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 |
|---|---|---|---|---|
| Pt evaluation high complexity patient/family CPT 97163 | $340.00 | $425.00 | $56.80 – $325.00 | 8 |
| Pt evaluation low complexity patient/family CPT 97161 | $259.20 | $324.00 | $56.80 – $325.00 | 8 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $301.60 | $377.00 | $56.80 – $325.00 | 8 |
| Pt re-evaluation patient/family CPT 97164 | $156.00 | $195.00 | $53.90 – $325.00 | 8 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $157.60 | $197.00 | $39.85 – $3,246.00 | 23 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $162.40 | $203.00 | $50.00 – $146.16 | 7 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $141.60 | $177.00 | $50.00 – $325.00 | 8 |
| Pt wheelchair management each 15 minutes CPT 97542 | $155.20 | $194.00 | $50.00 – $325.00 | 8 |
| Pulmonary vent imaging CPT 78579 | $1,713.60 | $2,142.00 | $138.42 – $2,259.58 | 25 |
| Pulse ox continuous overnight monitoring CPT 94762 | $180.80 | $226.00 | $78.23 – $719.56 | 19 |
| Pulse ox multiple CPT 94761 | $109.60 | $137.00 | $4.83 – $98.64 | 2 |
| Punc of shunt for asp or inj CPT 61070 | $2,371.20 | $2,964.00 | $81.25 – $3,184.98 | 23 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $124.80 | $156.00 | $16.25 – $592.82 | 23 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $634.40 | $793.00 | $30.00 – $1,837.46 | 23 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,392.00 | $1,740.00 | $52.50 – $3,184.98 | 23 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $32.20 | $40.25 | $6.56 – $44.00 | 6 |
| Pyruvate CPT 84210 | $72.00 | $90.00 | $8.00 – $64.80 | 26 |
| Quest t3 uptake CPT 84479 | $26.40 | $33.00 | $6.47 – $28.78 | 26 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $1,850.40 | $2,313.00 | $25.00 – $2,795.52 | 26 |
| Radiation physics consult CPT 77336 | $892.00 | $1,115.00 | $58.95 – $802.80 | 24 |
| Radiation therapy dose plan CPT 77300 | $608.80 | $761.00 | $26.88 – $610.62 | 24 |
| Radiation treatment aid(s) CPT 77334 | $1,484.00 | $1,855.00 | $68.75 – $1,683.59 | 24 |
| Radiation treatment delivery CPT 77412 | $1,763.20 | $2,204.00 | $55.00 – $1,586.88 | 24 |
| Radiology port images(s) CPT 77417 | $220.00 | $275.00 | $15.24 – $198.00 | 3 |
| Radiotherapy dose plan imrt CPT 77301 | $11,188.80 | $13,986.00 | $884.78 – $10,069.92 | 24 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $4,720.00 | $5,900.00 | $87.50 – $7,779.35 | 25 |
| Radphm lcl tumor plr sgl day CPT 78800 | $1,713.60 | $2,142.00 | $68.75 – $2,259.58 | 25 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $3,529.00 | $4,411.25 | $409.57 – $5,037.97 | 26 |
| Rbc count only automated CPT 85041 | $12.80 | $16.00 | $3.02 – $13.43 | 26 |
| Reconstruction knee CPT 27427 | not published | not published | $970.00 – $32,854.70 | 17 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $970.00 – $84,577.62 | 17 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $1,181.60 | $1,477.00 | $30.00 – $1,063.44 | 23 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $1,409.60 | $1,762.00 | $30.00 – $1,268.64 | 23 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $526.00 | $657.50 | $3.27 – $473.40 | 6 |
| Relieve bladder contracture CPT 52640 | not published | not published | $970.00 – $15,862.15 | 17 |
| Relocation skin pocket aicd CPT 33223 | $7,968.00 | $9,960.00 | $494.83 – $13,939.00 | 20 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $1,815.20 | $2,269.00 | $7.30 – $2,993.26 | 26 |
| Rem endovas vena cava filter CPT 37193 | $5,162.40 | $6,453.00 | $369.78 – $14,475.66 | 18 |
| Removal biliary drg cath CPT 47537 | $1,539.20 | $1,924.00 | $101.27 – $4,311.92 | 23 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $2,804.00 | $3,505.00 | $162.94 – $2,843.44 | 23 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $2,996.00 | $3,745.00 | $230.11 – $7,144.41 | 22 |
| Removal cerclage without anes CPT 59899 | $192.80 | $241.00 | $150.88 – $925.20 | 18 |
| Removal cerumen impacted (both sides) CPT 69210 | $280.80 | $351.00 | $25.00 – $273.17 | 23 |
| Removal clot in graft xcp 35876 CPT 35876 | not published | not published | $970.00 – $24,861.33 | 17 |
| Removal foreign body foot subcutaneous right CPT 28190 | $2,960.80 | $3,701.00 | $38.13 – $3,235.87 | 23 |
| Removal of adenoids CPT 42830 | not published | not published | $970.00 – $14,915.19 | 17 |
| Removal of adenoids CPT 42831 | not published | not published | $970.00 – $14,915.19 | 17 |
| Removal of adenoids <12yrs 42835 CPT 42835 | not published | not published | $970.00 – $14,915.19 | 17 |
| Removal of anal fissure CPT 46200 | not published | not published | $970.00 – $12,612.53 | 17 |
| Removal of epididymis CPT 54860 | not published | not published | $970.00 – $15,862.15 | 17 |
| Removal of ethmoid sinus CPT 31200 | not published | not published | $970.00 – $27,206.69 | 17 |
