Fomepizole 1 gram/ml intravenous solution at WellSpan Chambersburg Hospital

112 N. 7th St., Chambersburg, PA · Wellspan · · NPI 1902804552

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 17, 2026

$2,718.00

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

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What you pay up front if you don't use insurance.

$3,397.50

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

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The hospital's undiscounted list price — almost no one pays this.

$7.40 with WellSpan_Capital_Blue_Cross vs $2,792.20 with Performance_Blue — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
WellSpan_Capital_Blue_Cross All_Plans $7.40 ↓ -100%
Blue_Cross Capital_Blue_Performance_PPO $12.58 ↓ -100%
Aetna_Better_Health_Kids All_Plans $392.45 ↓ -86%
Highmark_Wholecare_Gateway_Medicaid All_Plans $462.00 ↓ -83%
Health_Partners_Medicaid Kidz_Partners $627.70 ↓ -77%
United_Medicaid Community_Plan_For_Kids $627.70 ↓ -77%
Jefferson_Health_Medicare_Advantage All_Plans $627.70 ↓ -77%
Blue_Cross_BlueJourney_Medicare All_Plans $627.70 ↓ -77%
Health_Partners_Medicaid All_Other_Plans $627.70 ↓ -77%
Highmark_Medicare All_Plans $633.98 ↓ -77%
Highmark_Wholecare_Gateway_Medicare All_Plans $633.98 ↓ -77%
Aetna_Advantra_Medicare All_Plans $646.53 ↓ -76%
Aetna_Medicare All_Plans $646.53 ↓ -76%
Devoted_Medicare All_Plans $659.09 ↓ -76%
United_Medicare ISNP_DSNP_Plans $659.09 ↓ -76%
Amerihealth_Medicare All_Plans $662.22 ↓ -76%
Geisinger_Gold_Medicare All_Plans $671.64 ↓ -75%
PA_Health_&_Wellness_Medicare All_Plans $677.92 ↓ -75%
UPMC_Medicare UPMC_for_Life_Complete_Care $816.01 ↓ -70%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $816.01 ↓ -70%
Blue_Cross Capital_Cares_4_kids $880.60 ↓ -68%
Highmark Higmark_Healthy_Kids $947.89 ↓ -65%
Blue_Cross All_Other_Plans $1,258.00 ↓ -54%
UPMC UPMC_For_Kids $1,308.15 ↓ -52%
Aetna All_Plans $1,578.50 ↓ -42%
Geisinger All_Plans $1,613.39 ↓ -41%
Aetna PPO_Plan $1,789.99 ↓ -34%
United_Healthcare All_Plans $1,929.60 ↓ -29%
First_Health_Network All_Plans $2,071.24 ↓ -24%
Cigna All_Plans $2,530.46 ↓ -7%
Cigna PPO_Plan $2,657.18 ↓ -2%
Highmark All_Other_Plans $2,792.20 ↑ +3%
Highmark Blue_Cross_High_Performance_Network $2,792.20 ↑ +3%
Highmark Choice_Blue_PPO $2,792.20 ↑ +3%
Highmark My_Direct_Blue $2,792.20 ↑ +3%
Highmark Shared_Cost_Blue_PPO $2,792.20 ↑ +3%
Performance_Blue Blue_Cross_High_Performance_Network $2,792.20 ↑ +3%

Visitor-reported prices

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Fomepizole 1 gram/ml intravenous solution at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $1,671.60 $6.40 – $23.46
UPMC Carlisle Carlisle $600.00 $3.45 – $558.45
UPMC Cole Coudersport $2,265.60 $14.40 – $3,020.80
UPMC Community Osteopathic Harrisburg $600.00 $6.22 – $558.45
UPMC East Monroeville $6,012.60 $6.16 – $80.00
UPMC Hamot Erie $3,905.40 $6.28 – $15.30
UPMC Hanover Hanover $600.00 $6.22 – $10.05
UPMC Horizon-Greenville Greenville $6,093.60 $5.62 – $11.78

All Pennsylvania hospitals for this procedure →