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 |
|---|---|---|---|---|
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $42.40 | $53.00 | $1.79 – $5.76 | 3 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $21.80 | $27.25 | $1.04 – $5.50 | 4 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $569.00 | $2,645.00 | $53.13 – $1,983.13 | 24 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $472.00 | $2,350.00 | $58.13 – $2,106.92 | 24 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $286.00 | $2,280.00 | $81.25 – $1,130.42 | 24 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $700.50 | $2,646.00 | $145.94 – $3,141.41 | 24 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $635.50 | $2,350.00 | $109.49 – $2,483.69 | 24 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $454.00 | $2,225.00 | $124.69 – $2,024.08 | 24 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $650.40 | $813.00 | $33.13 – $602.31 | 24 |
| Lumizyme injection HCPCS J0221 | $2,781.60 | $3,477.00 | $31.59 – $3,527.48 | 20 |
| Lung Function Test (Spirometry) CPT 94010 | $495.20 | $619.00 | $15.75 – $567.15 | 21 |
| Lung perfusion imaging CPT 78580 | $1,713.60 | $2,142.00 | $82.95 – $2,259.58 | 23 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $29,502.00 | $36,877.50 | $49.51 – $14,434.00 | 20 |
| Macroscopic exam arthropod CPT 87168 | $21.60 | $27.00 | $3.20 – $28.15 | 18 |
| Macroscopic exam parasite CPT 87169 | $18.40 | $23.00 | $3.23 – $28.15 | 18 |
| Magnesium CPT 83735 | $30.00 | $81.00 | $6.70 – $44.20 | 25 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $26.80 | $33.50 | $0.73 – $3.43 | 4 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $240.00 | $300.00 | $96.68 – $226.76 | 15 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $328.00 | $410.00 | $96.68 – $226.76 | 15 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $72.00 | $90.00 | $14.46 – $95.40 | 24 |
| Mayo aathr protein s free CPT 85306 | $107.20 | $134.00 | $8.94 – $101.09 | 24 |
| Mayo activated protein c resistance assay CPT 85307 | $108.00 | $135.00 | $2.50 – $101.09 | 24 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $95.20 | $119.00 | $28.93 – $174.30 | 18 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $61.60 | $77.00 | $11.09 – $97.57 | 18 |
| Mayo alpha 1 antitrypsin CPT 82103 | $56.00 | $70.00 | $13.44 – $88.62 | 24 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $505.60 | $632.00 | $91.22 – $748.72 | 18 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $457.60 | $572.00 | $5.00 – $311.64 | 20 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $4,825.60 | $6,032.00 | $65.76 – $5,242.16 | 18 |
| Mayo androstenedione CPT 82157 | $146.40 | $183.00 | $11.70 – $193.15 | 24 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $73.60 | $92.00 | $8.75 – $96.30 | 24 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $62.40 | $78.00 | $15.05 – $99.33 | 24 |
| Mayo avwpr vw factor activity CPT 85397 | $157.60 | $197.00 | $25.20 – $151.44 | 24 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $162.40 | $203.00 | $29.47 – $158.58 | 24 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $50.40 | $63.00 | $5.63 – $67.11 | 24 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $54.40 | $68.00 | $4.04 – $85.14 | 24 |
| Mayo brcmg brucella antibody igm CPT 86622 | $37.60 | $47.00 | $8.93 – $53.96 | 24 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $84.00 | $105.00 | $12.65 – $111.31 | 18 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $508.00 | $635.00 | $50.08 – $753.51 | 21 |
| Mayo ceruloplasmin CPT 82390 | $44.80 | $56.00 | $10.50 – $70.86 | 24 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $59.20 | $74.00 | $10.59 – $93.23 | 18 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $64.00 | $80.00 | $8.75 – $85.00 | 18 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $63.20 | $79.00 | $4.40 – $83.74 | 24 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $581.60 | $727.00 | $9.29 – $768.70 | 24 |
| Mayo chromium CPT 82495 | $101.60 | $127.00 | $6.30 – $83.76 | 24 |
| Mayo coccidioides antibody CPT 86635 | $47.20 | $59.00 | $3.75 – $75.69 | 24 |
| Mayo cocou cortisone urine CPT 82542 | $120.80 | $151.00 | $20.23 – $119.17 | 24 |
| Mayo cortisol free CPT 82530 | $69.60 | $87.00 | $16.71 – $110.31 | 24 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $50.40 | $63.00 | $8.75 – $79.99 | 24 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $55.20 | $69.00 | $13.25 – $87.44 | 24 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $104.80 | $131.00 | $22.05 – $166.75 | 24 |
