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 |
|---|---|---|---|---|
| Cta abdomen without & /or w/contrast CPT 74175 | $532.50 | $2,763.00 | $105.10 – $2,040.98 | 24 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $397.50 | $2,763.00 | $103.61 – $2,039.92 | 24 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $528.50 | $2,763.00 | $23.75 – $2,038.92 | 24 |
| Cta neck without &/or w/contrast CPT 70498 | $538.00 | $2,763.00 | $21.65 – $2,042.72 | 24 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $517.50 | $3,682.00 | $32.28 – $2,600.20 | 24 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $531.50 | $2,649.00 | $48.40 – $2,041.35 | 24 |
| CT Angiogram of the Head CPT 70496 | $538.00 | $2,763.00 | $33.46 – $2,042.72 | 24 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $535.50 | $2,763.00 | $34.35 – $2,042.35 | 24 |
| CT guidance for needle placement CPT 77012 | $1,810.40 | $2,263.00 | $167.51 – $827.90 | 6 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,862.40 | $2,328.00 | $18.46 – $486.35 | 6 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $475.50 | $2,362.00 | $31.63 – $1,547.77 | 24 |
| CT lower extremity without contrast (both sides) CPT 73700 | $285.50 | $2,185.00 | $30.68 – $1,128.99 | 24 |
| CT lwr extremity w/o&w/dye CPT 73702 | $572.00 | $2,645.00 | $23.39 – $1,980.70 | 24 |
| CT neck soft tissue w/contrast CPT 70491 | $461.50 | $2,362.00 | $29.78 – $1,528.69 | 24 |
| CT neck soft tissue without contrast CPT 70490 | $268.00 | $2,020.00 | $30.68 – $1,128.99 | 24 |
| CT neck soft tissue without & w/contrast CPT 70492 | $557.50 | $2,645.00 | $23.53 – $1,924.16 | 24 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $557.50 | $2,645.00 | $30.68 – $1,977.20 | 24 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $461.50 | $2,362.00 | $30.78 – $1,784.15 | 24 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $268.00 | $2,309.00 | $26.39 – $1,127.24 | 24 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $408.80 | $511.00 | $83.48 – $841.81 | 21 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $525.00 | $4,967.00 | $92.54 – $2,106.92 | 24 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $437.50 | $4,340.00 | $95.44 – $2,106.92 | 24 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $242.50 | $2,322.00 | $176.70 – $1,342.45 | 24 |
| CT thoracic spine w/contrast CPT 72129 | $472.00 | $2,362.00 | $46.88 – $1,622.63 | 24 |
| CT thoracic spine without contrast CPT 72128 | $286.50 | $2,559.00 | $83.13 – $1,130.42 | 24 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $266.00 | $1,206.00 | $85.55 – $602.31 | 24 |
| CT t-spine w /wo contrast CPT 72130 | $568.50 | $2,645.00 | $46.88 – $1,983.13 | 24 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $475.50 | $2,350.00 | $81.86 – $2,106.92 | 24 |
| CT upper extremity without contrast (both sides) CPT 73200 | $285.50 | $2,252.00 | $20.71 – $1,128.99 | 24 |
| CT uppr extremity w/o&w/dye CPT 73202 | $572.00 | $2,645.00 | $75.14 – $1,980.70 | 24 |
| Culture aerobic additional method definitive id each CPT 87077 | $33.60 | $42.00 | $7.46 – $42.34 | 24 |
| Culture afb any source CPT 87116 | $54.40 | $68.00 | $7.88 – $71.31 | 24 |
| Culture anaerobic additional method definitive id each CPT 87076 | $40.00 | $50.00 | $8.08 – $42.34 | 24 |
| Culture anaerobic except blood CPT 87075 | $47.20 | $59.00 | $9.47 – $62.41 | 24 |
| Culture body fluid CPT 87070 | $43.20 | $54.00 | $7.25 – $56.81 | 24 |
| Culture fungi definitive id mold CPT 87107 | $51.20 | $64.00 | $10.32 – $68.10 | 24 |
| Culture fungi definitive id yeast CPT 87106 | $51.20 | $64.00 | $10.19 – $68.10 | 24 |
| Culture fungi other (except blood) CPT 87102 | $41.60 | $52.00 | $8.41 – $55.40 | 24 |
| Culture fungi skin/hair/nail CPT 87101 | $32.80 | $41.00 | $7.71 – $50.89 | 24 |
| Culture mycoplasma any source CPT 87109 | $64.00 | $80.00 | $15.39 – $101.54 | 24 |
| Culture quantitative aerobic other source CPT 87071 | $48.80 | $61.00 | $5.48 – $62.23 | 24 |
| Culture screening strep group a CPT 87081 | $33.60 | $42.00 | $5.46 – $42.34 | 24 |
| Culture typing immunologic CPT 87147 | $25.60 | $32.00 | $3.15 – $34.16 | 24 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $175.20 | $219.00 | $17.71 – $227.18 | 24 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $5.40 | $6.75 | $0.76 – $3.06 | 4 |
| Cyclic citrullinated peptide antibody CPT 86200 | $54.40 | $68.00 | $7.61 – $85.46 | 24 |
| Cyclosporine 2 hour CPT 80158 | $75.20 | $94.00 | $17.94 – $119.12 | 24 |
