WellSpan Chambersburg Hospital
112 N. 7th St., Chambersburg, PA · Wellspan · · NPI 1902804552
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 17-hydroxypregnenolone CPT 84143 | $95.20 | $119.00 | $22.81 – $101.47 | 26 |
| 2nd order venous cath CPT 36012 | $1,457.60 | $1,822.00 | $143.13 – $1,311.84 | 2 |
| 3-d radiotherapy plan CPT 77295 | $8,770.40 | $10,963.00 | $401.83 – $7,893.36 | 24 |
| 3d recon without postprocess indpndt CPT 76376 | $628.80 | $786.00 | $64.50 – $299.52 | 2 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $20.00 | $25.00 | $3.66 – $28.21 | 3 |
| 5' nucleotidase - sendout CPT 83915 | $46.40 | $58.00 | $11.15 – $49.60 | 26 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $140.00 | $175.00 | $12.23 – $224.82 | 5 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $3,627.00 | $4,533.75 | $47.85 – $4,905.27 | 26 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $49.60 | $62.00 | $12.01 – $53.42 | 26 |
| Abd/low ext cath 1st CPT 36245 | $1,803.20 | $2,254.00 | $168.13 – $1,622.88 | 2 |
| Abd/low ext cath 2nd CPT 36246 | $1,803.20 | $2,254.00 | $317.61 – $1,622.88 | 2 |
| Abd/low ext cath 3rd CPT 36247 | $2,102.40 | $2,628.00 | $370.00 – $1,892.16 | 2 |
| Abd/low ext cath addl CPT 36248 | $1,803.20 | $2,254.00 | $60.73 – $1,622.88 | 2 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $560.00 | $2,645.00 | $139.38 – $1,006.60 | 25 |
| Abdominal CT scan (with contrast) CPT 74160 | $468.50 | $2,362.00 | $112.50 – $1,006.60 | 25 |
| Abdominal CT scan (without contrast) CPT 74150 | $273.50 | $1,610.00 | $96.88 – $602.31 | 25 |
| Abdominal MRI (with and without contrast) CPT 74183 | $706.00 | $4,259.00 | $369.24 – $2,106.92 | 25 |
| Abdominal MRI (with contrast) CPT 74182 | $639.50 | $2,350.00 | $369.24 – $2,106.92 | 25 |
| Abdominal MRI (without contrast) CPT 74181 | $457.00 | $2,225.00 | $249.91 – $1,342.45 | 25 |
| Abdominal paracentesis w/image guidance CPT 49083 | $2,604.80 | $3,256.00 | $105.41 – $4,311.92 | 23 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,272.00 | $1,590.00 | $71.88 – $602.31 | 25 |
| Abdominal Ultrasound (limited) CPT 76705 | $946.40 | $1,183.00 | $46.88 – $602.31 | 25 |
| Abdominoplasty 15830 CPT 15830 | not published | not published | $970.00 – $29,992.84 | 17 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $940.80 | $1,176.00 | $68.16 – $4,311.92 | 23 |
| Ablate bone tumor(s) perq CPT 20982 | $27,863.20 | $34,829.00 | $456.50 – $59,175.78 | 19 |
| Ablate heart dysrhythm focus CPT 93650 | $17,766.40 | $22,208.00 | $681.41 – $34,898.43 | 19 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $4,380.80 | $5,476.00 | $117.35 – $13,939.00 | 19 |
| Ablation cryo abd perit om CPT 49999 | $2,803.20 | $3,504.00 | $703.17 – $4,311.92 | 18 |
| Ablation cryo retro lymph node CPT 38999 | not published | not published | $452.00 – $2,010.63 | 16 |
| Abscess drain retroperitoneal surg code CPT 49406 | $4,962.40 | $6,203.00 | $217.03 – $7,451.66 | 22 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $22.00 | $27.50 | $0.06 – $19.80 | 6 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $1,676.00 | $2,095.00 | $0.36 – $17.64 | 3 |
| Acetylcholine receptor modulating antibody CPT 86043 | $49.60 | $62.00 | $9.64 – $53.60 | 25 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $531.60 | $664.50 | $0.42 – $478.44 | 6 |
| Actinotherapy uv light CPT 96900 | $184.00 | $230.00 | $19.63 – $180.51 | 19 |
| Acute hepatitis panel CPT 80074 | $237.60 | $297.00 | $47.63 – $213.84 | 26 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $9.60 | $12.00 | $0.04 – $14.00 | 6 |
| #acylcarnitineprfl CPT 82017 | $84.00 | $105.00 | $8.44 – $75.60 | 22 |
| Adapter b 8 channel 10cm HCPCS C1883 | $36.96 | $46.20 | $33.26 – $33.26 | 1 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $382.60 | $478.25 | $0.60 – $10.44 | 6 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $754.60 | $943.25 | $0.42 – $161.00 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $283.20 | $354.00 | $35.35 – $327.31 | 23 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $218.40 | $273.00 | $73.58 – $327.31 | 23 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $795.20 | $994.00 | $156.00 – $1,525.46 | 23 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $246.40 | $308.00 | $115.25 – $1,525.46 | 23 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $187.20 | $234.00 | $62.78 – $327.31 | 23 |
| Administration immunization 1 vaccine CPT 90471 | $205.60 | $257.00 | $12.50 – $327.31 | 19 |
| Administration immunization each additional vaccine CPT 90472 | $80.00 | $100.00 | $72.00 – $72.00 | 1 |
| Administration vaccine hepatitis b HCPCS G0010 | $23.20 | $29.00 | $20.88 – $212.18 | 18 |