| Mayo dihydrotestosterone CPT 82642 | $146.40 | $183.00 | $21.96 – $147.01 | 18 |
| Mayo estrone CPT 82679 | $104.00 | $130.00 | $13.65 – $164.72 | 24 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $68.00 | $85.00 | $13.65 – $107.83 | 24 |
| Mayo everolimus therapeutic drug level CPT 80169 | $57.60 | $72.00 | $13.73 – $84.64 | 24 |
| Mayo factor v CPT 85220 | $120.80 | $151.00 | $5.25 – $116.46 | 24 |
| Mayo factor viii vw factor antigen CPT 85246 | $153.60 | $192.00 | $22.94 – $151.44 | 24 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $153.60 | $192.00 | $22.94 – $151.44 | 24 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $158.40 | $198.00 | $2.50 – $151.44 | 24 |
| Mayo fbl culture fungi blood CPT 87103 | $84.80 | $106.00 | $13.08 – $84.50 | 24 |
| Mayo ffspg allergen clam igg CPT 86001 | $32.80 | $41.00 | $6.07 – $34.44 | 24 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $175.20 | $219.00 | $20.31 – $231.60 | 18 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $145.60 | $182.00 | $18.75 – $231.60 | 18 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $57.60 | $72.00 | $13.79 – $82.47 | 24 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $107.20 | $134.00 | $12.60 – $170.28 | 24 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $56.80 | $71.00 | $11.90 – $69.68 | 24 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $136.00 | $170.00 | $21.53 – $179.23 | 24 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $71.20 | $89.00 | $4.34 – $85.46 | 18 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $62.40 | $78.00 | $14.99 – $98.92 | 24 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $85.00 | $108.00 | $8.75 – $137.29 | 24 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $104.00 | $130.00 | $12.50 – $137.29 | 24 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $80.00 | $100.00 | $12.05 – $72.67 | 18 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $60.00 | $75.00 | $11.98 – $72.67 | 24 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $145.60 | $182.00 | $26.81 – $231.60 | 24 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $175.20 | $219.00 | $29.47 – $158.58 | 24 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $211.20 | $264.00 | $19.00 – $231.60 | 18 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $178.40 | $223.00 | $42.84 – $282.62 | 24 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $300.00 | $375.00 | $49.71 – $326.23 | 24 |
| Mayo infliximab therapeutic drug level CPT 80230 | $160.80 | $201.00 | $28.93 – $174.30 | 18 |
| Mayo inhab inhibin a CPT 86336 | $64.80 | $81.00 | $11.69 – $89.16 | 18 |
| Mayo insulin antibodies CPT 86337 | $88.80 | $111.00 | $8.99 – $92.05 | 24 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $95.20 | $119.00 | $22.77 – $122.51 | 24 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $95.20 | $119.00 | $20.33 – $122.51 | 18 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $55.20 | $69.00 | $13.25 – $81.75 | 24 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $53.60 | $67.00 | $11.55 – $84.46 | 24 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $77.60 | $97.00 | $4.04 – $102.18 | 24 |
| Mayo metanephrines plasma CPT 83835 | $70.40 | $88.00 | $13.65 – $111.80 | 24 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $91.20 | $114.00 | $12.05 – $83.15 | 24 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $76.80 | $96.00 | $15.46 – $83.15 | 23 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $60.80 | $76.00 | $8.31 – $96.03 | 24 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $77.60 | $97.00 | $16.07 – $90.34 | 24 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $770.40 | $963.00 | $28.99 – $836.94 | 15 |
| Mayo muramidase CPT 85549 | $98.40 | $123.00 | $17.26 – $95.76 | 24 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $76.80 | $96.00 | $13.80 – $83.15 | 17 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $89.60 | $112.00 | $18.05 – $111.31 | 24 |
| Mayo myoglobin CPT 83874 | $64.80 | $81.00 | $12.50 – $85.23 | 24 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $88.00 | $110.00 | $7.50 – $108.64 | 24 |
| Mayo oxalate 24 hour urine CPT 83945 | $60.00 | $75.00 | $13.65 – $84.96 | 24 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $75.20 | $94.00 | $3.75 – $99.19 | 24 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $60.00 | $75.00 | $12.05 – $79.54 | 24 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $116.80 | $146.00 | $17.98 – $114.33 | 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.