WellSpan Surgery & Rehabilitation Hospital
55 Monument Road, York PA 17403, PA · Wellspan · · NPI 1760787576
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 |
|---|---|---|---|---|
| 5% dextrose and 0.45% saline HCPCS S5010 | $75.60 | $94.50 | $28.21 – $28.21 | 1 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,440.80 | $1,801.00 | $105.41 – $1,588.35 | 22 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,272.00 | $1,590.00 | $71.88 – $602.31 | 24 |
| Abdominal Ultrasound (limited) CPT 76705 | $910.40 | $1,138.00 | $46.88 – $602.31 | 24 |
| Ablation cryo thigh/knee CPT 27599 | not published | not published | $970.00 – $1,165.00 | 6 |
| Ablation of upper extremity nerves rf CPT 64999 | not published | not published | $803.75 – $1,101.92 | 6 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $84.60 | $105.75 | $4.80 – $17.50 | 9 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $2.80 | $3.50 | $1.72 – $1.72 | 1 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $280.60 | $350.75 | $17.88 – $66.71 | 9 |
| Acetylcholine receptor modulating antibody CPT 86043 | $49.60 | $62.00 | $9.64 – $36.15 | 23 |
| Acute hepatitis panel CPT 80074 | $198.40 | $248.00 | $47.63 – $196.71 | 25 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $36.00 | $45.00 | $3.00 – $14.00 | 9 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $1,877.60 | $2,347.00 | $1.61 – $1.61 | 1 |
| Administration vaccine influenza virus HCPCS G0008 | $17.60 | $22.00 | $12.50 – $78.17 | 22 |
| Administration vaccine pneumococcal HCPCS G0009 | $17.60 | $22.00 | $12.50 – $78.17 | 22 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $217.40 | $271.75 | $53.08 – $339.71 | 10 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $163.20 | $204.00 | $10.62 – $169.86 | 25 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $24.00 | $30.00 | $5.78 – $27.20 | 26 |
| Albumin serum plasma or whole blood CPT 82040 | $20.80 | $26.00 | $3.65 – $20.44 | 25 |
| Alkaline phosphatase CPT 84075 | $21.60 | $27.00 | $5.18 – $21.66 | 25 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $5,063.89 | $6,329.86 | $300.86 – $436.70 | 3 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $1,223.20 | $1,529.00 | $111.38 – $640.22 | 25 |
| Alt/sgpt CPT 84460 | $22.40 | $28.00 | $5.30 – $24.48 | 25 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $55.00 | $68.75 | $2.14 – $8.16 | 9 |
| Ammonia CPT 82140 | $60.80 | $76.00 | $5.00 – $60.17 | 25 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $31.60 | $39.50 | $1.02 – $4.20 | 9 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $41.60 | $52.00 | $2.78 – $10.99 | 9 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $970.00 – $1,101.92 | 6 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $970.00 – $1,101.92 | 6 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $970.00 – $1,101.92 | 6 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $912.50 – $1,101.92 | 6 |
| Amylase CPT 82150 | $26.40 | $33.00 | $5.00 – $26.76 | 25 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $162.40 | $203.00 | $28.07 – $144.92 | 25 |
| An fluoro guide for cvp CPT 77001 | $824.80 | $1,031.00 | $57.83 – $205.26 | 7 |
| Ankle arthroscopy/surgery CPT 29891 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ankle arthroscopy/surgery CPT 29892 | not published | not published | $970.00 – $1,101.92 | 5 |
| Ankle arthroscopy/surgery CPT 29897 | not published | not published | $970.00 – $1,165.00 | 6 |
| Ankle X-ray CPT 73610 | $291.20 | $364.00 | $23.41 – $497.84 | 24 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $120.00 | $150.00 | $5.00 – $75.87 | 25 |
| Antibody id rbc panel CPT 86870 | $1,403.20 | $1,754.00 | $8.45 – $1,027.44 | 23 |
| Antibody screen rbc CPT 86850 | $208.80 | $261.00 | $8.45 – $90.51 | 25 |
| Antinuclear antibodies CPT 86038 | $49.60 | $62.00 | $12.09 – $51.00 | 25 |
| Antinuclear antibodies titer CPT 86039 | $46.40 | $58.00 | $11.16 – $51.00 | 25 |
| Application lower leg splint 29515 CPT 29515 | $375.20 | $469.00 | $43.75 – $267.31 | 22 |
| Application multi layer compression below knee (both sides) CPT 29581 | $236.80 | $296.00 | $31.59 – $267.31 | 22 |
| Application of forearm cast 29075 CPT 29075 | $458.40 | $573.00 | $56.88 – $449.93 | 22 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | not published | not published | $970.00 – $3,098.97 | 21 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | not published | not published | $885.42 – $1,549.49 | 21 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $189.60 | $237.00 | $11.22 – $56.80 | 22 |
