WellSpan Gettysburg Hospital
147 Gettys Street, Gettysburg, PA · Wellspan · · NPI 1265466957
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 |
|---|---|---|---|---|
| Lap ing hernia repair recur CPT 49651 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lap insert tunnel ip cath CPT 49324 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lap jejunostomy 44186 CPT 44186 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lap paraesophag hern repair CPT 43281 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lap paraesoph her rpr w/mesh CPT 43282 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lap revision perm ip cath CPT 49325 | not published | not published | $970.00 – $1,101.92 | 6 |
| Laps surg prst8ect rpbic rad CPT 55866 | not published | not published | $970.00 – $1,101.92 | 5 |
| Laryngoscopy w/biopsy CPT 31535 | not published | not published | $952.50 – $1,101.92 | 6 |
| Lead capillary CPT 83655 | $50.40 | $63.00 | $10.00 – $50.01 | 26 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $869.60 | $1,087.00 | $142.75 – $498.64 | 23 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $691.36 | $864.20 | $142.87 – $142.87 | 1 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $502.00 | $627.50 | $22.53 – $88.48 | 9 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $3,509.20 | $4,386.50 | $208.07 – $1,809.05 | 27 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $19.40 | $24.25 | $2.00 – $8.75 | 9 |
| Levetiracetam therapeutic drug level CPT 80177 | $55.20 | $69.00 | $13.25 – $54.72 | 26 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $136.40 | $170.50 | $2.03 – $7.72 | 9 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $621.00 | $776.25 | $68.72 – $254.10 | 9 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $91.20 | $114.00 | $0.70 – $19.20 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $105.80 | $132.25 | $6.00 – $70.00 | 24 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $510.00 – $1,101.92 | 6 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $113.40 | $141.75 | $10.71 – $36.44 | 9 |
| Lipase CPT 83690 | $28.00 | $35.00 | $5.00 – $28.46 | 26 |
| Lipoprotein blood quant CPT 83704 | $139.20 | $174.00 | $25.64 – $141.20 | 21 |
| Lipoprotein direct measurement hdl CPT 83718 | $34.40 | $43.00 | $7.00 – $33.82 | 26 |
| Lipoprotein direct measurement ldl CPT 83721 | $44.00 | $55.00 | $10.50 – $43.37 | 26 |
| Lithium therapeutic drug level CPT 80178 | $27.20 | $34.00 | $6.61 – $27.30 | 26 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $2,094.40 | $2,618.00 | $140.95 – $528.57 | 24 |
| Liver Function Test CPT 80076 | $25.00 | $42.00 | $8.17 – $33.74 | 26 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $5.60 | $7.00 | $0.96 – $5.76 | 6 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $25.80 | $32.25 | $1.36 – $5.50 | 9 |
| Low back disk surgery CPT 63030 | not published | not published | $970.00 – $1,101.92 | 6 |
| 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 | $1,462.00 | $108.90 – $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 | $339.20 | $424.00 | $28.13 – $602.31 | 25 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lung function test (mbc/mvv) CPT 94200 | $61.60 | $77.00 | $6.75 – $106.45 | 23 |
| Lung perfusion imaging CPT 78580 | $1,713.60 | $2,142.00 | $59.38 – $2,259.58 | 24 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $624.00 | $780.00 | $180.91 – $869.37 | 21 |
| Lymphatics/lymph node imaging CPT 78195 | $2,225.60 | $2,782.00 | $162.50 – $2,961.19 | 24 |
| Macro exam dissect molec study ea CPT 88387 | $368.00 | $460.00 | $7.69 – $137.61 | 9 |
| Macroscopic exam arthropod CPT 87168 | $16.80 | $21.00 | $2.14 – $17.64 | 22 |
| Macroscopic exam parasite CPT 87169 | $18.40 | $23.00 | $2.16 – $17.80 | 22 |
| Magnesium CPT 83735 | $30.00 | $46.00 | $6.70 – $31.00 | 27 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $134.40 | $168.00 | $0.48 – $3.43 | 9 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $228.80 | $286.00 | $64.45 – $231.00 | 19 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $328.00 | $410.00 | $96.68 – $231.00 | 18 |
| Mastectomy partial CPT 19301 | not published | not published | $970.00 – $1,101.92 | 6 |
| Mast mod rad CPT 19307 | not published | not published | $970.00 – $1,101.92 | 6 |
