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 |
|---|---|---|---|---|
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $970.00 – $7,931.01 | 17 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $970.00 – $16,956.65 | 17 |
| Laser surgery of prostate CPT 52648 | not published | not published | $970.00 – $23,380.04 | 17 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $1,500.84 | $1,876.05 | $1,350.76 – $1,350.76 | 1 |
| Lead capillary CPT 83655 | $50.40 | $63.00 | $10.00 – $53.87 | 26 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $582.12 | $727.65 | $401.54 – $401.54 | 1 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,928.91 | $7,411.14 | $2,732.40 – $2,732.40 | 1 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,147.20 | $1,434.00 | $142.75 – $1,111.67 | 23 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $5.20 | $6.50 | $0.04 – $8.75 | 6 |
| Levetiracetam therapeutic drug level CPT 80177 | $55.20 | $69.00 | $13.25 – $58.94 | 26 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $43.00 | $53.75 | $2.03 – $7.72 | 6 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $195.40 | $244.25 | $7.46 – $254.10 | 10 |
| Liberta rc ipg HCPCS C1820 | $28,050.00 | $35,062.50 | $3,088.80 – $3,088.80 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $24.20 | $30.25 | $0.03 – $7.68 | 4 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $32.00 | $40.00 | $0.01 – $70.00 | 26 |
| Lidocaine therapeutic drug level CPT 80176 | $60.80 | $76.00 | $13.00 – $65.35 | 26 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $970.00 – $7,451.66 | 17 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $970.00 – $14,475.66 | 17 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $970.00 – $14,475.66 | 17 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $30.00 | $37.50 | $3.87 – $36.44 | 6 |
| Lipase CPT 83690 | $41.60 | $52.00 | $5.00 – $37.44 | 26 |
| Lipoprotein blood quant CPT 83704 | $142.40 | $178.00 | $25.64 – $152.09 | 21 |
| Lipoprotein direct measurement hdl CPT 83718 | $34.40 | $43.00 | $7.00 – $36.43 | 26 |
| Lipoprotein direct measurement ldl CPT 83721 | $44.00 | $55.00 | $10.50 – $46.71 | 26 |
| Lithium therapeutic drug level CPT 80178 | $27.20 | $34.00 | $6.61 – $29.40 | 26 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $31,708.00 | $39,635.00 | $13,939.00 – $28,537.20 | 2 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $2,094.40 | $2,618.00 | $140.95 – $1,884.96 | 25 |
| Liver Function Test CPT 80076 | $25.00 | $51.00 | $8.17 – $36.72 | 26 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $970.00 – $14,922.27 | 17 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $42.40 | $53.00 | $1.87 – $5.76 | 3 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $21.80 | $27.25 | $1.36 – $19.62 | 6 |
| Low back disk surgery CPT 63030 | not published | not published | $970.00 – $32,854.70 | 17 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $569.00 | $2,645.00 | $170.00 – $1,006.60 | 25 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $472.00 | $2,350.00 | $117.50 – $2,106.92 | 25 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $286.00 | $2,280.00 | $109.94 – $602.31 | 25 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $700.50 | $2,646.00 | $336.25 – $2,106.92 | 25 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $635.50 | $2,350.00 | $336.25 – $2,106.92 | 25 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $454.00 | $2,225.00 | $234.00 – $1,342.45 | 25 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $650.40 | $813.00 | $25.25 – $602.31 | 25 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $970.00 – $84,577.62 | 17 |
| Lung Function Test (Spirometry) CPT 94010 | $495.20 | $619.00 | $11.25 – $719.56 | 23 |
| Lung perfusion imaging CPT 78580 | $1,713.60 | $2,142.00 | $59.38 – $2,259.58 | 25 |
| Lymphatics/lymph node imaging CPT 78195 | $2,225.60 | $2,782.00 | $162.50 – $2,961.19 | 25 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $970.00 – $9,421.28 | 17 |
| Macroscopic exam arthropod CPT 87168 | $21.60 | $27.00 | $2.14 – $19.44 | 22 |
| Macroscopic exam parasite CPT 87169 | $18.40 | $23.00 | $2.16 – $19.17 | 22 |
| Magnesium CPT 83735 | $30.00 | $81.00 | $6.70 – $31.00 | 26 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $36.80 | $46.00 | $0.52 – $6.48 | 6 |
| Mammosite ced HCPCS C1728 | $455.34 | $569.18 | $17.40 – $17.40 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $240.00 | $300.00 | $64.45 – $592.82 | 19 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $328.00 | $410.00 | $96.68 – $592.82 | 18 |
