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 |
|---|---|---|---|---|
| Cystoscopy and treatment CPT 52240 | not published | not published | $970.00 – $23,380.04 | 17 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $970.00 – $9,421.28 | 17 |
| Cystoscopy and treatment CPT 52310 | $2,661.60 | $3,327.00 | $161.25 – $9,421.28 | 22 |
| Cystoscopy (Bladder Scope) CPT 52000 | $2,470.40 | $3,088.00 | $93.75 – $3,069.77 | 22 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $970.00 – $9,421.28 | 17 |
| Cystoscopy removal of clots CPT 52001 | not published | not published | $970.00 – $15,862.15 | 17 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $970.00 – $9,421.28 | 17 |
| Cystoscopy & ureter catheter CPT 52005 | not published | not published | $970.00 – $15,862.15 | 17 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | not published | not published | $970.00 – $9,421.28 | 17 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $970.00 – $15,862.15 | 17 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $970.00 – $15,862.15 | 17 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $970.00 – $23,380.04 | 17 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $970.00 – $23,380.04 | 17 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $970.00 – $23,380.04 | 17 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $970.00 – $15,862.15 | 17 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $970.00 – $23,380.04 | 17 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | not published | not published | $970.00 – $9,421.28 | 17 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $970.00 – $9,421.28 | 17 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $970.00 – $23,380.04 | 17 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $60.00 | $75.00 | $14.39 – $64.01 | 26 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $69.60 | $87.00 | $16.85 – $74.95 | 26 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $198.40 | $248.00 | $41.48 – $264.96 | 26 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $101.60 | $127.00 | $16.00 – $91.44 | 26 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $171.20 | $214.00 | $5.00 – $261.24 | 26 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $171.20 | $214.00 | $8.13 – $274.04 | 26 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $49.60 | $62.00 | $6.23 – $117.47 | 4 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $598.40 | $748.00 | $20.80 – $788.11 | 22 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $250.40 | $313.00 | $26.72 – $640.74 | 22 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $268.00 | $335.00 | $177.17 – $1,643.67 | 26 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $3,743.00 | $4,678.75 | $16.94 – $6,945.13 | 26 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $1,247.40 | $1,559.25 | $0.03 – $1,122.66 | 6 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $970.00 – $14,622.99 | 17 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $970.00 – $26,832.77 | 17 |
| Dch validity tests CPT 81002 | $17.60 | $22.00 | $3.48 – $15.84 | 26 |
| Deamidated gliadin antibody iga CPT 86258 | $60.00 | $75.00 | $6.03 – $54.00 | 22 |
| Debridement (>20 cm) charge pt CPT 97598 | $612.80 | $766.00 | $14.45 – $551.52 | 2 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,048.80 | $1,311.00 | $41.25 – $7,451.66 | 22 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $829.60 | $1,037.00 | $746.64 – $746.64 | 1 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,048.00 | $1,310.00 | $943.20 – $943.20 | 1 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $1,563.20 | $1,954.00 | $41.25 – $1,837.46 | 23 |
| Debride nail1-5 11720 CPT 11720 | $188.00 | $235.00 | $19.46 – $273.17 | 23 |
| Debride nail6 or more 11721 CPT 11721 | $155.20 | $194.00 | $25.00 – $273.17 | 23 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $596.80 | $746.00 | $537.12 – $537.12 | 1 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,432.00 | $1,790.00 | $41.25 – $2,815.24 | 23 |
| Decalcification CPT 88311 | $115.20 | $144.00 | $5.73 – $103.68 | 5 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $1,252.00 | $1,565.00 | $31.33 – $1,525.46 | 23 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $970.00 – $32,854.70 | 17 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $970.00 – $13,162.83 | 17 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $52.80 | $66.00 | $9.36 – $47.52 | 6 |
| Delayed breast prosthesis 19342 CPT 19342 | not published | not published | $970.00 – $44,008.99 | 17 |
