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 |
|---|---|---|---|---|
| Treat toe dislocation CPT 28636 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat toe fracture CPT 28525 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat ulnar fracture CPT 24685 | not published | not published | $970.00 – $1,101.92 | 6 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $134.00 | $167.50 | $3.38 – $12.18 | 9 |
| Triglycerides CPT 84478 | $24.00 | $30.00 | $5.74 – $24.45 | 25 |
| Troponin quantitative CPT 84484 | $61.60 | $77.00 | $9.87 – $51.50 | 25 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | not published | not published | $970.00 – $1,101.92 | 6 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | not published | not published | $970.00 – $1,101.92 | 6 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $970.00 – $1,101.92 | 6 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | not published | not published | $970.00 – $1,125.00 | 6 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $492.00 | $615.00 | $51.17 – $497.84 | 24 |
| Ultrasound chest CPT 76604 | $480.00 | $600.00 | $58.65 – $602.31 | 24 |
| Ultrasound guidance for vascular access CPT 76937 | $504.00 | $630.00 | $15.77 – $86.80 | 7 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $780.80 | $976.00 | $54.00 – $244.80 | 7 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $468.00 | $585.00 | $9.82 – $602.31 | 24 |
| Ultrasound scrotum and contents CPT 76870 | $617.60 | $772.00 | $55.00 – $602.31 | 24 |
| Unlisted CT procedure CPT 76497 | $942.40 | $1,178.00 | $85.24 – $497.84 | 17 |
| Unlisted mr procedure CPT 76498 | $400.00 | $500.00 | $85.24 – $497.84 | 17 |
| Unlisted px arthroscopy CPT 29999 | not published | not published | $970.00 – $1,101.92 | 6 |
| Unlisted px foot/toes CPT 28899 | not published | not published | $970.00 – $1,101.92 | 6 |
| Unlisted px hands/fingers CPT 26989 | not published | not published | $232.22 – $1,101.92 | 20 |
| Unlisted px leg/ankle CPT 27899 | not published | not published | $232.22 – $1,101.92 | 20 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $684.00 | $855.00 | $349.86 – $1,185.42 | 17 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $454.00 | $2,225.00 | $234.00 – $1,342.45 | 24 |
| Urea nitrogen CPT 84520 | $16.00 | $20.00 | $3.95 – $18.50 | 25 |
| Urea nitrogen 24 hour urine CPT 84540 | $23.20 | $29.00 | $5.56 – $22.96 | 19 |
| Uric acid blood CPT 84550 | $15.00 | $24.00 | $4.52 – $21.22 | 25 |
| Urinalysis (with microscopy) CPT 81001 | $10.00 | $20.00 | $3.00 – $13.09 | 26 |
| Urinalysis (without microscopy) CPT 81003 | $10.00 | $11.00 | $2.25 – $10.54 | 25 |
| Urine Culture Test CPT 87086 | $25.00 | $41.00 | $8.00 – $33.33 | 26 |
| Urine pregnancy test CPT 81025 | $35.20 | $44.00 | $4.00 – $35.56 | 25 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | $531.80 | $664.75 | $12.50 – $287.56 | 7 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $119.60 | $149.50 | $12.50 – $77.35 | 9 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | $1,742.00 | $2,177.50 | $12.50 – $1,076.43 | 9 |
| Valproic acid total therapeutic drug level CPT 80164 | $56.80 | $71.00 | $13.54 – $63.65 | 25 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $1,396.00 | $1,745.00 | $1.50 – $4.80 | 8 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $179.40 | $224.25 | $14.38 – $48.00 | 8 |
| Vancomycin peak therapeutic drug level CPT 80202 | $55.20 | $69.00 | $13.54 – $63.65 | 25 |
| Vasc graft into carpal bone CPT 25430 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ven blood coll snf/hha HCPCS G0471 | $20.00 | $25.00 | $11.09 – $19.41 | 16 |
| Vitamin b-12 CPT 82607 | $40.00 | $77.00 | $13.00 – $62.28 | 26 |
| Vitamin D Test CPT 82306 | $100.00 | $151.00 | $29.60 – $139.09 | 26 |
| Warde 1015200 kappa light chain free CPT 83521 | $71.20 | $89.00 | $13.82 – $71.33 | 25 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $37.60 | $47.00 | $7.50 – $36.76 | 25 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $75.20 | $94.00 | $17.98 – $74.26 | 25 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $76.80 | $96.00 | $14.72 – $55.20 | 23 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $33.60 | $42.00 | $4.05 – $33.45 | 20 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $160.80 | $201.00 | $38.62 – $159.50 | 25 |
| Warde aldolase CPT 82085 | $40.80 | $51.00 | $9.00 – $40.10 | 25 |
| Warde collagen cross links c-telopeptide CPT 82523 | $77.60 | $97.00 | $9.34 – $77.15 | 20 |