| Removal of foot lesion CPT 28080 | not published | not published | $970.00 – $7,360.42 | 17 |
| Removal of foot lesion CPT 28090 | not published | not published | $970.00 – $14,922.27 | 17 |
| Removal of foot lesion CPT 28104 | not published | not published | $970.00 – $14,922.27 | 17 |
| Removal of hydrocele CPT 55040 | not published | not published | $970.00 – $16,230.51 | 17 |
| Removal of hydrocele CPT 55500 | not published | not published | $970.00 – $15,862.15 | 17 |
| Removal of hydroceles CPT 55041 | not published | not published | $970.00 – $16,230.51 | 17 |
| Removal of implant deep CPT 20680 | not published | not published | $970.00 – $13,162.83 | 17 |
| Removal of tendon lesion CPT 27630 | not published | not published | $970.00 – $32,854.70 | 17 |
| Removal of testis CPT 54520 | not published | not published | $970.00 – $15,862.15 | 17 |
| Removal of testis CPT 54530 | not published | not published | $970.00 – $16,230.51 | 17 |
| Removal of thyroid CPT 60240 | not published | not published | $970.00 – $26,832.77 | 17 |
| Removal of thyroid CPT 60252 | not published | not published | $970.00 – $27,206.69 | 17 |
| Removal of toe lesions CPT 28108 | not published | not published | $970.00 – $7,360.42 | 17 |
| Removal/replacement ppm generator dual lead system CPT 33228 | $35,613.60 | $44,517.00 | $351.68 – $48,131.05 | 19 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $207.20 | $259.00 | $38.75 – $913.86 | 23 |
| Removal tunnled intprtnl cath CPT 49422 | $4,098.40 | $5,123.00 | $418.65 – $14,475.66 | 22 |
| Remove anal fist subq CPT 46270 | not published | not published | $970.00 – $12,612.53 | 17 |
| Remove bladder stone CPT 52317 | not published | not published | $970.00 – $23,380.04 | 17 |
| Remove bladder stone CPT 52318 | not published | not published | $970.00 – $15,862.15 | 17 |
| Remove epididymis lesion CPT 54840 | not published | not published | $970.00 – $15,862.15 | 17 |
| Remove/graft foot lesion CPT 28102 | not published | not published | $970.00 – $32,854.70 | 17 |
| Remove pilonidal cyst compl CPT 11772 | not published | not published | $970.00 – $13,162.83 | 17 |
| Remove pilonidal cyst exten CPT 11771 | not published | not published | $970.00 – $13,162.83 | 17 |
| Remove prostate regrowth CPT 52630 | not published | not published | $970.00 – $23,380.04 | 17 |
| Remove renal tube w/fluoro CPT 50389 | $707.20 | $884.00 | $56.48 – $3,069.77 | 22 |
| Remove spine eltrd plate CPT 63662 | not published | not published | $970.00 – $15,816.33 | 17 |
| Remove spine infusion device CPT 62365 | not published | not published | $970.00 – $29,452.95 | 17 |
| Remove spine lamieieiotina >2 crvcl 63015 CPT 63015 | not published | not published | $970.00 – $32,854.70 | 16 |
| Remove thyroid lesion 60200 CPT 60200 | not published | not published | $970.00 – $27,206.69 | 17 |
| Remove tonsils and adenoids CPT 42820 | not published | not published | $970.00 – $27,206.69 | 17 |
| Remove tonsils and adenoids CPT 42821 | not published | not published | $970.00 – $14,915.19 | 17 |
| Remove ureter stent percut CPT 50384 | $4,295.20 | $5,369.00 | $257.41 – $9,421.28 | 18 |
| Renal function panel CPT 80069 | $36.00 | $45.00 | $8.68 – $38.61 | 26 |
| Reopen fallopian tube CPT 58350 | not published | not published | $970.00 – $26,832.77 | 17 |
| Repair achilles tendon CPT 27650 | not published | not published | $970.00 – $32,854.70 | 17 |
| Repair biceps tendon CPT 23430 | not published | not published | $970.00 – $84,577.62 | 17 |
| Repair bladder defect CPT 57288 | not published | not published | $970.00 – $22,703.23 | 17 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $1,156.80 | $1,446.00 | $316.44 – $1,407.62 | 23 |
| Repair dental ellis ii fx CPT 41899 | not published | not published | $970.00 – $1,101.92 | 6 |
| Repair elbow deb/attch open CPT 24359 | not published | not published | $970.00 – $14,922.27 | 17 |
| Repair foot dislocation CPT 28615 | not published | not published | $970.00 – $32,854.70 | 17 |
| Repair/graft of foot tendon CPT 28210 | not published | not published | $970.00 – $32,854.70 | 17 |
| Repair ing hernia sliding CPT 49525 | not published | not published | $970.00 – $16,230.51 | 17 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $1,976.80 | $2,471.00 | $384.10 – $2,342.07 | 23 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $2,312.80 | $2,891.00 | $460.33 – $6,812.57 | 22 |
| Repair lower leg tendons CPT 27675 | not published | not published | $970.00 – $14,922.27 | 17 |
| Repair lower leg tendons CPT 27676 | not published | not published | $970.00 – $32,854.70 | 17 |
| Repair of achilles tendon CPT 27654 | not published | not published | $970.00 – $32,854.70 | 17 |
| Repair of ankle ligament CPT 27695 | not published | not published | $970.00 – $32,854.70 | 17 |
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.