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 |
|---|---|---|---|---|
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $436.12 – $1,482.81 | 13 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $441.60 | $552.00 | $142.50 – $1,103.22 | 23 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $300.80 | $376.00 | $62.64 – $602.31 | 25 |
| Ultrasound breast complete CPT 76641 | $540.80 | $676.00 | $66.79 – $602.31 | 25 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $492.00 | $615.00 | $51.17 – $497.84 | 25 |
| Ultrasound chest CPT 76604 | $724.00 | $905.00 | $54.11 – $602.31 | 25 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $329.60 | $412.00 | $26.91 – $602.31 | 25 |
| Ultrasound encephalogram CPT 76506 | $588.80 | $736.00 | $58.05 – $602.31 | 25 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $544.00 | $680.00 | $79.36 – $602.31 | 25 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $909.60 | $1,137.00 | $51.61 – $818.64 | 25 |
| Ultrasound guidance for vascular access CPT 76937 | $504.00 | $630.00 | $15.77 – $453.60 | 3 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $1,184.80 | $1,481.00 | $54.00 – $1,066.32 | 3 |
| Ultrasound guide intraoperative CPT 76998 | $1,126.40 | $1,408.00 | $114.44 – $1,013.76 | 2 |
| Ultrasound hips infant dynamic CPT 76885 | $636.80 | $796.00 | $58.05 – $497.84 | 25 |
| Ultrasound infant hips ltd without stress CPT 76886 | $558.40 | $698.00 | $58.11 – $497.84 | 20 |
| Ultrasound joint complete left CPT 76881 | $575.20 | $719.00 | $82.72 – $602.31 | 25 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $468.00 | $585.00 | $9.81 – $602.31 | 25 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $892.00 | $1,115.00 | $27.48 – $191.00 | 3 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $666.40 | $833.00 | $49.73 – $602.31 | 25 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $728.00 | $910.00 | $48.75 – $602.31 | 25 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $534.40 | $668.00 | $58.05 – $602.31 | 25 |
| Ultrasound retroperitoneal limited CPT 76775 | $626.40 | $783.00 | $61.25 – $602.31 | 25 |
| Ultrasound scrotum and contents CPT 76870 | $702.40 | $878.00 | $55.00 – $602.31 | 25 |
| Ultrasound spinal canal and contents CPT 76800 | $592.00 | $740.00 | $63.50 – $602.31 | 25 |
| Ultrasound transvaginal non obstetric CPT 76830 | $708.80 | $886.00 | $58.13 – $602.31 | 24 |
| Umbilicoplasty 15847 CPT 15847 | not published | not published | $970.00 – $7,079.67 | 8 |
| Unlisted CT procedure CPT 76497 | $1,177.60 | $1,472.00 | $66.04 – $1,059.84 | 20 |
| Unlisted laparoscopic procedure 49659 CPT 49659 | not published | not published | $970.00 – $26,832.77 | 15 |
| Unlisted laps px uterus CPT 58578 | not published | not published | $970.00 – $26,832.77 | 15 |
| Unlisted mr procedure CPT 76498 | $942.40 | $1,178.00 | $66.04 – $497.84 | 20 |
| Unlisted px pelvis/hip joint CPT 27299 | not published | not published | $248.01 – $1,103.22 | 16 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $1,124.00 | $1,405.00 | $193.68 – $3,044.31 | 19 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $700.50 | $2,646.00 | $336.25 – $2,106.92 | 25 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $633.50 | $2,350.00 | $336.25 – $2,106.92 | 25 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $454.00 | $2,225.00 | $234.00 – $1,342.45 | 25 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $969.34 – $4,311.92 | 18 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $969.34 – $4,311.92 | 18 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $969.34 – $4,311.92 | 18 |
| Urea nitrogen CPT 84520 | $20.00 | $25.00 | $3.95 – $18.00 | 26 |
| Urea nitrogen 24 hour urine CPT 84540 | $23.20 | $29.00 | $4.17 – $24.73 | 21 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $672.00 | $840.00 | $28.13 – $1,342.45 | 25 |
| Urethrocystography void s&i CPT 74455 | $600.00 | $750.00 | $34.38 – $1,342.45 | 25 |
| Uric acid blood CPT 84550 | $15.00 | $24.00 | $4.52 – $20.11 | 26 |
| Uric acid urine CPT 84560 | $20.80 | $26.00 | $4.50 – $22.60 | 26 |
| Urinalysis microscopic only CPT 81015 | $15.20 | $19.00 | $2.71 – $13.68 | 26 |
| Urinalysis (with microscopy) CPT 81001 | $10.00 | $24.00 | $3.00 – $14.10 | 26 |
| Urinalysis (without microscopy) CPT 81003 | $10.00 | $11.00 | $2.25 – $10.01 | 26 |
| Urine Culture Test CPT 87086 | $25.00 | $60.00 | $8.00 – $35.90 | 26 |
| Urine pregnancy test CPT 81025 | $43.20 | $54.00 | $4.00 – $38.88 | 26 |
