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 |
|---|---|---|---|---|
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,132.00 | $1,415.00 | $26.75 – $2,563.14 | 18 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $1,094.40 | $1,368.00 | $22.78 – $1,312.57 | 18 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $178.40 | $223.00 | $32.13 – $282.62 | 18 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $178.40 | $223.00 | $21.60 – $282.62 | 24 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $178.40 | $223.00 | $17.29 – $282.62 | 24 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $354.40 | $443.00 | $16.48 – $561.45 | 24 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,666.60 | $2,083.25 | $26.25 – $1,068.20 | 20 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $1,706.80 | $2,133.50 | $5.15 – $693.77 | 20 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,038.40 | $1,298.00 | $42.83 – $737.29 | 16 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $19.00 | $23.75 | $1.22 – $6.29 | 19 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $660.80 | $826.00 | $35.08 – $47.22 | 5 |
| Inj. denosumab-bbdz, 1 mg HCPCS Q5136 | $4,741.40 | $5,926.75 | $26.25 – $5,287.68 | 17 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $264.80 | $331.00 | $50.64 – $68.16 | 5 |
| Injection for arthrography wrist (both sides) CPT 25246 | $268.80 | $336.00 | $36.93 – $49.70 | 5 |
| Injection for bladder x-ray CPT 51600 | $196.80 | $246.00 | $33.76 – $45.44 | 5 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $222.40 | $278.00 | $34.82 – $46.86 | 5 |
| Injection,onabotulinumtoxina HCPCS J0585 | $1,822.80 | $2,278.50 | $7.66 – $2,208.98 | 20 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $1,635.20 | $2,044.00 | $22.05 – $2,510.39 | 21 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $814.80 – $3,566.00 | 22 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | not published | not published | $814.80 – $3,566.00 | 22 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | not published | not published | $814.80 – $3,566.00 | 22 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $736.98 – $3,566.00 | 22 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | not published | not published | $736.98 – $3,566.00 | 22 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $422.40 | $528.00 | $33.60 – $1,070.08 | 21 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $548.80 | $686.00 | $32.61 – $1,807.00 | 22 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $548.80 | $686.00 | $36.19 – $1,070.08 | 21 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $217.60 | $272.00 | $13.66 – $167.25 | 21 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $144.00 | $180.00 | $26.88 – $763.74 | 21 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $283.20 | $354.00 | $13.34 – $257.99 | 21 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $64.25 – $40,444.79 | 22 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $21.00 | $26.25 | $2.80 – $25.60 | 3 |
| Inj proc elbow arthro CPT 24220 | $272.00 | $340.00 | $36.93 – $49.70 | 5 |
| Insert cath pleura with image CPT 32557 | $1,232.00 | $1,540.00 | $60.00 – $5,631.25 | 21 |
| Insert cath pleura without image CPT 32556 | $2,524.00 | $3,155.00 | $102.17 – $6,876.60 | 21 |
| Insert intrauterine device iud CPT 58300 | $131.20 | $164.00 | $18.20 – $21,149.63 | 18 |
| Insertion catheter bladder non indwelling CPT 51701 | $375.20 | $469.00 | $26.72 – $467.26 | 21 |
| Insertion catheter bladder temporary simple CPT 51702 | $375.20 | $469.00 | $28.89 – $467.26 | 21 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $5,036.00 | $6,295.00 | $25.00 – $12,792.87 | 16 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $8,252.80 | $10,316.00 | $138.75 – $19,595.73 | 16 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $3,967.20 | $4,959.00 | $118.87 – $11,409.72 | 21 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $2,982.40 | $3,728.00 | $91.76 – $5,631.25 | 21 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $4,058.40 | $5,073.00 | $73.25 – $5,631.25 | 21 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | not published | not published | $814.80 – $36,334.73 | 23 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $304.80 | $381.00 | $77.42 – $537.93 | 8 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $565.60 | $707.00 | $14.28 – $710.65 | 24 |
| Ins pq tunnld ip cath w/img CPT 49418 | $2,670.40 | $3,338.00 | $117.50 – $12,792.87 | 16 |
| Insulin total CPT 83525 | $47.20 | $59.00 | $4.54 – $75.42 | 24 |
| Intrinsic factor antibody CPT 86340 | $62.40 | $78.00 | $10.00 – $99.47 | 24 |