| Mast simple complete CPT 19303 | not published | not published | $970.00 – $1,101.92 | 6 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $58.40 | $73.00 | $14.46 – $59.72 | 26 |
| Mayo aathr protein s free CPT 85306 | $101.60 | $127.00 | $15.32 – $72.01 | 26 |
| Mayo activated protein c resistance assay CPT 85307 | $100.00 | $125.00 | $15.32 – $63.27 | 26 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $157.60 | $197.00 | $28.93 – $159.29 | 21 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $61.60 | $77.00 | $7.39 – $61.04 | 22 |
| Mayo alpha 1 antitrypsin CPT 82103 | $56.00 | $70.00 | $13.44 – $57.80 | 26 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $62.40 | $78.00 | $11.00 – $62.28 | 26 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $380.80 | $476.00 | $91.66 – $378.56 | 25 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $4,825.60 | $6,032.00 | $300.20 – $4,790.80 | 23 |
| Mayo androstenedione CPT 82157 | $119.20 | $149.00 | $25.00 – $120.93 | 26 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $59.20 | $74.00 | $14.60 – $68.58 | 26 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $62.40 | $78.00 | $15.05 – $70.72 | 26 |
| Mayo avwpr vw factor activity CPT 85397 | $196.00 | $245.00 | $26.30 – $127.45 | 26 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $162.40 | $203.00 | $28.07 – $144.92 | 26 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $42.40 | $53.00 | $10.18 – $42.04 | 26 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $54.40 | $68.00 | $12.90 – $60.62 | 26 |
| Mayo brcmg brucella antibody igm CPT 86622 | $37.60 | $47.00 | $8.93 – $36.88 | 26 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $68.80 | $86.00 | $8.44 – $69.67 | 22 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $107.20 | $134.00 | $26.78 – $110.60 | 26 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $508.00 | $635.00 | $122.22 – $504.77 | 25 |
| Mayo ceruloplasmin CPT 82390 | $44.80 | $56.00 | $10.00 – $44.36 | 26 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $59.20 | $74.00 | $7.06 – $58.32 | 22 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $53.60 | $67.00 | $9.66 – $53.19 | 21 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $48.80 | $61.00 | $9.88 – $48.82 | 26 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $52.80 | $66.00 | $12.68 – $59.67 | 26 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $475.20 | $594.00 | $116.49 – $547.40 | 26 |
| Mayo chromium CPT 82495 | $84.80 | $106.00 | $6.00 – $83.76 | 26 |
| Mayo coccidioides antibody CPT 86635 | $47.20 | $59.00 | $11.47 – $53.89 | 26 |
| Mayo cocou cortisone urine CPT 82542 | $97.60 | $122.00 | $19.27 – $99.49 | 26 |
| Mayo cortisol free CPT 82530 | $69.60 | $87.00 | $16.71 – $79.39 | 26 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $140.00 | $175.00 | $11.16 – $174.00 | 27 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $50.40 | $63.00 | $12.12 – $56.95 | 26 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $55.20 | $69.00 | $13.25 – $54.72 | 26 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $104.80 | $131.00 | $21.00 – $104.37 | 26 |
| Mayo dihydrotestosterone CPT 82642 | $122.40 | $153.00 | $21.96 – $120.93 | 21 |
| Mayo estriol CPT 82677 | $100.80 | $126.00 | $17.50 – $99.86 | 26 |
| Mayo estrone CPT 82679 | $104.00 | $130.00 | $13.00 – $103.04 | 26 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $68.00 | $85.00 | $13.00 – $67.48 | 26 |
| Mayo everolimus therapeutic drug level CPT 80169 | $57.60 | $72.00 | $13.73 – $56.70 | 26 |
| Mayo factor v CPT 85220 | $108.00 | $135.00 | $5.00 – $72.89 | 26 |
| Mayo factor viii vw factor antigen CPT 85246 | $128.80 | $161.00 | $22.94 – $107.81 | 26 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $153.60 | $192.00 | $22.94 – $107.81 | 26 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $153.60 | $192.00 | $22.94 – $107.81 | 26 |
| Mayo factor x CPT 85260 | $105.60 | $132.00 | $12.00 – $73.93 | 26 |
| Mayo factor xi CPT 85270 | $110.40 | $138.00 | $12.00 – $73.93 | 26 |
| Mayo fat/lipids feces quantitative CPT 82710 | $69.60 | $87.00 | $4.02 – $69.38 | 26 |
| Mayo fbl culture fungi blood CPT 87103 | $84.80 | $106.00 | $12.46 – $84.50 | 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.