WellSpan Waynesboro Hospital
501 E. Main St., Waynesboro, PA · Wellspan · · NPI 1821091059
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 |
|---|---|---|---|---|
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $9.20 | $11.50 | $1.85 – $8.26 | 4 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $46.20 | $57.75 | $13.30 – $65.10 | 4 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $13.20 | $16.50 | $0.28 – $10.78 | 4 |
| Organic acids total quant ea spec CPT 83918 | $118.40 | $148.00 | $7.51 – $108.64 | 24 |
| Ortho dvc repair per 15 min HCPCS L4205 | $158.40 | $198.00 | $30.02 – $52.54 | 15 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $148.00 | $185.00 | $99.38 – $985.52 | 16 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $283.20 | $354.00 | $90.00 – $1,168.85 | 16 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $454.40 | $568.00 | $33.75 – $1,360.75 | 16 |
| Oscillation chest wall mechanical per session CPT 94669 | $612.80 | $766.00 | $152.54 – $271.06 | 15 |
| Osmolality blood CPT 83930 | $33.60 | $42.00 | $3.15 – $43.61 | 24 |
| Osmolality urine CPT 83935 | $34.40 | $43.00 | $3.15 – $44.97 | 24 |
| Ot evaluation high complexity patient/family CPT 97167 | $576.00 | $720.00 | $50.00 – $87.66 | 6 |
| Ot evaluation low complexity patient/family CPT 97165 | $335.20 | $419.00 | $65.13 – $87.66 | 5 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $440.00 | $550.00 | $65.13 – $87.66 | 5 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $84.00 | $105.00 | $42.20 – $56.80 | 6 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $156.00 | $195.00 | $42.20 – $56.80 | 5 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $140.00 | $175.00 | $42.20 – $56.80 | 5 |
| Ot re-evaluation patient/family CPT 97168 | $206.40 | $258.00 | $42.93 – $57.78 | 6 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $187.20 | $234.00 | $42.20 – $56.80 | 5 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $162.40 | $203.00 | $20.32 – $69.09 | 18 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $162.40 | $203.00 | $19.13 – $71.30 | 19 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $160.00 | $200.00 | $42.20 – $56.80 | 5 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $170.40 | $213.00 | $42.20 – $56.80 | 5 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $162.40 | $203.00 | $42.20 – $56.80 | 5 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $6.00 | $7.50 | $1.25 – $6.43 | 3 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $57.80 | $72.25 | $7.32 – $48.58 | 4 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $21.40 | $26.75 | $3.24 – $30.53 | 3 |
| Parathormone (pth) intact CPT 83970 | $248.80 | $311.00 | $29.19 – $272.37 | 24 |
| Parathyroid planar imaging CPT 78070 | $1,713.60 | $2,142.00 | $78.13 – $2,259.58 | 23 |
| Pelvic CT scan (with contrast) CPT 72193 | $475.50 | $2,362.00 | $18.13 – $1,543.28 | 24 |
| Pelvic CT scan (without contrast) CPT 72192 | $281.00 | $2,416.00 | $113.17 – $1,130.73 | 24 |
| Pelvic MRI (with and without contrast) CPT 72197 | $706.00 | $2,646.00 | $216.79 – $3,130.50 | 24 |
| Pelvic MRI (with contrast) CPT 72196 | $639.00 | $2,350.00 | $198.81 – $2,478.77 | 24 |
| Pelvic MRI (without contrast) CPT 72195 | $455.50 | $2,225.00 | $167.50 – $2,018.10 | 24 |
| Pelvic Ultrasound (complete) CPT 76856 | $517.60 | $647.00 | $33.13 – $602.31 | 23 |
| Pelvic Ultrasound (limited) CPT 76857 | $468.00 | $585.00 | $33.60 – $602.31 | 24 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $979.60 | $1,224.50 | $35.09 – $1,224.44 | 20 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $400.00 | $500.00 | $247.17 – $293.16 | 4 |
| Ph body fluid CPT 83986 | $15.20 | $19.00 | $2.10 – $18.39 | 24 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $39.60 | $49.50 | $22.91 – $103.04 | 4 |
| Phenobarbital therapeutic drug level CPT 80184 | $64.00 | $80.00 | $15.30 – $75.56 | 24 |
| Phentolaine mesylate inj HCPCS J2760 | $796.40 | $995.50 | $47.76 – $1,572.55 | 20 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $13.00 | $16.25 | $3.04 – $17.50 | 4 |
| Phenytoin total therapeutic drug level CPT 80185 | $55.20 | $69.00 | $13.25 – $87.49 | 24 |
| Phlebotomy therapeutic CPT 99195 | $110.00 | $580.00 | $10.50 – $467.26 | 21 |
| Phosphorus CPT 84100 | $15.00 | $29.00 | $4.74 – $31.32 | 24 |
| Phosphorus 24 hour urine CPT 84105 | $24.00 | $30.00 | $5.78 – $34.16 | 24 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $139.80 | $174.75 | $2.07 – $9.09 | 4 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $37.00 | $46.25 | $1.62 – $7.84 | 4 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $196.80 | $246.00 | $1,250.00 – $12,415.90 | 2 |
