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 |
|---|---|---|---|---|
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $970.00 – $1,101.92 | 6 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $970.00 – $1,101.92 | 6 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $970.00 – $1,101.92 | 6 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $970.00 – $1,101.92 | 6 |
| Rubella antibody igg CPT 86762 | $60.00 | $75.00 | $14.39 – $66.78 | 26 |
| Rubeola antibody igg CPT 86765 | $53.60 | $67.00 | $11.80 – $53.19 | 26 |
| Russell viper venom diluted CPT 85613 | $64.00 | $80.00 | $9.58 – $39.71 | 26 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $744.00 | $930.00 | $149.17 – $620.33 | 23 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $639.20 | $799.00 | $98.25 – $445.40 | 23 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $639.20 | $799.00 | $113.28 – $433.20 | 23 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $303.20 | $379.00 | $98.25 – $339.15 | 23 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $605.60 | $757.00 | $98.25 – $339.32 | 23 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $989.60 | $1,237.00 | $149.17 – $499.15 | 23 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $702.40 | $878.00 | $98.25 – $330.34 | 23 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $776.80 | $971.00 | $98.25 – $317.70 | 23 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $970.00 – $1,101.92 | 6 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $5,652.00 | $7,065.00 | $1,427.13 – $2,497.48 | 16 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $117.60 | $147.00 | $19.00 – $116.76 | 26 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $108.80 | $136.00 | $19.00 – $191.43 | 26 |
| Screening Mammogram CPT 77067 | $225.00 | $427.00 | $83.06 – $521.53 | 25 |
| Screening prostate cancer PSA HCPCS G0103 | $45.00 | $99.00 | $19.31 – $82.82 | 26 |
| Sedimentation rate erythrocyte automated CPT 85652 | $20.00 | $54.00 | $2.70 – $20.00 | 27 |
| Semen analysis presence/motility CPT 89321 | $48.80 | $61.00 | $9.04 – $49.77 | 21 |
| Serpina1 gene CPT 81332 | $177.60 | $222.00 | $43.65 – $180.27 | 25 |
| Set radiation therapy field CPT 77280 | $1,069.60 | $1,337.00 | $45.63 – $237.93 | 23 |
| Set radiation therapy field CPT 77290 | $1,634.40 | $2,043.00 | $90.63 – $656.04 | 23 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $970.00 – $2,113.04 | 22 |
| Sho arthrs srg bicp tenodsis CPT 29828 | not published | not published | $970.00 – $1,101.92 | 6 |
| Sho arthrs srg capsulorraphy CPT 29806 | not published | not published | $970.00 – $1,101.92 | 6 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | not published | not published | $970.00 – $1,165.00 | 6 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $970.00 – $1,165.00 | 6 |
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $970.00 – $1,165.00 | 6 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $970.00 – $1,165.00 | 6 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $970.00 – $1,101.92 | 6 |
| Shoulder MRI (with and without contrast) CPT 73223 | $712.50 | $2,646.00 | $365.72 – $2,106.92 | 25 |
| Shoulder MRI (with contrast) CPT 73222 | $645.50 | $2,900.00 | $384.69 – $4,386.56 | 25 |
| Shoulder MRI (without contrast) CPT 73221 | $461.50 | $2,225.00 | $247.54 – $1,342.45 | 25 |
| Shoulder X-ray CPT 73030 | $330.40 | $413.00 | $20.63 – $497.84 | 25 |
| Sickling rbc CPT 85660 | $32.00 | $40.00 | $3.00 – $22.76 | 26 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $283.75 – $1,633.89 | 22 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $351.25 – $2,113.04 | 22 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $970.00 – $2,113.04 | 22 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $800.20 | $1,000.25 | $123.36 – $501.41 | 9 |
| Sinus CT scan (with and without contrast) CPT 70488 | $568.00 | $2,645.00 | $125.00 – $1,006.60 | 25 |
| Sinus CT scan (with contrast) CPT 70487 | $494.00 | $2,362.00 | $100.00 – $1,006.60 | 25 |
| Sinus CT scan (without contrast) CPT 70486 | $295.00 | $1,462.00 | $96.88 – $602.31 | 25 |
| Skyla, 13.5 mg HCPCS J7301 | $1,701.60 | $2,127.00 | $737.57 – $3,883.71 | 8 |
| Sleep Study (Polysomnography) CPT 95810 | $3,935.20 | $4,919.00 | $433.20 – $1,823.27 | 23 |
| Sleeve fing rolyan med HCPCS L3933 | $316.00 | $395.00 | $67.93 – $399.56 | 19 |
| Slp ther svc non-spch gen CPT 92606 | $300.00 | $375.00 | $50.00 – $56.80 | 6 |
