Wellspan Evangelical Community Hospital
One Hospital Drive, Lewisburg, PA 17837 · 86 Priced Procedures · 76% Patient Recommendation
Typical commercial prices here are +6% above the fair benchmark (1.06×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.06× fair market pricing.
Aligned Regional Benchmark Peer
Wellspan Evangelical Community Hospital prices shoppable and inpatient services (1.3× to 1.6× Medicare, divergence 1.23×) in alignment with regional hospital peers (1.06× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 22% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 76% patient recommendation (67/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (12.9% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 3.4× markup over Medicare rates
- Captive ER (3.0×) & laboratory (2.8×) services average 1.23× higher multiples than routine shoppable care (1.3×)
- Upper-quartile procedures (Q75 1.38×) jump +48% above the median procedure ratio (Q50 0.93×)
- Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Wellspan Evangelical Community Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 86 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $28,025 | 1.4× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $26,319 | 1.4× |
| Total knee replacement CPT Code: 27447 | $18,567 | 1.4× |
| Total hip replacement CPT Code: 27130 | $15,782 | 1.2× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $8,419 | 1.4× |
| Inguinal hernia repair CPT Code: 49505 | $5,093 | 1.4× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,682 | 1.4× |
| Breast lump removal CPT Code: 19120 | $3,691 | 1.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,701 | 1.4× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,353 | 1.4× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,316 | 1.3× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $979 | 1.0× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $760 | 1.3× |
| Blood transfusion CPT Code: 36430 | $421 | 0.8× |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $407 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $345 | 0.8× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $345 | 0.7× |
| Screening mammogram (both breasts) CPT Code: 77067 | $337 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $233 | 0.9× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $233 | 0.8× |
| MRI, lower back (no contrast) CPT Code: 72148 | $233 | 0.7× |
| MRI, brain (no contrast) CPT Code: 70551 | $233 | 0.7× |
| MRI, knee or other leg joint CPT Code: 73721 | $233 | 0.6× |
| Breathing treatment (nebulizer) CPT Code: 94640 | $196 | 1.0× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $172 | 0.7× |
Audit a Bill or Quote at Wellspan Evangelical Community Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $8,650
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (12.9% of gross = $8,650).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Wellspan Evangelical Community Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)
Your bill ($67,260) is $47,828 above the denoised Fair BaseRate ($19,432) and 4.8× the $14,044 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (12.9% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (479 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Wellspan Evangelical Community Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.