62	$2,486.57	3.1×	$4,576.5
MRI chest with and without contrast	CPT	71552	15	$6,643	$3,985.8	$343.82	$3,168.71	5.3×	$5,978.7
Lumbosacral spine X-ray	CPT	72100	15	$695	$417	$28.8	$331.51	3.2×	$625.5
CT cervical spine without contrast	CPT	72125	15	$3,514	$2,108.4	$102.37	$1,676.18	8.3×	$3,162.6
CT thoracic spine without contrast	CPT	72128	15	$3,457	$2,074.2	$102.37	$1,648.99	8.3×	$3,111.3
CT lumbar spine without contrast	CPT	72131	15	$3,419	$2,051.4	$102.37	$1,630.86	8.0×	$3,077.1
MRI cervical spine without contrast	CPT	72141	15	$4,040	$2,424	$232.71	$1,927.08	4.9×	$3,636
MRI thoracic spine without contrast	CPT	72146	15	$4,190	$2,514	$232.71	$1,998.63	5.4×	$3,771
MRI lumbar spine without contrast	CPT	72148	15	$4,190	$2,514	$232.71	$1,998.63	5.3×	$3,771
MRI lumbar spine with and without contrast	CPT	72149	15	$5,085	$3,051	$343.82	$2,486.57	5.5×	$4,576.5
MRI cervical spine with and without contrast	CPT	72156	15	$6,446	$3,867.6	$343.82	$3,074.74	5.7×	$5,801.4
MRI lumbar spine with contrast	CPT	72158	15	$6,684	$4,010.4	$343.82	$3,188.27	5.8×	$6,015.6
CT pelvis without contrast	CPT	72192	15	$2,189	$1,313.4	$86.4	$1,044.15	5.2×	$1,970.1
CT pelvis with contrast	CPT	72193	15	$3,170	$1,902	$110.72	$1,512.09	5.4×	$2,853
Shoulder X-ray	CPT	73030	15	$512	$307.2	$21.12	$276.23	3.0×	$460.8
Humerus X-ray	CPT	73060	15	$945	$567	$14.72	$509.83	5.7×	$850.5
Hand X-ray 3 views	CPT	73130	15	$491	$294.6	$14.72	$264.9	2.8×	$441.9
MRI upper extremity joint without contrast	CPT	73221	15	$4,190	$2,514	$232.71	$2,260.51	5.4×	$3,771
MRI upper extremity joint with and without contrast	CPT	73223	15	$6,684	$4,010.4	$343.82	$3,606.02	5.9×	$6,015.6
Knee X-ray 1-2 views	CPT	73560	15	$1,014	$608.4	$21.12	$547.06	5.9×	$912.6
Ankle X-ray 3 views	CPT	73610	15	$512	$307.2	$23.97	$276.23	3.0×	$460.8
MRI lower extremity joint without contrast	CPT	73721	15	$4,190	$2,514	$232.71	$2,260.51	4.8×	$3,771
MRI lower extremity joint with and without contrast	CPT	73723	15	$6,684	$4,010.4	$343.82	$3,606.02	5.7×	$6,015.6
CT abdomen without contrast	CPT	74150	15	$3,625	$2,175	$99.2	$1,729.12	9.2×	$3,262.5
CT abdomen with contrast	CPT	74160	15	$4,621	$2,772.6	$115.2	$2,204.22	7.7×	$4,158.9
CT abdomen with and without contrast	CPT	74170	15	$5,794	$3,476.4	$142.72	$2,763.74	8.3×	$5,214.6
CT abdomen and pelvis without contrast	CPT	74176	15	$5,534	$3,320.4	$129.37	$2,639.72	7.2×	$4,980.6
CT abdomen and pelvis with contrast	CPT	74177	15	$7,422	$4,453.2	$246.69	$3,540.29	6.5×	$6,679.8
CT abdomen and pelvis with and without contrast	CPT	74178	15	$9,539	$5,723.4	$326.02	$4,550.1	7.9×	$8,585.1
MRI abdomen without contrast	CPT	74181	15	$4,190	$2,514	$232.71	$1,998.63	5.1×	$3,771
MRI abdomen with and without contrast	CPT	74183	15	$6,684	$4,010.4	$343.82	$3,188.27	5.6×	$6,015.6
Abdominal ultrasound complete	CPT	76700	15	$1,528	$916.8	$73.6	$728.86	4.9×	$1,375.2
Abdominal ultrasound limited	CPT	76705	15	$1,151	$690.6	$48	$549.03	3.8×	$1,035.9
Retroperitoneal ultrasound complete	CPT	76770	15	$1,221	$732.6	$62.72	$582.42	4.1×	$1,098.9
Obstetric ultrasound first trimester	CPT	76801	15	$1,151	$690.6	$49.14	$549.03	3.9×	$1,035.9