| Appl unipln uni ext fixj sys CPT 20690 | not published | not published | $970.00 – $1,101.92 | 6 |
| Aquatic exercise - group charge CPT 97150 | $79.20 | $99.00 | $16.88 – $56.80 | 21 |
| Arterial blood draw/perc 36620 CPT 36620 | $1,788.00 | $2,235.00 | $59.48 – $161.77 | 7 |
| Arthrd ant ntrbdy cervical CPT 22551 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrd cmbn 1ntrspc lumbar CPT 22633 | not published | not published | $970.00 – $1,101.92 | 5 |
| Arthrd pst tq 1ntrspc lum CPT 22630 | not published | not published | $970.00 – $1,101.92 | 5 |
| Arthrd wrist complete wo grf CPT 25800 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrd wrist lmtd without b1 grf CPT 25820 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrd wrist with autograft CPT 25825 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrd wrst iliac/oth agrft CPT 25810 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $660.00 | $825.00 | $29.38 – $500.10 | 22 |
| Arthrodesis pantalar CPT 28705 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrodesis subtalar CPT 28725 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrodesis triple CPT 28715 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthro shoulder surgical distal claviculectomy incl/distal art surf left (rest method ii cah) CPT 29824 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrp ntrcrp/crp/mtcr ntrps CPT 25447 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrp ntrcrpl/crp/mtcrp ssp CPT 25448 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arthrt elbw capsl exc rls CPT 24006 | not published | not published | $970.00 – $1,101.92 | 6 |
| Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ast/sgot CPT 84450 | $21.60 | $27.00 | $5.18 – $24.24 | 25 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | not published | not published | $192.36 – $1,101.92 | 21 |
| Azathioprine 50 mg tablet HCPCS J7500 | $1.40 | $1.75 | $0.06 – $6.85 | 9 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $23.40 | $29.25 | $2.04 – $8.35 | 9 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | $4,612.80 | $5,766.00 | $213.71 – $2,447.20 | 25 |
| Baclofen eval charges CPT 97750 | $138.40 | $173.00 | $31.95 – $56.95 | 22 |
| Bacterial vaginosis pcr CPT 87801 | $292.00 | $365.00 | $38.80 – $289.93 | 25 |
| #bac vag cand-c. albicans naa CPT 87481 | $140.00 | $175.00 | $35.09 – $144.92 | 25 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $358.00 | $447.50 | $69.56 – $239.75 | 9 |
| Bilirubin direct CPT 82248 | $24.80 | $31.00 | $5.02 – $23.56 | 25 |
| Bilirubin total CPT 82247 | $10.00 | $31.00 | $5.02 – $23.56 | 25 |
| Binder abdominal lg 12 x 62-74 HCPCS L0625 | $80.80 | $101.00 | $36.56 – $117.71 | 17 |
| Biopsy of nail unit 11755 CPT 11755 | not published | not published | $94.08 – $1,191.98 | 21 |
| Blood Clotting (PT/INR) Test CPT 85610 | $15.00 | $34.00 | $4.00 – $17.72 | 26 |
| Blood Clotting (PTT) Test CPT 85730 | $30.00 | $40.00 | $6.01 – $25.50 | 25 |
| Blood Count (CBC) Test CPT 85025 | $15.00 | $55.00 | $6.00 – $32.09 | 26 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $15.00 | $45.00 | $6.47 – $26.72 | 26 |
| Blood Culture Test CPT 87040 | $42.40 | $53.00 | $10.32 – $47.60 | 25 |
| Blood draw capillary 36416 CPT 36416 | $19.20 | $24.00 | $26.52 – $26.52 | 1 |
| Blood gases o2 saturation direct measurement CPT 82805 | $331.20 | $414.00 | $38.86 – $325.32 | 25 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $36.00 | $65.00 | $18.05 – $65.75 | 25 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $15.00 | $22.00 | $3.47 – $18.09 | 25 |
| Blood split unit HCPCS P9011 | $768.00 | $960.00 | $141.80 – $248.15 | 16 |
| Blood typing abo CPT 86900 | $146.00 | $242.00 | $4.12 – $218.38 | 25 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $257.60 | $322.00 | $3.28 – $609.42 | 25 |
| Blood typing rh (d) CPT 86901 | $43.00 | $88.00 | $4.17 – $66.50 | 25 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $70.40 | $88.00 | $17.03 – $80.04 | 25 |
| Borrelia miyamotoi amp prb CPT 87478 | $162.40 | $203.00 | $28.07 – $144.92 | 25 |
| Brain MRI (with and without contrast) CPT 70553 | $701.50 | $2,646.00 | $336.25 – $2,106.92 | 24 |
| Brain MRI (without contrast) CPT 70551 | $455.00 | $2,225.00 | $234.00 – $1,342.45 | 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.