| Small bowel endoscopy CPT 44360 | not published | not published | $970.00 – $1,101.92 | 6 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $22.40 | $28.00 | $3.00 – $22.26 | 26 |
| Smear gram stain CPT 87205 | $16.80 | $21.00 | $4.27 – $17.64 | 26 |
| Smear nasal eosinophil CPT 89190 | $24.00 | $30.00 | $5.79 – $23.91 | 26 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $24.80 | $31.00 | $4.50 – $24.74 | 26 |
| Sodium 24 hour urine CPT 84300 | $20.80 | $26.00 | $5.06 – $22.85 | 26 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $34.00 | $42.50 | $1.95 – $8.65 | 8 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $90.80 | $113.50 | $297.50 – $297.50 | 1 |
| Sodium serum/plasma/whole blood CPT 84295 | $25.60 | $32.00 | $4.81 – $22.10 | 26 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $1,007.60 | $1,259.50 | $358.75 – $372.00 | 2 |
| Special physics consult CPT 77370 | $563.20 | $704.00 | $120.63 – $328.10 | 23 |
| Special radiation treatment CPT 77470 | $1,792.80 | $2,241.00 | $26.88 – $1,036.68 | 23 |
| Special teletx port plan CPT 77321 | $1,828.80 | $2,286.00 | $39.38 – $656.04 | 23 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $970.00 – $1,101.92 | 6 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,096.80 | $1,371.00 | $91.73 – $1,241.07 | 23 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $841.60 | $1,052.00 | $14.25 – $558.06 | 23 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $552.80 | $691.00 | $312.50 – $850.00 | 19 |
| Splint finger frog med HCPCS L3927 | $79.20 | $99.00 | $28.13 – $76.50 | 19 |
| Split blood or products CPT 86985 | $653.60 | $817.00 | $128.52 – $488.22 | 19 |
| Staph a dna amp probe CPT 87640 | $143.20 | $179.00 | $35.09 – $144.92 | 26 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $384.80 | $481.00 | $50.00 – $205.97 | 23 |
| Sterile water/saline, 10 ml HCPCS A4216 | $46.40 | $58.00 | $0.45 – $0.45 | 1 |
| St evaluate speech sound production CPT 92522 | $384.80 | $481.00 | $50.00 – $184.24 | 22 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $384.80 | $481.00 | $50.00 – $378.46 | 22 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $464.00 | $580.00 | $52.90 – $149.84 | 23 |
| St evaluation swallow function CPT 92610 | $404.80 | $506.00 | $50.00 – $140.75 | 23 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $352.80 | $441.00 | $25.00 – $282.78 | 23 |
| Stress test pulmonary CPT 94618 | $455.20 | $569.00 | $10.83 – $231.00 | 23 |
| St treatment speech individual CPT 92507 | $270.40 | $338.00 | $27.13 – $127.10 | 23 |
| St treatment swallow dysfunction/oral CPT 92526 | $296.80 | $371.00 | $50.00 – $162.32 | 23 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $83.20 | $104.00 | $7.36 – $33.60 | 9 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $21.00 | $26.25 | $132.09 – $524.03 | 2 |
| Surg dx exam anorectal CPT 45990 | not published | not published | $970.00 – $1,101.92 | 6 |
| Surgical pathology level 1 gross examination only CPT 88300 | $102.40 | $128.00 | $1.88 – $85.11 | 26 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $102.40 | $128.00 | $6.25 – $129.10 | 26 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $204.80 | $256.00 | $8.13 – $167.80 | 26 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $218.40 | $273.00 | $11.25 – $283.77 | 26 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $1,124.00 | $1,405.00 | $14.38 – $1,142.81 | 26 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $1,920.00 | $2,400.00 | $21.88 – $2,457.87 | 26 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $20.00 | $25.00 | $4.75 – $19.62 | 26 |
| Susceptibility mic per plate CPT 87186 | $35.20 | $44.00 | $8.00 – $35.72 | 26 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $18.40 | $23.00 | $4.40 – $20.71 | 26 |
| T3 (triiodothyronine) free CPT 84481 | $70.40 | $88.00 | $16.94 – $79.59 | 26 |
| T3 (triiodothyronine) total CPT 84480 | $59.20 | $74.00 | $8.00 – $58.56 | 26 |
| T4 (thyroxine) free CPT 84439 | $35.00 | $46.00 | $8.00 – $37.25 | 27 |
| T4 (thyroxine) total CPT 84436 | $28.00 | $35.00 | $6.87 – $32.30 | 26 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $12.80 | $16.00 | $7.32 – $25.34 | 9 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $4.40 | $5.50 | $0.16 – $0.67 | 9 |
| Tacrolimus therapeutic drug level CPT 80197 | $50.00 | $72.00 | $13.73 – $56.70 | 26 |
| Target gsa panel hmtlmph neop CPT 81450 | $3,160.00 | $3,950.00 | $607.62 – $3,136.86 | 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.