| Administration vaccine influenza virus HCPCS G0008 | $205.60 | $257.00 | $12.50 – $212.18 | 23 |
| Administration vaccine pneumococcal HCPCS G0009 | $205.60 | $257.00 | $12.50 – $212.18 | 23 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $283.20 | $354.00 | $15.88 – $254.88 | 22 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $480.00 | $600.00 | $115.36 – $513.16 | 26 |
| Albumin body fluid quantitative each specimen CPT 82042 | $39.20 | $49.00 | $2.57 – $35.28 | 22 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $145.20 | $181.50 | $40.31 – $339.71 | 10 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $157.40 | $196.75 | $40.31 – $236.12 | 26 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $36.00 | $45.00 | $5.78 – $25.71 | 26 |
| Albumin serum plasma or whole blood CPT 82040 | $20.80 | $26.00 | $3.65 – $22.02 | 26 |
| Alkaline phosphatase CPT 84075 | $25.60 | $32.00 | $5.18 – $23.04 | 26 |
| Allergen alpha lactalbumin ige CPT 86008 | $89.60 | $112.00 | $17.71 – $80.64 | 26 |
| Allergen egg white ige CPT 86003 | $32.00 | $40.00 | $5.22 – $23.22 | 26 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $4,259.62 | $5,324.53 | $1,303.53 – $1,303.53 | 1 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $17,961.08 | $22,451.35 | $31.86 – $14,921.28 | 4 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $2,080.00 | $2,600.00 | $5.92 – $2,427.44 | 26 |
| Alpha-fetoprotein tumor marker CPT 82105 | $69.60 | $87.00 | $16.77 – $74.60 | 26 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $10,011.40 | $12,514.25 | $102.47 – $840.24 | 26 |
| Alt/sgpt CPT 84460 | $26.40 | $33.00 | $5.30 – $23.76 | 26 |
| Aluminum - quest CPT 82108 | $127.20 | $159.00 | $25.48 – $114.48 | 26 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $15.60 | $19.50 | $0.69 – $14.04 | 6 |
| Amino acid screen, urine CPT 82128 | $68.80 | $86.00 | $8.00 – $61.92 | 26 |
| Aminolevulinic acid delta CPT 82135 | $68.00 | $85.00 | $12.00 – $73.17 | 26 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $36.20 | $45.25 | $11.22 – $77.35 | 6 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $85.20 | $106.50 | $2.83 – $68.40 | 6 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $27.80 | $34.75 | $0.46 – $48.96 | 6 |
| Ammonia CPT 82140 | $60.80 | $76.00 | $5.00 – $64.81 | 26 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $970.00 – $14,922.27 | 17 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $838.80 | $1,048.50 | $23.31 – $477.84 | 26 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $11.60 | $14.50 | $0.51 – $4.50 | 6 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $11.00 | $13.75 | $1.51 – $9.72 | 6 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $970.00 – $14,922.27 | 17 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $970.00 – $14,922.27 | 17 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $970.00 – $14,922.27 | 17 |
| Amylase CPT 82150 | $26.40 | $33.00 | $5.00 – $28.82 | 26 |
| Analysis gene f2 20210g>a variant CPT 81240 | $272.80 | $341.00 | $53.70 – $292.21 | 23 |
| Analysis gene f5 leiden variant CPT 81241 | $305.60 | $382.00 | $66.70 – $326.37 | 23 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $75.20 | $94.00 | $38.55 – $171.48 | 23 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $162.40 | $203.00 | $28.07 – $156.09 | 26 |
| Anca screen with reflex to titer -quest CPT 86021 | $75.20 | $94.00 | $5.00 – $67.68 | 26 |
| An cholangiogram percutaneous compl CPT 47531 | $2,242.40 | $2,803.00 | $97.40 – $16,230.51 | 22 |
| An fluoro guide for cvp CPT 77001 | $824.80 | $1,031.00 | $57.83 – $742.32 | 3 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $15,871.20 | $19,839.00 | $127.98 – $14,284.08 | 2 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | $14,673.60 | $18,342.00 | $481.89 – $26,221.84 | 23 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | $14,186.40 | $17,733.00 | $437.68 – $26,221.84 | 23 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | $6,600.80 | $8,251.00 | $5,940.72 – $13,939.00 | 2 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $398.20 | $497.75 | $1.26 – $1.26 | 1 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | $15,250.40 | $19,063.00 | $589.13 – $52,156.41 | 23 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $10,860.00 | $13,575.00 | $364.70 – $26,221.84 | 23 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $12,846.40 | $16,058.00 | $313.61 – $26,221.84 | 22 |
| Ankle X-ray CPT 73610 | $483.20 | $604.00 | $20.13 – $497.84 | 25 |
| Anodyne therapy charges pt CPT 97026 | $164.80 | $206.00 | $6.44 – $148.32 | 7 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.