| Platelet automated CPT 85049 | $64.80 | $81.00 | $3.15 – $29.51 | 24 |
| Platelets leukocytes reduced each unit HCPCS P9031 | $565.60 | $707.00 | $31.50 – $427.62 | 21 |
| Platelets leukocytes reduced irradiated each unit HCPCS P9033 | $1,183.20 | $1,479.00 | $31.50 – $698.33 | 21 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $2,944.00 | $3,680.00 | $31.50 – $1,656.14 | 21 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $3,188.00 | $3,985.00 | $31.50 – $2,297.24 | 21 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $1,201.60 | $1,502.00 | $73.77 – $2,550.51 | 21 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $600.80 | $751.00 | $37.36 – $50.28 | 5 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $1,119.20 | $1,399.00 | $42.06 – $1,128.83 | 21 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $129.60 | $162.00 | $26.07 – $127.66 | 24 |
| Potassium 24 hour urine CPT 84133 | $20.00 | $25.00 | $4.73 – $28.38 | 24 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $27.00 | $33.75 | $0.08 – $2.72 | 4 |
| Potassium serum/plasma/whole blood CPT 84132 | $25.60 | $32.00 | $4.76 – $30.28 | 24 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $27,863.20 | $34,829.00 | $243.81 – $43,981.00 | 22 |
| Pr application of long arm splint CPT 29105 | $568.80 | $711.00 | $35.18 – $571.98 | 21 |
| Pr application splint static short arm CPT 29125 | $604.80 | $756.00 | $27.30 – $467.26 | 21 |
| Pr biopsy skin punch single lesion CPT 11104 | $756.00 | $945.00 | $42.45 – $1,448.30 | 21 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $712.00 | $890.00 | $33.12 – $720.29 | 21 |
| Prealbumin CPT 84134 | $73.60 | $92.00 | $14.59 – $96.26 | 24 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $164.00 | $205.00 | $0.53 – $123.55 | 4 |
| Prednisone 1 mg tablet HCPCS J7512 | $1.60 | $2.00 | $0.01 – $4.51 | 4 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $888.80 | $1,111.00 | $33.13 – $602.31 | 24 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $845.60 | $1,057.00 | $38.31 – $602.31 | 24 |
| Pressure max expiratory/inspiratory CPT 94799 | $666.40 | $833.00 | $117.35 – $208.51 | 15 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | not published | not published | $970.00 – $5,873.40 | 22 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $796.00 | $995.00 | $125.00 – $1,448.30 | 16 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $866.40 | $1,083.00 | $55.13 – $1,448.30 | 21 |
| Pr incision & drainage abscess simple/single CPT 10060 | $629.60 | $787.00 | $24.68 – $1,807.00 | 22 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $985.60 | $1,232.00 | $25.00 – $1,102.69 | 21 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $1,246.40 | $1,558.00 | $32.03 – $1,807.00 | 22 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $128.80 | $161.00 | $10.44 – $14.06 | 5 |
| Procalcitonin CPT 84145 | $136.00 | $170.00 | $16.25 – $125.45 | 24 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $9.80 | $12.25 | $1.37 – $10.22 | 4 |
| Progesterone CPT 84144 | $104.00 | $130.00 | $17.40 – $137.65 | 24 |
| Prolactin CPT 84146 | $80.80 | $101.00 | $19.38 – $127.89 | 24 |
| Promethazine hcl injection HCPCS J2550 | $6.40 | $8.00 | $2.24 – $11.59 | 4 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $33.20 | $41.50 | $1.40 – $28.80 | 4 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $7.40 | $9.25 | $5.58 – $34.79 | 3 |
| Protein c activity CPT 85303 | $127.20 | $159.00 | $13.84 – $91.24 | 24 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $40.00 | $56.00 | $10.74 – $70.86 | 24 |
| Protein s total CPT 85305 | $104.80 | $131.00 | $8.19 – $76.51 | 24 |
| Protein total 24 hour urine CPT 84156 | $15.20 | $19.00 | $3.67 – $24.18 | 24 |
| Protein total body fluid CPT 84157 | $20.00 | $25.00 | $4.00 – $24.18 | 24 |
| Protein total serum plasma whole blood CPT 84155 | $15.20 | $19.00 | $3.67 – $24.18 | 24 |
| Prp i/hern init block >5 yr CPT 49507 | not published | not published | $814.80 – $12,792.87 | 22 |
| Pr removal drug delivery implant CPT 11982 | not published | not published | $257.24 – $1,101.92 | 21 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $165.60 | $207.00 | $31.50 – $467.26 | 21 |
| Pr removal intrauterine device CPT 58301 | $1,265.60 | $1,582.00 | $18.11 – $1,102.69 | 21 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $1,160.00 | $1,450.00 | $34.65 – $1,448.30 | 21 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $535.20 | $669.00 | $33.08 – $720.29 | 21 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $723.20 | $904.00 | $49.88 – $720.29 | 21 |
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.