Community Health Systems · Wilkes-Barre, PA
35
In-network payers
239
Disclosed rate categories
412
Beds
1
Care quality
Wilkes-Barre General Hospital is a 412-bed proprietary hospital in Wilkes-Barre, PA, affiliated with Community Health Systems. Below you'll find publicly disclosed negotiated rates and facility details, including 35 in-network payers and 239 disclosed rate categories.
CCN (Medicare provider number)
390137
NPI
1255585303
Type
Short Term Acute Care Hospital
Ownership
Proprietary
Beds
412
Care Quality
1
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Wilkes-Barre General Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$6,315 - $11,595
from 3 insurers · median $9,999
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$9,624 - $13,731
from 3 insurers · median $13,332
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Gynecology
CPT 58558
$4,129 - $12,803
from 4 insurers · median $5,955
46 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
CT imaging
CPT 74177
$1,006 - $4,715
from 4 insurers · median $2,356
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$6,364 - $21,556
from 4 insurers · median $11,052
123 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 49650
$4,154 - $24,469
from 4 insurers · median $11,536
123 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
CT imaging
CPT 74176
$652 - $3,919
from 4 insurers · median $2,050
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$6,315 - $11,595
from 3 insurers · median $9,999
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 70450
$299 - $1,381
from 4 insurers · median $838
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 216
$97,261 - $160,786
from 3 insurers · median $156,310
Hospital reports cardiac thoracic surgery services to CMS
Cardiology and vascular testing
CPT 93306
$1,126 - $2,153
from 4 insurers · median $1,457
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 470
$30,437 - $30,820
from 3 insurers · median $30,566
19 Medicare discharges for this DRG in CMS hospital data
Digestive procedures
CPT 45385
$989 - $7,506
from 4 insurers · median $2,800
Common here, based on CMS Medicare volume
Digestive procedures
CPT 47563
$4,544 - $22,187
from 4 insurers · median $11,166
123 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 43239
$936 - $8,250
from 4 insurers · median $2,490
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$971 - $4,589
from 4 insurers · median $2,515
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$478 - $2,912
from 4 insurers · median $1,559
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$209 - $469
from 4 insurers · median $290
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 49505
$5,071 - $19,665
from 4 insurers · median $7,600
43 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
Medicine & Surgery
CPT 55700
$2,300 - $14,248
from 4 insurers · median $8,074
167 Medicare claims in Level 3 Urology and Related Services (CMS 2024)
Urology
CPT 50590
$7,080 - $8,411
from 4 insurers · median $8,203
153 Medicare claims in Level 4 Urology and Related Services (CMS 2024)
X-ray and bone density
CPT 71046
$172 - $291
from 4 insurers · median $233
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$1,245 - $4,599
from 4 insurers · median $3,105
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$8,261 - $29,313
from 4 insurers · median $16,470
16 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 467% | 5 | 2 |
| Insurer B* | 24 | 266% | 8 | 11 |
| Insurer C* | 24 | 241% | 5 | 2 |
| Insurer D* | 19 | 196% | 7 | 11 |
How we chose these services: 9 appear in this hospital's own Medicare claims, 11 are common here based on CMS Medicare volume, and 4 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Wilkes-Barre General Hospital.
575 North River Street, Wilkes-Barre, PA 18764
(570) 829-8111
The nearest hospitals of similar type and size. Their rates are compared with Wilkes-Barre General Hospital for the same insurers and services above.
Geisinger Wyoming Valley Medical Center
▲ Rates typically 59% higher than Wilkes-Barre General Hospital (20 services)
Geisinger Community Medical Center
▲ Rates typically 20% higher than Wilkes-Barre General Hospital (21 services)
Lehigh Valley Hospital – Pocono
▲ Rates typically 32% higher than Wilkes-Barre General Hospital (21 services)
Geisinger Medical Center
▼ Rates typically 13% lower than Wilkes-Barre General Hospital (21 services)
Geisinger St Lukes Hospital
▲ Rates typically 22% higher than Wilkes-Barre General Hospital (21 services)
St Lukes University Hospital - Bethlehem
▼ Rates typically 28% lower than Wilkes-Barre General Hospital (21 services)
Regional Hospital Of Scranton
Moses Taylor Hospital
Tyler Memorial Hospital
Holy Redeemer Hospital
About Wilkes-Barre General Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Wilkes-Barre General Hospital range from $971 to $4,589 across 4 insurers. Cigna's rate is $4,589. The median at nearby comparable hospitals is $1,431. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Wilkes-Barre General Hospital range from $1,006 to $4,715 across 4 insurers. Aetna's rate is $2,791. The median at nearby comparable hospitals is $1,188. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Wilkes-Barre General Hospital range from $989 to $7,506 across 4 insurers. Cigna's rate is $7,506. The median at nearby comparable hospitals is $3,739. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Wilkes-Barre General Hospital range from $6,315 to $11,595 across 3 insurers. UnitedHealthcare's rate is $9,999. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Wilkes-Barre General Hospital range from $209 to $469 across 4 insurers. UnitedHealthcare's rate is $338. The median at nearby comparable hospitals is $274. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Wilkes-Barre General Hospital range from $30,437 to $30,820 across 3 insurers. Blue Cross Blue Shield's rate is $30,437. The median at nearby comparable hospitals is $39,522. What a patient pays depends on their plan's deductible, coinsurance and network status.
Wilkes-Barre General Hospital has 412 beds. Facility type: Short Term Acute Care Hospital.
Wilkes-Barre General Hospital is located at 575 North River Street, Wilkes-Barre, PA 18764. Its main phone number is (570) 829-8111.
Wilkes-Barre General Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 390137.
The National Provider Identifier (NPI) on file for Wilkes-Barre General Hospital is 1255585303.
Wilkes-Barre General Hospital is affiliated with Community Health Systems.
Wilkes-Barre General Hospital lists 35 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
239 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers