Diagnostic & Therapeutic Charges

CPT Code Service/Procedure WellSpan Good Samaritan Hospital
Cardiac Diagnostics
93017 Treadmill stress test $866
93351 Treadmill stress echocardiogram w/ monitoring $1,943
93306 Echocardiogram w/ Doppler $1,973
Cardiac Rehabilitation
93798 Therapy -- initial visit $246
Physical Therapy
97161 Physical therapy evaluation (low complex) $440
97162 Physical therapy evaluation (moderate complex) $440
97163 Physical therapy evaluation (high complex) $440
97140 Manual therapy (15 min.) $205
Diagnostic Imaging Studies
74150 CT scan of the abdomen (unenhanced) $879
72141 MRI scan of the cervical spine (unenhanced) $1,526
77067 Digital screening mammogram with computer aided detection $551
71045 X-ray - Chest 1 View $424
71046 X-ray - Chest 2 View $424
Laboratory Studies
80061 Lipid panel $96
81003 Routine urinalysis $17

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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.

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