| Cystatin c CPT 82610 | $77.60 | $97.00 | $15.96 – $89.70 | 24 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $60.00 | $75.00 | $14.39 – $94.99 | 24 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $69.60 | $87.00 | $6.25 – $111.17 | 24 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $101.60 | $127.00 | $15.00 – $133.67 | 24 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $171.20 | $214.00 | $16.80 – $261.31 | 24 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $171.20 | $214.00 | $27.83 – $274.11 | 24 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $49.60 | $62.00 | $5.85 – $117.50 | 4 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $598.40 | $748.00 | $10.56 – $488.22 | 18 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $250.40 | $313.00 | $10.56 – $640.89 | 18 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $268.00 | $335.00 | $23.75 – $1,644.07 | 24 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $3,743.00 | $4,678.75 | $18.41 – $5,449.50 | 20 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $36.20 | $45.25 | $10.50 – $52.50 | 4 |
| Deamidated gliadin antibody iga CPT 86258 | $60.00 | $75.00 | $9.04 – $52.11 | 18 |
| Debridement (>20 cm) charge pt CPT 97598 | $612.80 | $766.00 | $12.20 – $82.86 | 6 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,048.80 | $1,311.00 | $34.65 – $5,873.40 | 22 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $1,563.20 | $1,954.00 | $34.65 – $1,807.00 | 22 |
| Debride nail6 or more 11721 CPT 11721 | $155.20 | $194.00 | $21.00 – $215.32 | 21 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $596.80 | $746.00 | $18.06 – $18.06 | 1 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $1,432.00 | $1,790.00 | $34.65 – $2,218.98 | 22 |
| Decalcification CPT 88311 | $115.20 | $144.00 | $17.64 – $81.82 | 8 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $1,252.00 | $1,565.00 | $26.31 – $1,202.38 | 21 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $725.55 – $10,374.96 | 22 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $303.20 | $379.00 | $12.41 – $737.29 | 21 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $5,273.80 | $6,592.25 | $34.65 – $5,993.52 | 20 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $737.60 | $922.00 | $24.68 – $467.26 | 21 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $147.40 | $184.25 | $10.70 – $62.86 | 19 |
| Destroy cervthor facet jnt 64633 CPT 64633 | not published | not published | $814.80 – $7,078.80 | 22 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | not published | not published | $814.80 – $7,078.80 | 22 |
| Device intraute mirena HCPCS J7298 | $2,656.00 | $3,320.00 | $850.24 – $4,664.19 | 8 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $323.20 | $404.00 | $28.85 – $497.84 | 24 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $2.00 | $2.50 | $0.22 – $3.36 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $19.80 | $24.75 | $0.28 – $1.54 | 4 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $13.60 | $17.00 | $1.07 – $4.59 | 3 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $8.00 | $10.00 | $3.57 – $28.49 | 2 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $7.60 | $9.50 | $1.37 – $6.37 | 3 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $92.00 | $115.00 | $22.05 – $146.69 | 24 |
| Diabetes (HbA1c) Test CPT 83036 | $25.00 | $75.00 | $7.35 – $64.04 | 25 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $814.80 – $21,149.63 | 22 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $157.60 | $197.00 | $14.09 – $109.19 | 21 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $104.80 | $131.00 | $14.09 – $109.19 | 21 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $540.80 | $676.00 | $37.10 – $703.77 | 21 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $208.00 | $682.00 | $100.45 – $707.77 | 24 |
| Diagnostic Mammogram (one breast) CPT 77065 | $222.00 | $551.00 | $78.86 – $553.30 | 24 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.24 | $0.30 | $0.12 – $0.28 | 3 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $78.40 | $98.00 | $11.16 – $44.68 | 4 |
| Dicyclomine injection HCPCS J0500 | $50.00 | $62.50 | $8.62 – $45.01 | 4 |
| Diffusing capacity CPT 94729 | $477.60 | $597.00 | $41.71 – $56.15 | 5 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $9.60 | $12.00 | $6.87 – $27.52 | 4 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $11,317.00 | $14,146.25 | $37.50 – $17,571.98 | 20 |
| Digoxin total therapeutic drug level CPT 80162 | $55.20 | $69.00 | $11.55 – $87.63 | 24 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $295.05 – $51,188.43 | 23 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $33.80 | $42.25 | $1.40 – $25.60 | 3 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $11.20 | $14.00 | $0.57 – $2.88 | 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.