| Mastectomy partial CPT 19301 | not published | not published | $970.00 – $29,992.84 | 17 |
| Mast mod rad CPT 19307 | not published | not published | $970.00 – $29,992.84 | 17 |
| Mastoids complete CPT 70130 | $501.60 | $627.00 | $34.31 – $602.31 | 25 |
| Mastopexy CPT 19316 | not published | not published | $970.00 – $29,992.84 | 17 |
| Mast simple complete CPT 19303 | not published | not published | $970.00 – $29,992.84 | 17 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $72.00 | $90.00 | $14.46 – $64.80 | 26 |
| Mayo aathr protein s free CPT 85306 | $107.20 | $134.00 | $15.32 – $96.48 | 26 |
| Mayo activated protein c resistance assay CPT 85307 | $108.00 | $135.00 | $15.32 – $97.20 | 26 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $95.20 | $119.00 | $28.93 – $171.57 | 21 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $61.60 | $77.00 | $7.39 – $65.75 | 22 |
| Mayo alpha 1 antitrypsin CPT 82103 | $56.00 | $70.00 | $13.44 – $59.79 | 26 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $62.40 | $78.00 | $11.00 – $67.08 | 26 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $505.60 | $632.00 | $60.82 – $541.05 | 22 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $380.80 | $476.00 | $91.66 – $407.73 | 22 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $4,825.60 | $6,032.00 | $300.20 – $5,160.03 | 23 |
| Mayo androstenedione CPT 82157 | $146.40 | $183.00 | $25.00 – $131.76 | 26 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $73.60 | $92.00 | $14.60 – $66.24 | 26 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $62.40 | $78.00 | $15.05 – $66.95 | 26 |
| Mayo avwpr vw factor activity CPT 85397 | $157.60 | $197.00 | $26.30 – $141.84 | 26 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $162.40 | $203.00 | $28.07 – $156.09 | 26 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $50.40 | $63.00 | $10.18 – $45.36 | 26 |
| Mayo brcmg brucella antibody igm CPT 86622 | $37.60 | $47.00 | $8.93 – $39.72 | 26 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $84.00 | $105.00 | $8.44 – $75.60 | 22 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $107.20 | $134.00 | $26.78 – $119.13 | 26 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $508.00 | $635.00 | $122.22 – $543.67 | 23 |
| Mayo ceruloplasmin CPT 82390 | $44.80 | $56.00 | $10.00 – $47.77 | 26 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $59.20 | $74.00 | $7.06 – $62.81 | 22 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $64.00 | $80.00 | $9.66 – $57.60 | 21 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $63.20 | $79.00 | $12.68 – $56.88 | 26 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $581.60 | $727.00 | $116.49 – $523.44 | 26 |
| Mayo chromium CPT 82495 | $101.60 | $127.00 | $6.00 – $91.44 | 26 |
| Mayo coccidioides antibody CPT 86635 | $47.20 | $59.00 | $11.47 – $51.02 | 26 |
| Mayo cocou cortisone urine CPT 82542 | $120.80 | $151.00 | $19.27 – $108.72 | 26 |
| Mayo cortisol free CPT 82530 | $69.60 | $87.00 | $16.71 – $74.33 | 26 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $55.20 | $69.00 | $13.25 – $58.94 | 26 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $104.80 | $131.00 | $21.00 – $112.41 | 26 |
| Mayo dihydrotestosterone CPT 82642 | $146.40 | $183.00 | $21.96 – $131.76 | 21 |
| Mayo efpo chloride stool CPT 82438 | $24.80 | $31.00 | $3.00 – $22.32 | 26 |
| Mayo estrone CPT 82679 | $104.00 | $130.00 | $13.00 – $110.99 | 26 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $68.00 | $85.00 | $13.00 – $72.69 | 26 |
| Mayo everolimus therapeutic drug level CPT 80169 | $57.60 | $72.00 | $13.73 – $61.08 | 26 |
| Mayo factor v CPT 85220 | $120.80 | $151.00 | $5.00 – $108.72 | 26 |
| Mayo factor vii CPT 85230 | $123.20 | $154.00 | $5.00 – $110.88 | 26 |
| Mayo factor viii vw factor antigen CPT 85246 | $153.60 | $192.00 | $22.94 – $138.24 | 26 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $153.60 | $192.00 | $22.94 – $138.24 | 26 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $158.40 | $198.00 | $22.94 – $142.56 | 26 |
| Mayo factor x CPT 85260 | $105.60 | $132.00 | $12.00 – $95.04 | 26 |
| Mayo factor xi CPT 85270 | $115.20 | $144.00 | $12.00 – $103.68 | 26 |
| Mayo fat/lipids feces quantitative CPT 82710 | $69.60 | $87.00 | $4.02 – $74.73 | 26 |
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.