Obstetric ultrasound after first trimester	CPT	76805	15	$1,151	$690.6	$59.52	$549.03	3.6×	$1,035.9
Transvaginal ultrasound	CPT	76830	15	$1,131	$678.6	$59.52	$539.49	3.7×	$1,017.9
Pelvic ultrasound complete	CPT	76856	15	$1,220	$732	$59.52	$581.94	4.1×	$1,098
Scrotal ultrasound	CPT	76870	15	$1,077	$646.2	$56.32	$513.73	3.9×	$969.3
Diagnostic mammography unilateral	CPT	77065	14	$528	$316.8	$90.89	$321.03	2.1×	$475.2
Diagnostic mammography bilateral	CPT	77066	14	$805	$483	$116.26	$489.44	2.6×	$724.5
Screening mammography bilateral	CPT	77067	14	$342	$205.2	$92.34	$207.94	1.3×	$307.8
EKG tracing only	CPT	93005	15	$453	$271.8	$11.51	$58.4	0.50×	$407.7
Transthoracic echocardiogram complete	CPT	93306	15	$3,775	$2,265	$125.62	$1,800.67	3.0×	$3,397.5
Stress echocardiogram	CPT	93350	15	$1,360	$816	$59.52	$737.8	1.5×	$1,224
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	9	—	—	$10,396	$16,598	0.82×	$37,832
Intracranial hemorrhage/CVA w CC	MS-DRG	065	9	—	—	$4,613.08	$8,576.43	0.80×	$23,766
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	9	—	—	$4,621.28	$5,964.03	0.78×	$18,566
Respiratory infections & inflammations w MCC	MS-DRG	177	9	—	—	$7,339.78	$13,004	0.84×	$29,155
COPD w MCC	MS-DRG	190	9	—	—	$6,106.17	$9,357.18	0.83×	$19,670
COPD w CC	MS-DRG	191	9	—	—	$6,765.69	$7,481.92	0.85×	$44,427
COPD w/o CC/MCC	MS-DRG	192	9	—	—	$5,259.08	$5,815.82	0.83×	$17,709
Simple pneumonia & pleurisy w CC	MS-DRG	194	9	—	—	$6,487.61	$7,174.41	0.85×	$16,656
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	9	—	—	$5,157.88	$5,703.9	0.85×	$24,716
AMI discharged alive w MCC	MS-DRG	280	9	—	—	$6,126.2	$13,336	0.85×	$29,532
AMI discharged alive w CC	MS-DRG	281	9	—	—	$3,954.85	$7,845.38	0.81×	$20,371
AMI discharged alive w/o CC/MCC	MS-DRG	282	9	—	—	$3,246.55	$6,274.26	0.80×	$18,377
Heart failure & shock w MCC	MS-DRG	291	9	—	—	$4,644.95	$10,769	0.84×	$22,823
Heart failure & shock w CC	MS-DRG	292	9	—	—	$6,810.68	$7,531.67	0.84×	$27,352
Heart failure & shock w/o CC/MCC	MS-DRG	293	9	—	—	$4,689.42	$5,185.85	0.83×	$13,931
Cardiac arrhythmia w MCC	MS-DRG	308	9	—	—	$9,471.59	$10,474	0.87×	$21,179
Cardiac arrhythmia w CC	MS-DRG	309	9	—	—	$5,961.39	$6,592.48	0.85×	$13,338
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	9	—	—	$4,690.17	$5,186.68	0.84×	$10,428
GI hemorrhage w CC	MS-DRG	378	9	—	—	$6,420.26	$8,339.15	0.83×	$20,748
GI hemorrhage w/o CC/MCC	MS-DRG	379	9	—	—	$2,916.98	$5,531.18	0.81×	$14,631
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	9	—	—	$6,290.48	$6,956.4	0.86×	$32,203
Fractures of femur w/o MCC	MS-DRG	533	7	—	—	$12,198	$13,046	0.86×	$41,173
Kidney/UTI w MCC	MS-DRG	689	7	—	—	$9,144.03	$9,779.71	0.84×	$24,574
Kidney/UTI w/o MCC	MS-DRG	690	7	—	—	$6,514.59	$6,967.48	0.84×	$13,815
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	7	—	—	$15,007	$16,050	0.86×	$37,778
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	7	—	—	$8,117.15	$8,681.44	0.84×	$19,293
lab
Basic metabolic panel (BMP)	CPT	80048	15	$311	$186.6	$8.36	$134.42	4.1×	$279.9
Electrolyte panel	CPT	80051	15	$218	$130.8	$6.92	$94.22	4.0×	$196.2
Comprehensive metabolic panel	CPT	80053	15	$359	$215.4	$10.43	$155.16	3.5×	$323.1
