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 |
|---|---|---|---|---|
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $46.40 | $58.00 | $0.73 – $9.76 | 24 |
| Bundled special stain group 1 microorganisms CPT 88312 | $210.40 | $263.00 | $51.72 – $442.41 | 25 |
| Bundled special stain group 2 CPT 88313 | $144.00 | $180.00 | $51.01 – $320.78 | 25 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $29.00 | $36.25 | $1.00 – $3.50 | 9 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $3,341.00 | $4,176.25 | $484.97 – $5,355.00 | 17 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $108.20 | $135.25 | $64.00 – $64.00 | 1 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $184.20 | $230.25 | $7.80 – $51.20 | 9 |
| Calcium ionized CPT 82330 | $55.20 | $69.00 | $8.85 – $56.50 | 25 |
| Calcium total CPT 82310 | $21.60 | $27.00 | $5.16 – $24.17 | 25 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | not published | not published | $970.00 – $1,183.75 | 6 |
| Carbamazepine total therapeutic drug level CPT 80156 | $60.80 | $76.00 | $14.57 – $62.90 | 25 |
| Carbon dioxide CPT 82374 | $19.20 | $24.00 | $4.88 – $22.85 | 25 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $1,321.60 | $1,652.00 | $149.17 – $502.72 | 22 |
| Carpal Tunnel Release Surgery CPT 64721 | not published | not published | $830.00 – $1,101.92 | 6 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $48.60 | $60.75 | $1.60 – $5.81 | 9 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $66.80 | $83.50 | $2.44 – $8.40 | 9 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $1,675.20 | $2,094.00 | $4.99 – $837.90 | 25 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $45.80 | $57.25 | $3.14 – $11.20 | 9 |
| Ceftazidime and avibactam HCPCS J0714 | $2,742.40 | $3,428.00 | $123.50 – $1,407.00 | 25 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $45.20 | $56.50 | $1.72 – $6.86 | 9 |
| Cell count body fluid CPT 89050 | $19.20 | $24.00 | $4.50 – $19.49 | 25 |
| Cell count w differential body fluid CPT 89051 | $23.20 | $29.00 | $5.60 – $23.80 | 25 |
| Change g-tube to g-j perc CPT 49446 | $2,888.00 | $3,610.00 | $157.30 – $427.86 | 7 |
| Change of windpipe airway 31502 CPT 31502 | $567.20 | $709.00 | $116.11 – $393.42 | 17 |
| Chest CT scan (with contrast) CPT 71260 | $470.00 | $2,362.00 | $109.38 – $1,006.60 | 24 |
| Chest CT scan (without contrast) CPT 71250 | $285.00 | $1,462.00 | $102.95 – $602.31 | 24 |
| Chest X-ray CPT 71046 | $322.40 | $403.00 | $18.57 – $497.84 | 24 |
| Chest X-ray (single view) CPT 71045 | $292.80 | $366.00 | $10.14 – $497.84 | 24 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $236.80 | $296.00 | $70.01 – $1,006.60 | 23 |
| Chloride CPT 82435 | $18.40 | $23.00 | $4.60 – $21.56 | 25 |
| Chloride 24 hour urine CPT 82436 | $24.00 | $30.00 | $5.75 – $23.75 | 25 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $243.20 | $304.00 | $39.45 – $129.22 | 9 |
| Cholesterol (Lipid) Test CPT 80061 | $40.00 | $100.00 | $13.39 – $55.30 | 26 |
| Clearance of airways CPT 31720 | $295.20 | $369.00 | $41.25 – $344.58 | 22 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $145.00 | $181.25 | $1.73 – $5.64 | 9 |
| Cllr miami j sm HCPCS L0174 | $188.66 | $235.83 | $309.48 – $541.59 | 17 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $540.00 | $675.00 | $123.75 – $406.39 | 22 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $747.20 | $934.00 | $60.00 – $406.39 | 22 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $970.00 – $1,101.92 | 6 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $3,321.60 | $4,152.00 | $232.22 – $805.80 | 22 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $777.60 | $972.00 | $86.88 – $406.39 | 22 |
| Cltx post ankle fx w/mnpj CPT 27768 | not published | not published | $970.00 – $1,101.92 | 6 |
| Collar cerv patriot adlt HCPCS L0150 | $164.00 | $205.00 | $135.08 – $306.92 | 17 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $100.00 | $130.00 | $124.79 – $218.38 | 16 |
| Collection of venous blood by venipuncture CPT 36415 | $5.00 | $15.00 | $9.09 – $26.49 | 19 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $653.60 | $817.00 | $21.00 – $488.22 | 23 |
| Compatibility test each unit electronic CPT 86923 | $653.60 | $817.00 | $21.00 – $488.22 | 23 |
| Compatibility test each unit immediate spin technique CPT 86920 | $653.60 | $817.00 | $21.00 – $488.22 | 23 |
| Complement antigen each component c3 CPT 86160 | $49.60 | $62.00 | $12.00 – $56.41 | 25 |
| Concentration infection agents any type CPT 87015 | $27.20 | $34.00 | $6.68 – $27.59 | 25 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $463.20 | $579.00 | $9.38 – $488.22 | 25 |