| Urography, antegrade CPT 74425 | $531.20 | $664.00 | $28.13 – $2,106.92 | 25 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $217.20 | $271.50 | $12.50 – $692.34 | 13 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $70.00 | $87.50 | $12.50 – $223.14 | 12 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $167.20 | $209.00 | $12.50 – $532.95 | 12 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $37.60 | $47.00 | $12.50 – $119.85 | 13 |
| Vaccine mmr live subcutaneous CPT 90707 | $141.60 | $177.00 | $12.50 – $373.17 | 5 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $567.60 | $709.50 | $12.50 – $1,809.24 | 13 |
| Vaccine rabies im CPT 90675 | $1,368.40 | $1,710.50 | $12.50 – $1,622.53 | 26 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $750.80 | $938.50 | $12.50 – $2,180.05 | 10 |
| Vaccine tdap >=7 years im CPT 90715 | $121.40 | $151.75 | $12.50 – $191.10 | 5 |
| Vag hyst incl t/o complex CPT 58291 | not published | not published | $970.00 – $22,703.23 | 17 |
| Vag hyst including t/o CPT 58262 | not published | not published | $970.00 – $22,703.23 | 17 |
| Vaginal hysterectomy CPT 58260 | not published | not published | $970.00 – $22,703.23 | 17 |
| Valproic acid total therapeutic drug level CPT 80164 | $56.80 | $71.00 | $13.54 – $60.23 | 26 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $561.00 | $701.25 | $0.03 – $7.92 | 9 |
| Vancomycin peak therapeutic drug level CPT 80202 | $67.20 | $84.00 | $13.54 – $60.48 | 26 |
| Varicella zoster antibody igg CPT 86787 | $53.60 | $67.00 | $12.88 – $57.29 | 26 |
| Vasectomy CPT 55250 | not published | not published | $970.00 – $9,421.28 | 17 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $22,378.60 | $27,973.25 | $23.12 – $28,439.32 | 26 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $2,765.60 | $3,457.00 | $1,051.88 – $4,679.08 | 24 |
| Veeg unmon 12-26 hrs CPT 95714 | $2,904.00 | $3,630.00 | $200.00 – $3,201.00 | 24 |
| Veeg unmon 2-12 hrs CPT 95711 | $2,904.00 | $3,630.00 | $125.00 – $3,201.00 | 24 |
| Vein x-ray liver w/hemodynam CPT 75889 | $6,960.00 | $8,700.00 | $164.38 – $17,462.81 | 24 |
| Ven blood coll snf/hha HCPCS G0471 | $16.80 | $21.00 | $5.00 – $49.33 | 19 |
| Venogram ext bil s&i CPT 75822 | $4,980.00 | $6,225.00 | $28.13 – $8,774.10 | 24 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $3,320.00 | $4,150.00 | $28.13 – $8,774.10 | 24 |
| Venous mech thrombectomy CPT 37187 | $10,528.00 | $13,160.00 | $427.58 – $52,156.41 | 19 |
| Ventilator each subsequent day CPT 94003 | $2,020.00 | $2,525.00 | $59.73 – $3,040.46 | 19 |
| Ventilator initial day CPT 94002 | $2,300.80 | $2,876.00 | $82.19 – $3,040.46 | 19 |
| Version cephalic external CPT 59412 | $935.20 | $1,169.00 | $841.68 – $14,622.99 | 21 |
| Very long chain fatty acids CPT 82726 | $82.40 | $103.00 | $19.75 – $87.85 | 26 |
| Vincristine 1 mg/ml intravenous solution HCPCS J9370 | $63.20 | $79.00 | $8.92 – $57.40 | 6 |
| Vital capacity test CPT 94150 | $210.40 | $263.00 | $3.00 – $719.56 | 23 |
| Vitamin b-12 CPT 82607 | $40.00 | $113.00 | $13.00 – $67.08 | 26 |
| Vitamin D Test CPT 82306 | $100.00 | $224.00 | $29.60 – $131.67 | 26 |
| Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 | $52.20 | $65.25 | $0.84 – $74.20 | 6 |
| Vulvectomy radical partial CPT 56630 | not published | not published | $904.36 – $3,074.82 | 14 |
| Vulvectomy simple partial CPT 56620 | not published | not published | $970.00 – $14,622.99 | 17 |
| Warde 1003990 aldosterone CPT 82088 | $204.00 | $255.00 | $26.00 – $183.60 | 26 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $116.00 | $145.00 | $13.90 – $123.66 | 22 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $54.40 | $68.00 | $12.90 – $57.38 | 26 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $104.80 | $131.00 | $22.00 – $112.32 | 26 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $64.80 | $81.00 | $12.00 – $68.95 | 26 |
| Warde 1015200 kappa light chain free CPT 83521 | $71.20 | $89.00 | $13.82 – $76.82 | 26 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $40.00 | $50.00 | $8.02 – $36.00 | 26 |
| Warde 3008005 oligoclonal bands CPT 83916 | $136.80 | $171.00 | $15.00 – $123.12 | 26 |
| Warde 3016000 west nile virus antibody CPT 86788 | $84.00 | $105.00 | $16.85 – $75.60 | 26 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $71.20 | $89.00 | $14.39 – $64.08 | 26 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $50.40 | $63.00 | $9.19 – $54.49 | 21 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $37.60 | $47.00 | $7.50 – $39.59 | 26 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $75.20 | $94.00 | $17.98 – $79.98 | 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.