Lipid panel	CPT	80061	15	$380	$228	$13.24	$164.24	4.3×	$342
Renal function panel	CPT	80069	15	$260	$156	$8.58	$112.37	4.1×	$234
Hepatic function panel	CPT	80076	15	$387	$232.2	$8.08	$167.26	6.3×	$348.3
Urinalysis non-automated	CPT	81002	15	$85	$51	$3.44	$8.79	1.3×	$76.5
Urinalysis automated	CPT	81003	15	$63	$37.8	$2.22	$27.23	2.0×	$56.7
Glucose quantitative	CPT	82947	15	$87	$52.2	$3.89	$37.6	2.1×	$78.3
Hemoglobin A1c	CPT	83036	15	$276	$165.6	$3.06	$9.9	0.37×	$248.4
Thyroid stimulating hormone (TSH)	CPT	84443	15	$378	$226.8	$16.6	$163.38	3.5×	$340.2
Complete blood count with automated differential	CPT	85025	15	$159	$95.4	$6.6	$68.72	2.6×	$143.1
Complete blood count without differential	CPT	85027	15	$134	$80.4	$6.39	$57.92	2.7×	$120.6
Urine culture bacterial	CPT	87086	15	$364	$218.4	$7.98	$157.32	6.7×	$327.6
Tissue exam by pathologist level IV	CPT	88305	15	$417	$250.2	$11.52	$195.41	1.9×	$375.3
maternity
Fetal non-stress test	CPT	59025	15	$622	$373.2	$6.04	$304.16	1.6×	$559.8
Vaginal delivery only	CPT	59409	15	$15,106	$9,063.6	$1,230	$8,149.69	3.7×	$13,595
Vaginal delivery with postpartum	CPT	59410	15	$1,688	$1,012.8	$455.76	$1,145.31	1.1×	$2,951.01
C-section with postpartum	CPT	59515	15	$1,688	$1,012.8	$455.76	$1,145.31	0.90×	$3,380.56
office
Office visit, new patient, 15-29 min	CPT	99202	15	$418	$250.8	$38.86	$226.77	2.6×	$376.2
Office visit, new patient, 30-44 minutes	CPT	99203	15	$545	$327	$41.85	$124	1.0×	$490.5
Office visit, new patient, 45-59 min	CPT	99204	15	$702	$421.2	$41.85	$133.24	0.77×	$631.8
Office visit, new patient, 60-74 min	CPT	99205	15	$983	$589.8	$41.85	$157.8	0.71×	$884.7
Office visit, established patient, 5 min	CPT	99211	15	$333	$199.8	$22	$120.9	1.9×	$299.7
Office visit, established patient, 10-19 min	CPT	99212	15	$418	$250.8	$28.6	$120.9	1.5×	$376.2
Office visit, established patient, 20-29 minutes	CPT	99213	15	$418	$250.8	$38.5	$120.9	1.1×	$376.2
Office visit, established patient, 30-39 minutes	CPT	99214	15	$545	$327	$41.85	$124	0.81×	$490.5
Office visit, established patient, 40-54 min	CPT	99215	15	$702	$421.2	$41.85	$128.51	0.68×	$631.8
preventive
Upper GI endoscopy diagnostic	CPT	43235	15	$5,877	$3,526.2	$137.74	$2,803.33	3.1×	$5,289.3
Upper GI endoscopy with biopsy	CPT	43239	15	$5,877	$3,526.2	$163.44	$2,803.33	2.9×	$5,289.3
Sigmoidoscopy diagnostic	CPT	45330	15	$997	$598.2	$58.47	$658.02	0.78×	$938.75
Sigmoidoscopy with biopsy	CPT	45331	15	$5,261	$3,156.6	$70.04	$2,509.5	2.8×	$4,734.9
Colonoscopy diagnostic	CPT	45378	15	$2,500	$1,500	$198.55	$1,192.5	1.4×	$2,250
Colonoscopy with biopsy	CPT	45380	15	$5,421	$3,252.6	$247.96	$2,585.82	2.1×	$4,878.9
Colonoscopy with polyp removal	CPT	45385	15	$5,421	$3,252.6	$294.89	$2,585.82	2.1×	$4,878.9
surgery
PCI w drug-eluting stent w MCC	MS-DRG	246	2	—	—	$5,033.7	$5,297.09	0.19×	$5,560.48
PCI w drug-eluting stent w/o MCC	MS-DRG	247	2	—	—	$5,036.43	$5,299.96	0.29×	$5,563.49
Total knee replacement	CPT	27447	9	—	—	$993.28	$12,512	3.0×	$13,248
Shoulder arthroscopy with decompression	CPT	29826	4	—	—	$695.68	$2,548.05	7.8×	$2,719.83
Shoulder arthroscopy with rotator cuff repair	CPT	29827	9	—	—	$993.28	$6,946.9	2.1×	$7,355.55