| Consultation/report referred slides prepared elsewhere CPT 88321 | $143.20 | $179.00 | $19.63 – $334.90 | 21 |
| Contrast baths charges CPT 97034 | $84.80 | $106.00 | $13.09 – $56.80 | 22 |
| Control of nosebleed ant comp 30903 CPT 30903 | $384.00 | $480.00 | $50.63 – $218.38 | 22 |
| Coombs direct CPT 86880 | $238.40 | $298.00 | $7.43 – $100.63 | 25 |
| Cor hlx vlgs prx phlx osteot CPT 28298 | not published | not published | $970.00 – $1,715.00 | 6 |
| Correct finger deformity CPT 26567 | not published | not published | $970.00 – $1,101.92 | 6 |
| Correct metacarpal flaw CPT 26565 | not published | not published | $970.00 – $1,101.92 | 6 |
| Corrj halux rigdus without implt CPT 28289 | not published | not published | $970.00 – $1,101.92 | 6 |
| Cortisol acth stimulation test - sendout CPT 80400 | $136.00 | $170.00 | $32.62 – $153.20 | 25 |
| Cortisol total am CPT 82533 | $68.00 | $85.00 | $12.00 – $67.32 | 25 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $187.60 | $234.50 | $25.37 – $116.90 | 9 |
| Co-treatment - group 15 mins, st CPT 92508 | $190.40 | $238.00 | $22.67 – $56.80 | 22 |
| Counseling smoke cess interm >10mins CPT 99407 | $60.00 | $75.00 | $24.16 – $65.72 | 22 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $58.40 | $73.00 | $40.19 – $70.33 | 16 |
| Cptr-asst dir ms px CPT 20985 | not published | not published | $970.00 – $1,101.92 | 6 |
| C-reactive protein CPT 86140 | $20.00 | $27.00 | $3.00 – $21.39 | 26 |
| Creatine kinase CPT 82550 | $27.20 | $34.00 | $6.51 – $26.89 | 25 |
| Creatine kinase mb CPT 82553 | $47.20 | $59.00 | $10.08 – $47.70 | 25 |
| Creatinine CPT 82565 | $15.00 | $27.00 | $5.12 – $21.79 | 25 |
| Creatinine 24 hour urine CPT 82570 | $20.00 | $27.00 | $5.18 – $24.31 | 26 |
| Creatinine clearance urine CPT 82575 | $39.20 | $49.00 | $9.46 – $39.07 | 25 |
| Crnec exc tum/bone les skull CPT 61500 | not published | not published | $970.00 – $2,149.25 | 20 |
| Crystal identification light microscopy CPT 89060 | $30.40 | $38.00 | $7.33 – $30.27 | 25 |
| CT 3d report other modality w/workstation CPT 76377 | $691.20 | $864.00 | $18.82 – $18.82 | 1 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $528.50 | $2,763.00 | $172.34 – $1,006.60 | 24 |
| Cta neck without &/or w/contrast CPT 70498 | $538.00 | $2,763.00 | $172.34 – $1,006.60 | 24 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $517.50 | $3,682.00 | $345.73 – $2,106.92 | 24 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $531.50 | $2,649.00 | $172.34 – $1,040.30 | 24 |
| CT Angiogram of the Head CPT 70496 | $538.00 | $2,763.00 | $172.34 – $1,006.60 | 24 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $475.50 | $2,362.00 | $103.13 – $1,006.60 | 24 |
| CT lower extremity without contrast (both sides) CPT 73700 | $285.50 | $1,462.00 | $98.80 – $602.31 | 24 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $525.00 | $3,065.00 | $318.38 – $2,106.92 | 24 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $437.50 | $2,896.00 | $240.91 – $2,106.92 | 24 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $242.50 | $2,322.00 | $126.34 – $1,342.45 | 24 |
| CT thoracic spine without contrast CPT 72128 | $286.50 | $1,462.00 | $102.95 – $602.31 | 24 |
| CT upper extremity without contrast (both sides) CPT 73200 | $285.50 | $1,462.00 | $98.80 – $602.31 | 24 |
| Culture aerobic additional method definitive id each CPT 87077 | $33.60 | $42.00 | $7.10 – $33.37 | 25 |
| Culture afb any source CPT 87116 | $44.00 | $55.00 | $7.50 – $44.60 | 25 |
| Culture anaerobic additional method definitive id each CPT 87076 | $32.80 | $41.00 | $8.08 – $33.37 | 25 |
| Culture anaerobic except blood CPT 87075 | $38.40 | $48.00 | $9.47 – $39.11 | 25 |
| Culture body fluid CPT 87070 | $35.20 | $44.00 | $6.90 – $35.60 | 25 |
| Culture fungi definitive id mold CPT 87107 | $44.00 | $55.00 | $10.32 – $42.62 | 25 |
| Culture fungi definitive id yeast CPT 87106 | $42.40 | $53.00 | $9.70 – $42.62 | 25 |
| Culture fungi other (except blood) CPT 87102 | $34.40 | $43.00 | $8.41 – $34.73 | 25 |
| Culture fungi skin/hair/nail CPT 87101 | $32.80 | $41.00 | $7.71 – $32.98 | 25 |
| Culture quantitative aerobic other source CPT 87071 | $40.00 | $50.00 | $5.22 – $40.85 | 25 |
| Culture typing immunologic CPT 87147 | $21.60 | $27.00 | $3.00 – $21.39 | 25 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $872.00 | $1,090.00 | $218.06 – $900.59 | 19 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $143.20 | $179.00 | $35.09 – $144.92 | 25 |
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.