| Intro cath svc/ivc CPT 36010 | $1,604.80 | $2,006.00 | $120.80 – $162.59 | 5 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $4,220.80 | $5,276.00 | $12,415.90 – $12,415.90 | 1 |
| Intubation endotracheal emergency procedure CPT 31500 | $877.60 | $1,097.00 | $41.25 – $841.81 | 21 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $8.00 | $10.00 | $0.59 – $1.44 | 3 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $1.60 | $2.00 | $0.48 – $0.76 | 3 |
| Iron CPT 83540 | $20.00 | $49.00 | $4.54 – $42.75 | 25 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $99.80 | $124.75 | $10.80 – $123.11 | 20 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $312.80 | $391.00 | $17.50 – $84.00 | 4 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $100.00 | $354.00 | $20.45 – $215.32 | 21 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $283.20 | $354.00 | $20.20 – $257.99 | 21 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $123.20 | $154.00 | $12.06 – $50.00 | 6 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $154.40 | $193.00 | $12.90 – $167.25 | 21 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $552.00 | $690.00 | $27.11 – $763.74 | 21 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $844.00 | $1,055.00 | $48.83 – $1,006.60 | 23 |
| Jak2 targeted sequence analysis CPT 81279 | $770.40 | $963.00 | $47.88 – $836.94 | 21 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $40.80 | $51.00 | $5.25 – $47.41 | 24 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $21.20 | $26.50 | $0.23 – $1.75 | 20 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $2,225.60 | $2,782.00 | $92.50 – $2,961.19 | 23 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $893.60 | $1,117.00 | $34.38 – $602.31 | 24 |
| Knee MRI (with and without contrast) CPT 73723 | $712.50 | $3,764.00 | $351.61 – $3,127.38 | 24 |
| Knee MRI (with contrast) CPT 73722 | $645.00 | $3,193.00 | $351.61 – $4,386.56 | 24 |
| Knee MRI (without contrast) CPT 73721 | $462.00 | $2,225.00 | $192.50 – $2,017.04 | 24 |
| Knee X-ray CPT 73564 | $736.80 | $921.00 | $34.07 – $602.31 | 24 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $9.80 | $12.25 | $0.26 – $1.47 | 4 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $273.20 | $341.50 | $140.00 – $140.00 | 1 |
| Lactate dehydrogenase (ldh) CPT 83615 | $25.00 | $37.00 | $6.04 – $39.81 | 24 |
| Lactated ringers intravenous solution HCPCS J7120 | $8.00 | $10.00 | $1.83 – $8.05 | 3 |
| Lactic acid CPT 83605 | $75.20 | $94.00 | $8.40 – $70.45 | 24 |
| Lactoferrin fecal qualitative CPT 83630 | $82.40 | $103.00 | $12.93 – $129.52 | 24 |
| Laparo cholecystectomy/graph CPT 47563 | not published | not published | $814.80 – $21,149.63 | 22 |
| Laparoscopy excise lesions CPT 58662 | not published | not published | $814.80 – $21,149.63 | 22 |
| Laparoscopy remove adnexa CPT 58661 | not published | not published | $814.80 – $21,149.63 | 22 |
| Laparo-vag hyst incl t/o CPT 58552 | not published | not published | $814.80 – $37,740.78 | 22 |
| Lap ing hernia repair init CPT 49650 | not published | not published | $815.84 – $21,149.63 | 22 |
| Lap ing hernia repair recur CPT 49651 | not published | not published | $814.80 – $21,149.63 | 22 |
| Lead capillary CPT 83655 | $50.40 | $63.00 | $10.50 – $79.85 | 24 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,147.20 | $1,434.00 | $23.05 – $876.25 | 21 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $176.88 | $221.10 | $142.87 – $142.87 | 1 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $5.20 | $6.50 | $1.40 – $8.75 | 4 |
| Levetiracetam therapeutic drug level CPT 80177 | $55.20 | $69.00 | $13.25 – $81.75 | 24 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $43.00 | $53.75 | $3.85 – $15.43 | 4 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $311.20 | $389.00 | $52.22 – $254.10 | 4 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $24.20 | $30.25 | $1.05 – $19.20 | 3 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $28.00 | $35.00 | $6.00 – $70.00 | 19 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $30.00 | $37.50 | $8.13 – $36.44 | 4 |
| Lipase CPT 83690 | $41.60 | $52.00 | $5.25 – $45.46 | 24 |
| Lipoprotein blood quant CPT 83704 | $142.40 | $178.00 | $10.00 – $208.19 | 18 |
| Lipoprotein direct measurement hdl CPT 83718 | $34.40 | $43.00 | $7.35 – $54.05 | 24 |
| Lipoprotein direct measurement ldl CPT 83721 | $44.00 | $55.00 | $8.40 – $62.95 | 24 |
| Lithium therapeutic drug level CPT 80178 | $27.20 | $34.00 | $6.61 – $43.61 | 24 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $2,094.40 | $2,618.00 | $146.31 – $796.22 | 23 |
| Liver Function Test CPT 80076 | $25.00 | $51.00 | $8.17 – $53.91 | 24 |
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.