Knee arthroscopy with meniscectomy	CPT	29881	10	—	—	$597.85	$2,184.48	1.1×	$3,340.82
Major small/large bowel procedures w MCC	MS-DRG	329	9	—	—	$3,906.6	$37,323	0.87×	$78,444
Major small/large bowel procedures w CC	MS-DRG	330	9	—	—	$2,642.94	$19,694	0.85×	$47,721
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	9	—	—	$9,052.28	$13,968	0.85×	$35,865
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	9	—	—	$8,765.49	$14,038	0.85×	$34,383
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	9	—	—	$8,460.51	$11,426	0.84×	$28,589
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	9	—	—	$5,797.54	$27,789	0.86×	$86,768
Laparoscopic appendectomy	CPT	44970	9	—	—	$993.28	$5,673.61	3.6×	$6,007.35
Spinal fusion (non-cervical) w MCC	MS-DRG	459	2	—	—	$15,971	$16,807	0.34×	$17,643
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	2	—	—	$9,125.11	$9,602.59	0.29×	$10,080
Major joint replacement w MCC	MS-DRG	469	7	—	—	$23,183	$24,794	0.84×	$57,664
Major joint replacement w/o MCC	MS-DRG	470	7	—	—	$14,905	$15,941	0.84×	$32,919
Laparoscopic cholecystectomy	CPT	47562	9	—	—	$993.28	$5,673.61	3.2×	$6,007.35
Lap cholecystectomy with cholangiography	CPT	47563	9	—	—	$993.28	$5,673.61	3.0×	$6,007.35
Hip & femur procedures except major joint w MCC	MS-DRG	480	9	—	—	$22,276	$24,635	0.88×	$183,620
Hip & femur procedures except major joint w CC	MS-DRG	481	9	—	—	$16,146	$17,856	0.88×	$153,947
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	9	—	—	$12,672	$14,014	0.88×	$36,939
Lap inguinal hernia repair	CPT	49650	9	—	—	$818.32	$5,673.61	5.0×	$6,007.35
Lap salpingo-oophorectomy	CPT	58661	15	$12,649	$7,589.4	$993.28	$6,956.95	3.4×	$11,384
OR procedure for obesity w MCC	MS-DRG	619	7	—	—	$22,090	$23,625	0.87×	$56,807
OR procedure for obesity w CC	MS-DRG	620	7	—	—	$12,442	$13,307	0.82×	$34,410
OR procedure for obesity w/o CC/MCC	MS-DRG	621	7	—	—	$11,753	$12,570	0.83×	$27,781
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	7	—	—	$9,746.68	$10,424	0.85×	$23,524
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	7	—	—	$15,806	$16,905	0.88×	$34,970
PCI single major coronary artery	CPT	92920	14	$6,590	$3,954	$773.91	$4,349.4	0.77×	$5,931
PCI with drug-eluting stent	CPT	92928	14	$13,175	$7,905	$859.73	$8,695.5	0.87×	$11,858
PCI bypass graft	CPT	92937	15	$20,374	$12,224	$858.79	$11,448	1.1×	$18,337
Left heart catheterization	CPT	93452	15	$6,593	$3,955.8	$993.28	$3,626.15	1.2×	$5,933.7
Coronary angiography with cath	CPT	93455	15	$7,939	$4,763.4	$993.28	$4,366.45	1.4×	$7,145.1
Coronary angiography with bypass cath	CPT	93458	15	$8,166	$4,899.6	$993.28	$4,491.3	1.4×	$7,349.4

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 15)

Payer	Codes covered	Median rate
UnitedHealthcare	160	$425.45
upmc health plan	159	$236.34
pa health & wellness	159	$253.21
Aetna	159	$614.88
Blue Cross Blue Shield	159	$493.4
amerihealth caritas	157	$179.33
geisinger	153	$369.83
Multiplan	151	$951.6
upmc work partners	148	$820.78
three rivers provider network	117	$758.64
wirerope works	109	$678.6
america's choice	109	$976.4
Cigna	109	$836.04
First Health	109	$774.62
intergroup	109	$976.4

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