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 |
|---|---|---|---|---|
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $535.20 | $669.00 | $25.73 – $720.29 | 21 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $723.20 | $904.00 | $37.28 – $720.29 | 21 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $2,180.80 | $2,726.00 | $139.61 – $5,631.25 | 21 |
| PSA (Prostate) Test CPT 84153 | $45.00 | $96.00 | $8.80 – $121.34 | 24 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $149.60 | $187.00 | $42.20 – $56.80 | 5 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $133.60 | $167.00 | $42.20 – $56.80 | 5 |
| Pt application of modality traction mechanical CPT 97012 | $157.60 | $197.00 | $42.20 – $56.80 | 5 |
| Pt evaluation high complexity patient/family CPT 97163 | $340.00 | $425.00 | $67.11 – $90.33 | 5 |
| Pt evaluation low complexity patient/family CPT 97161 | $259.20 | $324.00 | $67.11 – $90.33 | 5 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $301.60 | $377.00 | $67.11 – $90.33 | 5 |
| Pt re-evaluation patient/family CPT 97164 | $156.00 | $195.00 | $45.49 – $61.23 | 5 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $107.20 | $134.00 | $39.85 – $69.74 | 19 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $162.40 | $203.00 | $42.20 – $56.80 | 5 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $89.60 | $112.00 | $42.20 – $56.80 | 5 |
| Pt wheelchair management each 15 minutes CPT 97542 | $155.20 | $194.00 | $42.20 – $56.80 | 5 |
| Pulmonary vent imaging CPT 78579 | $1,713.60 | $2,142.00 | $95.63 – $2,259.58 | 23 |
| Pulse ox continuous overnight monitoring CPT 94762 | $180.80 | $226.00 | $117.35 – $275.24 | 15 |
| Pulse ox multiple CPT 94761 | $109.60 | $137.00 | $4.07 – $5.48 | 5 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $124.80 | $156.00 | $13.65 – $467.26 | 21 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $634.40 | $793.00 | $25.20 – $1,448.30 | 21 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,392.00 | $1,740.00 | $43.09 – $2,510.39 | 21 |
| Pyruvate CPT 84210 | $72.00 | $90.00 | $8.40 – $71.63 | 24 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $1,850.40 | $2,313.00 | $14.39 – $2,795.52 | 25 |
| Rbc count only automated CPT 85041 | $12.80 | $16.00 | $3.02 – $19.88 | 24 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $1,181.60 | $1,477.00 | $22.14 – $618.80 | 21 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $1,409.60 | $1,762.00 | $31.50 – $869.72 | 21 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $526.00 | $657.50 | $9.16 – $61.74 | 4 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $1,815.20 | $2,269.00 | $7.94 – $2,287.86 | 20 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $2,996.00 | $3,745.00 | $152.50 – $18,380.78 | 23 |
| Removal cerumen impacted (both sides) CPT 69210 | $280.80 | $351.00 | $21.00 – $215.32 | 21 |
| Removal foreign body foot subcutaneous right CPT 28190 | $2,960.80 | $3,701.00 | $32.03 – $2,550.51 | 21 |
| Removal of implant deep CPT 20680 | not published | not published | $756.00 – $10,374.96 | 22 |
| Removal of lens material CPT 66840 | not published | not published | $970.00 – $8,267.68 | 22 |
| Renal function panel CPT 80069 | $36.00 | $45.00 | $8.68 – $57.30 | 24 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $1,976.80 | $2,471.00 | $163.75 – $1,846.03 | 21 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $2,448.00 | $3,060.00 | $30.63 – $1,846.03 | 21 |
| Replace g/c tube perc CPT 49450 | $2,430.40 | $3,038.00 | $41.25 – $3,398.67 | 21 |
| Rerepair ing hernia reduce CPT 49520 | not published | not published | $967.05 – $12,792.87 | 22 |
| Resuscitation cardiopulmonary CPT 92950 | $845.60 | $1,057.00 | $186.31 – $415.01 | 15 |
| Reticulated platelet assay CPT 85055 | $185.60 | $232.00 | $3.75 – $176.65 | 24 |
| Reticulocyte direct measurement automated CPT 85046 | $54.40 | $68.00 | $5.57 – $36.83 | 24 |
| Rheumatoid factor quantitative CPT 86431 | $23.20 | $29.00 | $5.67 – $37.46 | 24 |
| Rho d immune globulin inj HCPCS J2790 | $278.40 | $348.00 | $27.56 – $270.06 | 5 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $1,389.80 | $1,737.25 | $32.84 – $946.73 | 20 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $4,387.80 | $5,484.75 | $12.99 – $4,680.54 | 20 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $814.80 – $23,023.00 | 22 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | not published | not published | $814.80 – $17,057.00 | 22 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | not published | not published | $814.80 – $23,023.00 | 22 |