| Delivery of placenta 59414 CPT 59414 | $3,380.00 | $4,225.00 | $106.78 – $14,622.99 | 21 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $303.20 | $379.00 | $14.77 – $935.39 | 23 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $5,273.80 | $6,592.25 | $31.87 – $7,841.46 | 26 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $737.60 | $922.00 | $29.38 – $663.84 | 23 |
| Design mlc device for imrt CPT 77338 | $1,832.80 | $2,291.00 | $183.04 – $1,683.59 | 20 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $128.80 | $161.00 | $3.82 – $115.92 | 26 |
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $970.00 – $8,980.98 | 17 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $970.00 – $8,980.98 | 17 |
| Device intraute mirena HCPCS J7298 | $2,656.00 | $3,320.00 | $850.24 – $4,664.19 | 10 |
| Device tiss remov myosure reach HCPCS C1782 | $1,221.00 | $1,526.25 | $594.00 – $594.00 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $323.20 | $404.00 | $18.30 – $497.84 | 25 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $2.60 | $3.25 | $0.02 – $1.68 | 6 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $19.80 | $24.75 | $0.10 – $4.86 | 6 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $23.80 | $29.75 | $1.41 – $21.42 | 5 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $8.00 | $10.00 | $5.10 – $28.49 | 3 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $4.40 | $5.50 | $1.96 – $6.37 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $92.00 | $115.00 | $21.00 – $98.89 | 26 |
| Diabetes (HbA1c) Test CPT 83036 | $25.00 | $75.00 | $7.00 – $43.19 | 26 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $970.00 – $26,832.77 | 17 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $157.60 | $197.00 | $14.09 – $109.19 | 23 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $104.80 | $131.00 | $14.09 – $109.19 | 23 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $540.80 | $676.00 | $86.25 – $892.86 | 23 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $208.00 | $682.00 | $100.45 – $632.62 | 25 |
| Diagnostic Mammogram (one breast) CPT 77065 | $222.00 | $551.00 | $78.86 – $493.29 | 25 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $29,771.20 | $37,214.00 | $182.08 – $26,794.08 | 2 |
| Dialysis one evaluation CPT 90945 | $960.00 | $1,200.00 | $43.75 – $1,958.41 | 19 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.24 | $0.30 | $0.08 – $0.28 | 4 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $78.40 | $98.00 | $7.97 – $70.56 | 6 |
| Dicyclomine injection HCPCS J0500 | $50.00 | $62.50 | $12.12 – $45.01 | 6 |
| Diffusing capacity CPT 94729 | $477.60 | $597.00 | $41.40 – $429.84 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $9.60 | $12.00 | $4.15 – $27.52 | 6 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,317.00 | $14,146.25 | $3,924.93 – $22,989.84 | 26 |
| Digoxin total therapeutic drug level CPT 80162 | $55.20 | $69.00 | $11.00 – $59.07 | 26 |
| Dilate urethra stricture CPT 53600 | $468.00 | $585.00 | $25.00 – $1,118.53 | 23 |
| Dilator fascial 10fx20cm HCPCS C2627 | $93.70 | $117.13 | $78.48 – $78.48 | 1 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $12.40 | $15.50 | $0.04 – $12.80 | 9 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $11.20 | $14.00 | $0.82 – $10.08 | 6 |
| Disability dlco CPT 94727 | $782.40 | $978.00 | $27.42 – $719.56 | 23 |
| Disaccharidases CPT 82657 | $92.00 | $115.00 | $11.09 – $98.62 | 22 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $970.00 – $27,206.69 | 17 |
| Dna antibody native/double stranded CPT 86225 | $57.60 | $72.00 | $13.74 – $61.12 | 26 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $115.20 | $144.00 | $7.68 – $103.68 | 6 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $32.00 | $40.00 | $0.90 – $28.80 | 6 |
| Doppler echo complete CPT 93320 | $622.40 | $778.00 | $51.74 – $2,587.00 | 3 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $4,128.80 | $5,161.00 | $3,715.92 – $13,939.00 | 2 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,152.80 | $1,441.00 | $87.57 – $1,037.52 | 23 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $464.80 | $581.00 | $46.39 – $592.82 | 23 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $40.00 | $50.00 | $0.12 – $42.00 | 10 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $496.80 | $621.00 | $33.13 – $3,235.87 | 23 |
| Drainage external ear simple 69000 CPT 69000 | $829.60 | $1,037.00 | $53.75 – $3,235.87 | 23 |
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.