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 |
|---|---|---|---|---|
| Assay of interleukin-6 (il-6) CPT 83529 | $86.40 | $108.00 | $12.95 – $78.04 | 18 |
| Assay of urine sulfate CPT 84392 | $22.40 | $28.00 | $4.12 – $31.32 | 18 |
| Ast/sgot CPT 84450 | $21.60 | $27.00 | $5.18 – $34.12 | 24 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $33.60 | $42.00 | $7.70 – $38.50 | 4 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $690.40 | $863.00 | $211.46 – $1,101.92 | 21 |
| Azathioprine 50 mg tablet HCPCS J7500 | $2.60 | $3.25 | $0.05 – $6.85 | 4 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $6.20 | $7.75 | $1.55 – $8.35 | 4 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $87.80 | $109.75 | $19.25 – $86.80 | 4 |
| Baclofen eval charges CPT 97750 | $156.00 | $195.00 | $42.20 – $56.80 | 5 |
| Bacterial meningitis antigen CPT 86403 | $48.00 | $60.00 | $5.63 – $67.24 | 24 |
| Bacterial vaginosis pcr CPT 87801 | $292.00 | $365.00 | $24.79 – $463.16 | 24 |
| #bac vag cand-c. albicans naa CPT 87481 | $140.00 | $175.00 | $35.09 – $231.60 | 24 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | not published | not published | $785.40 – $11,525.83 | 22 |
| Bartonella dna pcr-sendout CPT 87471 | $145.60 | $182.00 | $26.28 – $231.60 | 24 |
| B cells total count CPT 86355 | $188.00 | $235.00 | $37.73 – $248.91 | 24 |
| Benign lesion paring 2-4 CPT 11056 | $224.80 | $281.00 | $31.16 – $720.29 | 21 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $75.40 | $94.25 | $23.28 – $117.39 | 4 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $105.60 | $132.00 | $25.45 – $167.84 | 24 |
| Beta-2 microglobulin CPT 82232 | $67.20 | $84.00 | $16.18 – $106.74 | 24 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $112.60 | $140.75 | $52.85 – $239.75 | 4 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $1,064.80 | $1,331.00 | $13.65 – $1,070.08 | 21 |
| Bilirubin direct CPT 82248 | $24.80 | $31.00 | $5.02 – $33.13 | 24 |
| Bilirubin total CPT 82247 | $10.00 | $31.00 | $5.02 – $33.13 | 24 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $80.80 | $101.00 | $36.56 – $124.30 | 16 |
| Biopsy muscle percutaneous needle CPT 20206 | $4,412.80 | $5,516.00 | $30.63 – $5,873.40 | 21 |
| Biopsy needle lymph node superficial CPT 38505 | $3,426.40 | $4,283.00 | $28.75 – $5,873.40 | 21 |
| Biopsy of salivary gland 42400 CPT 42400 | $1,200.00 | $1,500.00 | $36.75 – $2,550.51 | 21 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,992.80 | $2,491.00 | $115.00 – $5,873.40 | 21 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $945.60 | $1,182.00 | $30.14 – $881.65 | 21 |
| Bld prd mix CPT 86965 | $653.60 | $817.00 | $50.28 – $488.22 | 16 |
| Blood Clotting (PT/INR) Test CPT 85610 | $15.00 | $71.00 | $4.20 – $25.94 | 25 |
| Blood Clotting (PTT) Test CPT 85730 | $30.00 | $99.00 | $5.13 – $39.59 | 24 |
| Blood Count (CBC) Test CPT 85025 | $15.00 | $95.00 | $6.30 – $51.29 | 25 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $15.00 | $93.00 | $6.47 – $42.71 | 25 |
| Blood Culture Test CPT 87040 | $51.20 | $64.00 | $10.32 – $68.10 | 24 |
| Blood draw capillary 36416 CPT 36416 | $16.00 | $20.00 | $26.52 – $26.52 | 1 |
| Blood gases o2 saturation direct measurement CPT 82805 | $393.60 | $492.00 | $40.80 – $325.32 | 24 |
| Blood gases ph venous CPT 82800 | $55.20 | $69.00 | $11.00 – $55.90 | 24 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $36.00 | $65.00 | $15.92 – $104.93 | 24 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $16.80 | $21.00 | $3.81 – $21.47 | 24 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $15.00 | $22.00 | $3.64 – $21.47 | 24 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $21.60 | $27.00 | $3.81 – $21.97 | 24 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $18.40 | $23.00 | $3.80 – $22.69 | 24 |
| Blood split unit HCPCS P9011 | $861.60 | $1,077.00 | $10.00 – $177.25 | 15 |
| Blood typing abo CPT 86900 | $146.00 | $242.00 | $4.33 – $467.26 | 24 |
| Blood typing ag donor ea ag CPT 86902 | $166.40 | $208.00 | $2.96 – $1,304.00 | 24 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $257.60 | $322.00 | $3.44 – $1,304.00 | 24 |
| Blood typing rh (d) CPT 86901 | $43.00 | $88.00 | $4.38 – $142.29 | 24 |
| Bone biopsy open superficial CPT 20240 | $4,673.60 | $5,842.00 | $99.75 – $10,374.96 | 22 |
| Bone Density Scan (DEXA) CPT 77080 | $237.00 | $627.00 | $63.12 – $602.31 | 24 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $84.80 | $106.00 | $7.50 – $112.39 | 24 |
