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 |
|---|---|---|---|---|
| X-ray foot 2 views (both sides) CPT 73620 | $369.60 | $462.00 | $12.50 – $497.84 | 25 |
| X-ray forearm 2 views (both sides) CPT 73090 | $392.00 | $490.00 | $14.38 – $497.84 | 25 |
| X-ray hand 2 views (both sides) CPT 73120 | $280.00 | $350.00 | $12.50 – $602.31 | 25 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $372.80 | $466.00 | $14.38 – $497.84 | 25 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $481.60 | $602.00 | $34.60 – $602.31 | 25 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $501.60 | $627.00 | $25.97 – $602.31 | 25 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $501.60 | $627.00 | $31.28 – $602.31 | 25 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $697.60 | $872.00 | $37.61 – $602.31 | 25 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $369.60 | $462.00 | $18.65 – $497.84 | 25 |
| X-ray humerus >= 2 views left CPT 73060 | $420.80 | $526.00 | $14.38 – $497.84 | 25 |
| X-ray joint survey 1 view CPT 77077 | $232.00 | $290.00 | $25.03 – $602.31 | 25 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $380.00 | $475.00 | $17.79 – $497.84 | 25 |
| X-ray knee 3 views (both sides) CPT 73562 | $499.20 | $624.00 | $20.63 – $497.84 | 25 |
| X-ray knee ap standing bilateral CPT 73565 | $261.60 | $327.00 | $19.13 – $497.84 | 25 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $422.40 | $528.00 | $18.13 – $497.84 | 25 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $280.00 | $350.00 | $26.25 – $602.31 | 25 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $724.00 | $905.00 | $28.13 – $602.31 | 25 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $793.60 | $992.00 | $26.25 – $602.31 | 25 |
| X-ray mandible complete > 4 views CPT 70110 | $312.00 | $390.00 | $20.63 – $602.31 | 25 |
| X-ray mandible ltd <4 views CPT 70100 | $224.00 | $280.00 | $19.46 – $497.84 | 25 |
| X-ray nasal bones complete > 3 views CPT 70160 | $583.20 | $729.00 | $14.38 – $497.84 | 25 |
| X-ray neck soft tissue CPT 70360 | $280.00 | $350.00 | $12.50 – $497.84 | 25 |
| X-ray nose to rectum for foreign body child CPT 76010 | $261.60 | $327.00 | $10.88 – $497.84 | 25 |
| X-ray pelvis 1-2 views CPT 72170 | $479.20 | $599.00 | $12.50 – $602.31 | 25 |
| X-ray pelvis complete > 3 views CPT 72190 | $673.60 | $842.00 | $26.25 – $602.31 | 25 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,360.00 | $1,700.00 | $28.13 – $2,106.92 | 25 |
| X-ray ribs 2 views left CPT 71100 | $400.00 | $500.00 | $19.91 – $497.84 | 25 |
| X-ray ribs 3 views bilateral CPT 71110 | $501.60 | $627.00 | $20.63 – $602.31 | 25 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $552.00 | $690.00 | $20.63 – $602.31 | 25 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $501.60 | $627.00 | $20.63 – $602.31 | 25 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $546.40 | $683.00 | $20.63 – $602.31 | 25 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $480.00 | $600.00 | $19.24 – $497.84 | 25 |
| X-ray scapula complete (both sides) CPT 73010 | $336.00 | $420.00 | $17.79 – $602.31 | 25 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $410.40 | $513.00 | $14.46 – $497.84 | 25 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $501.60 | $627.00 | $24.64 – $497.84 | 25 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $1,128.00 | $1,410.00 | $20.63 – $3,022.37 | 25 |
| X-ray skull < 4 views CPT 70250 | $543.20 | $679.00 | $22.24 – $602.31 | 25 |
| X-ray skull > 4 views complete CPT 70260 | $753.60 | $942.00 | $28.69 – $602.31 | 25 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $694.40 | $868.00 | $28.13 – $1,006.60 | 25 |
| X-ray small intestine follow-through study CPT 74248 | $1,380.80 | $1,726.00 | $44.98 – $1,242.72 | 3 |
| X-ray spine single view CPT 72020 | $269.60 | $337.00 | $14.46 – $497.84 | 25 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $469.60 | $587.00 | $14.38 – $497.84 | 25 |
| X-ray sternum > 2 views CPT 71120 | $443.20 | $554.00 | $14.38 – $497.84 | 25 |
| X-ray surgical specimen CPT 76098 | $987.20 | $1,234.00 | $10.79 – $3,022.37 | 25 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $590.40 | $738.00 | $35.00 – $1,006.60 | 25 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $580.80 | $726.00 | $20.63 – $497.84 | 25 |
| X-ray thoracic spine 2 views CPT 72070 | $504.00 | $630.00 | $20.91 – $602.31 | 25 |
| X-ray thoracic spine 3 views CPT 72072 | $605.60 | $757.00 | $25.30 – $602.31 | 25 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $519.20 | $649.00 | $20.63 – $497.84 | 25 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $372.80 | $466.00 | $23.64 – $497.84 | 25 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $501.60 | $627.00 | $42.92 – $602.31 | 25 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $460.00 | $575.00 | $16.79 – $497.84 | 25 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $280.00 | $350.00 | $11.25 – $497.84 | 25 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $811.20 | $1,014.00 | $50.00 – $1,006.60 | 25 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $811.20 | $1,014.00 | $48.75 – $1,006.60 | 25 |
| X-ray wrist 2 views (both sides) CPT 73100 | $351.20 | $439.00 | $14.38 – $497.84 | 25 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $91.20 | $114.00 | $1.64 – $105.70 | 6 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $36.00 | $45.00 | $6.52 – $41.50 | 6 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $398.80 | $498.50 | $5.49 – $133.28 | 6 |
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.