| Rubella antibody igg CPT 86762 | $60.00 | $75.00 | $9.99 – $94.99 | 24 |
| Rubeola antibody igg CPT 86765 | $53.60 | $67.00 | $9.38 – $64.62 | 24 |
| Russell viper venom diluted CPT 85613 | $67.20 | $84.00 | $9.58 – $63.13 | 24 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $1,119.20 | $1,399.00 | $23.53 – $876.25 | 21 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $698.40 | $873.00 | $23.53 – $385.49 | 21 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $1,069.60 | $1,337.00 | $23.75 – $876.25 | 21 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $303.20 | $379.00 | $21.65 – $385.49 | 21 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $555.20 | $694.00 | $23.53 – $385.49 | 21 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $823.20 | $1,029.00 | $23.75 – $385.49 | 21 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,088.00 | $1,360.00 | $30.00 – $876.25 | 21 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $671.20 | $839.00 | $27.41 – $385.49 | 21 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $671.20 | $839.00 | $23.75 – $385.49 | 21 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $117.60 | $147.00 | $19.95 – $157.72 | 24 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $92.80 | $116.00 | $15.39 – $191.43 | 23 |
| Screening Mammogram CPT 77067 | $225.00 | $492.00 | $83.06 – $584.60 | 24 |
| Screening prostate cancer PSA HCPCS G0103 | $45.00 | $122.00 | $10.00 – $121.34 | 24 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $128.80 | $161.00 | $4.00 – $4.00 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $20.00 | $99.00 | $2.70 – $20.00 | 25 |
| Semen analysis presence/motility CPT 89321 | $60.00 | $75.00 | $9.04 – $79.54 | 18 |
| Shoulder MRI (with and without contrast) CPT 73223 | $712.50 | $4,226.00 | $207.16 – $3,129.44 | 24 |
| Shoulder MRI (with contrast) CPT 73222 | $645.50 | $3,019.00 | $167.50 – $4,386.56 | 24 |
| Shoulder MRI (without contrast) CPT 73221 | $461.50 | $2,225.00 | $162.50 – $2,017.04 | 24 |
| Shoulder X-ray CPT 73030 | $470.40 | $588.00 | $26.17 – $497.84 | 24 |
| Sickling rbc CPT 85660 | $80.00 | $100.00 | $3.15 – $33.89 | 24 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $238.35 – $3,532.00 | 22 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $814.80 – $3,532.00 | 22 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $335.80 | $419.75 | $93.69 – $501.41 | 4 |
| Sinus CT scan (with and without contrast) CPT 70488 | $568.00 | $2,645.00 | $31.75 – $1,978.26 | 24 |
| Sinus CT scan (with contrast) CPT 70487 | $494.00 | $2,362.00 | $40.56 – $1,582.74 | 24 |
| Sinus CT scan (without contrast) CPT 70486 | $295.00 | $1,610.00 | $31.15 – $1,128.67 | 24 |
| Skin Biopsy CPT 11102 | $617.60 | $772.00 | $33.84 – $720.29 | 21 |
| Sleeve fing rolyan med HCPCS L3933 | $316.00 | $395.00 | $67.93 – $776.29 | 16 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $26.40 | $33.00 | $3.15 – $30.68 | 24 |
| Smear gram stain CPT 87205 | $21.60 | $27.00 | $4.27 – $28.15 | 24 |
| Smear nasal eosinophil CPT 89190 | $24.00 | $30.00 | $5.79 – $31.32 | 24 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $29.60 | $37.00 | $4.73 – $39.54 | 24 |
| Sodium 24 hour urine CPT 84300 | $20.80 | $26.00 | $5.06 – $32.09 | 24 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $16.00 | $20.00 | $1.48 – $8.65 | 3 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $22.00 | $27.50 | $0.01 – $0.62 | 2 |
| Sodium serum/plasma/whole blood CPT 84295 | $25.60 | $32.00 | $4.09 – $31.72 | 24 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,758.40 | $2,198.00 | $77.05 – $2,510.39 | 21 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $841.60 | $1,052.00 | $19.95 – $1,128.83 | 21 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $552.00 | $690.00 | $50.63 – $1,602.22 | 16 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $67.20 | $84.00 | $39.65 – $188.36 | 16 |
| Splint finger frog med HCPCS L3927 | $79.20 | $99.00 | $28.13 – $127.23 | 16 |
| Split blood or products CPT 86985 | $653.60 | $817.00 | $128.52 – $488.22 | 16 |
| Staph a dna amp probe CPT 87640 | $175.20 | $219.00 | $22.78 – $231.60 | 24 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $424.80 | $531.00 | $42.20 – $56.80 | 5 |
| Sterile water/saline, 10 ml HCPCS A4216 | $36.80 | $46.00 | $0.45 – $0.45 | 1 |
| St evaluate speech sound production CPT 92522 | $380.00 | $475.00 | $42.20 – $56.80 | 5 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $380.00 | $475.00 | $42.20 – $56.80 | 5 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $429.60 | $537.00 | $44.44 – $291.11 | 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.