| Borrelia miyamotoi amp prb CPT 87478 | $162.40 | $203.00 | $29.47 – $158.58 | 24 |
| Bowel imaging CPT 78290 | $1,713.60 | $2,142.00 | $78.75 – $2,259.58 | 23 |
| Brace ank air stirrup univ HCPCS L4350 | $124.80 | $156.00 | $75.35 – $383.38 | 16 |
| Brace wrist classic lft sm HCPCS L3908 | $89.60 | $112.00 | $29.38 – $252.14 | 16 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $473.50 | $2,225.00 | $105.11 – $2,020.22 | 24 |
| Brain MRI (with and without contrast) CPT 70553 | $701.50 | $4,256.00 | $121.45 – $3,138.61 | 24 |
| Brain MRI (with contrast) CPT 70552 | $635.50 | $2,350.00 | $183.51 – $2,483.69 | 24 |
| Brain MRI (without contrast) CPT 70551 | $455.00 | $2,225.00 | $172.59 – $2,023.71 | 24 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $4,100.00 | $5,125.00 | $145.83 – $5,873.40 | 21 |
| Breast punct aspir cyst, bil CPT 19000 | $2,112.80 | $2,641.00 | $38.33 – $2,550.51 | 21 |
| Bronchial allergy tests CPT 95070 | $2,336.00 | $2,920.00 | $22.58 – $1,923.45 | 21 |
| Bronchial challenge CPT 94070 | $1,318.40 | $1,648.00 | $19.95 – $1,128.83 | 21 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $12.40 | $15.50 | $0.56 – $9.76 | 19 |
| Bundled special stain group 1 microorganisms CPT 88312 | $211.20 | $264.00 | $10.94 – $442.41 | 24 |
| Bundled special stain group 2 CPT 88313 | $171.20 | $214.00 | $8.88 – $467.26 | 24 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $7.00 | $8.75 | $0.35 – $1.75 | 4 |
| Bx breast 1st lesion strtctc CPT 19081 | $3,912.00 | $4,890.00 | $155.72 – $5,873.40 | 21 |
| Bx breast add lesion strtctc CPT 19082 | $867.20 | $1,084.00 | $74.25 – $99.94 | 5 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $2,744.00 | $3,430.00 | $69.76 – $93.89 | 5 |
| Bx skin punch ea sep/ addl les CPT 11105 | $99.20 | $124.00 | $23.26 – $31.31 | 5 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $699.20 | $874.00 | $38.83 – $2,550.51 | 21 |
| C1 esterase inhibitor func - sendout CPT 86161 | $60.00 | $75.00 | $8.40 – $79.22 | 24 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $1,672.40 | $2,090.50 | $174.83 – $5,355.00 | 17 |
| Calcium 24 hour urine CPT 82340 | $24.80 | $31.00 | $6.03 – $39.81 | 24 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $34.20 | $42.75 | $7.00 – $64.00 | 2 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $30.40 | $38.00 | $2.80 – $17.50 | 4 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $58.00 | $72.50 | $6.30 – $28.00 | 4 |
| Calcium ionized CPT 82330 | $68.00 | $85.00 | $9.29 – $90.16 | 24 |
| Calcium total CPT 82310 | $25.60 | $32.00 | $5.16 – $34.03 | 24 |
| Calprotectin fecal CPT 83993 | $98.40 | $123.00 | $8.99 – $129.52 | 24 |
| Carbamazepine free CPT 80157 | $55.20 | $69.00 | $11.54 – $87.49 | 24 |
| Carbamazepine free -sendout CPT 80161 | $77.60 | $97.00 | $16.07 – $84.24 | 20 |
| Carbamazepine total therapeutic drug level CPT 80156 | $60.80 | $76.00 | $14.57 – $96.08 | 24 |
| Carbohydrate deficient transf - sendout CPT 82373 | $75.20 | $94.00 | $8.30 – $119.17 | 24 |
| Carbon dioxide CPT 82374 | $24.00 | $30.00 | $4.88 – $32.27 | 24 |
| Carboxyhemoglobin quantitative CPT 82375 | $61.60 | $77.00 | $5.88 – $50.88 | 24 |
| Carcinoembryonic ag (cea) CPT 82378 | $65.00 | $99.00 | $17.85 – $125.18 | 24 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $4,720.00 | $5,900.00 | $90.35 – $7,779.35 | 23 |
| Cardiolipin antibody iga CPT 86147 | $127.20 | $159.00 | $25.45 – $167.84 | 24 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,271.20 | $1,589.00 | $91.35 – $12,415.90 | 22 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,266.40 | $1,583.00 | $30.68 – $876.25 | 21 |
| Carpal Tunnel Release Surgery CPT 64721 | not published | not published | $697.20 – $8,444.00 | 22 |
| Cataract Surgery CPT 66984 | not published | not published | $970.00 – $10,497.00 | 22 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $36.00 | $45.00 | $6.82 – $26.49 | 17 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $275.20 | $344.00 | $54.86 – $73.84 | 5 |
| Cauterization chemical granulation tissue CPT 17250 | $712.00 | $890.00 | $27.11 – $720.29 | 21 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $13.00 | $16.25 | $2.44 – $11.62 | 4 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $17.80 | $22.25 | $1.86 – $8.40 | 4 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $16.00 | $20.00 | $4.76 – $22.40 | 4 |
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.