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Patient Guide

Patient Guide

Request a Cost Estimate

To receive an estimate for a specific procedure at a WellSpan facility, please complete and submit the form below.

Phone Number:
May we leave a message on you answering machine?
What is the preferred location for your procedure? 

Will this be an inpatient or outpatient procedure?

CPT Code:
(This can be provided by your physician office)
Description of the procedure:
ICD-9 Diagnosis Code:
(This can be provided by your physician office)
Additional information that may be important in determining our estimate:


Are you sure you would like to cancel?

All information will be lost.

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About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.