| Warde folic acid rbc CPT 82747 | $73.60 | $92.00 | $17.65 – $76.67 | 25 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $40.80 | $51.00 | $8.00 – $40.06 | 25 |
| Warde immunofixation electrophoresis urine CPT 86335 | $122.40 | $153.00 | $29.35 – $121.22 | 25 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $93.60 | $117.00 | $18.38 – $94.87 | 25 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $160.80 | $201.00 | $38.50 – $182.85 | 25 |
| Warde zinc CPT 84630 | $47.20 | $59.00 | $11.39 – $47.04 | 25 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $137.60 | $172.00 | $50.00 – $676.87 | 21 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $296.80 | $371.00 | $50.00 – $676.87 | 21 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $137.60 | $172.00 | $50.00 – $336.63 | 21 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $296.80 | $371.00 | $50.00 – $676.87 | 21 |
| Wrist arthroscopy/surgery CPT 29844 | not published | not published | $970.00 – $1,101.92 | 6 |
| Wrist arthroscopy/surgery CPT 29845 | not published | not published | $970.00 – $1,101.92 | 6 |
| Wrist arthroscopy/surgery CPT 29846 | not published | not published | $970.00 – $1,101.92 | 6 |
| Wrist arthroscopy/surgery CPT 29847 | not published | not published | $970.00 – $1,101.92 | 6 |
| Wrist endoscopy/surgery CPT 29848 | not published | not published | $970.00 – $1,940.00 | 6 |
| Wrist X-ray CPT 73110 | $315.20 | $394.00 | $14.38 – $497.84 | 24 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | not published | not published | $970.00 – $3,098.97 | 21 |
| X-ray abdomen 1 view CPT 74018 | $292.80 | $366.00 | $17.22 – $497.84 | 24 |
| X-ray abdomen 2 views CPT 74019 | $482.40 | $603.00 | $20.60 – $602.31 | 24 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $583.20 | $729.00 | $30.00 – $602.31 | 24 |
| X-ray ankle 2 views (both sides) CPT 73600 | $248.80 | $311.00 | $14.38 – $497.84 | 24 |
| X-ray bone length studies CPT 77073 | $356.00 | $445.00 | $26.17 – $602.31 | 23 |
| X-ray cervical spine 2-3 views CPT 72040 | $155.20 | $194.00 | $20.63 – $497.84 | 24 |
| X-ray cervical spine 4-5 views CPT 72050 | $436.00 | $545.00 | $33.13 – $602.31 | 24 |
| X-ray clavicle complete (both sides) CPT 73000 | $292.00 | $365.00 | $14.38 – $497.84 | 24 |
| X-ray elbow 2 views (both sides) CPT 73070 | $257.60 | $322.00 | $14.38 – $497.84 | 24 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $297.60 | $372.00 | $14.38 – $497.84 | 24 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $236.80 | $296.00 | $28.13 – $1,006.60 | 23 |
| X-ray exam of femur 1 CPT 73551 | $300.00 | $375.00 | $17.98 – $497.84 | 24 |
| X-ray femur >=2 views (both sides) CPT 73552 | $312.00 | $390.00 | $21.32 – $497.84 | 24 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $231.20 | $289.00 | $11.25 – $497.84 | 24 |
| X-ray foot 2 views (both sides) CPT 73620 | $221.60 | $277.00 | $12.50 – $497.84 | 24 |
| X-ray forearm 2 views (both sides) CPT 73090 | $259.20 | $324.00 | $14.38 – $497.84 | 24 |
| X-ray hand 2 views (both sides) CPT 73120 | $280.00 | $350.00 | $12.50 – $602.31 | 24 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $236.00 | $295.00 | $14.38 – $497.84 | 24 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $434.40 | $543.00 | $34.60 – $602.31 | 24 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $474.40 | $593.00 | $37.61 – $602.31 | 24 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $274.40 | $343.00 | $18.65 – $497.84 | 24 |
| X-ray humerus >= 2 views left CPT 73060 | $266.40 | $333.00 | $14.38 – $497.84 | 24 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $262.40 | $328.00 | $20.63 – $497.84 | 24 |
| X-ray knee 3 views (both sides) CPT 73562 | $333.60 | $417.00 | $20.63 – $497.84 | 24 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $526.40 | $658.00 | $28.13 – $602.31 | 24 |
| X-ray nasal bones complete > 3 views CPT 70160 | $289.60 | $362.00 | $14.38 – $497.84 | 24 |
| X-ray pelvis 1-2 views CPT 72170 | $294.40 | $368.00 | $12.50 – $602.31 | 24 |
| X-ray pelvis complete > 3 views CPT 72190 | $334.40 | $418.00 | $26.25 – $602.31 | 24 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $599.20 | $749.00 | $28.13 – $2,106.92 | 23 |
| X-ray ribs 2 views left CPT 71100 | $352.80 | $441.00 | $20.63 – $497.84 | 24 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $417.60 | $522.00 | $20.63 – $602.31 | 24 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $501.60 | $627.00 | $20.63 – $602.31 | 24 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $308.00 | $385.00 | $20.63 – $497.84 | 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.