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 |
|---|---|---|---|---|
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $354.40 | $443.00 | $85.10 – $394.71 | 25 |
| Initiation & management bipap/cpap initial day CPT 94660 | $1,171.20 | $1,464.00 | $101.70 – $344.58 | 18 |
| Inj, bupivacaine liposome HCPCS J0666 | $1,345.20 | $1,681.50 | $1.73 – $661.01 | 25 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $71.20 | $89.00 | $5.56 – $20.37 | 24 |
| Injection for bladder x-ray CPT 51600 | $653.60 | $817.00 | $40.00 – $108.80 | 7 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | not published | not published | $627.50 – $1,101.92 | 6 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $147.20 | $184.00 | $16.26 – $78.17 | 22 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $147.20 | $184.00 | $38.77 – $356.93 | 22 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $113.60 | $142.00 | $15.88 – $120.58 | 22 |
| Injection treatment of nerve CPT 64610 | not published | not published | $970.00 – $1,101.92 | 6 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $99.40 | $124.25 | $7.00 – $25.60 | 2 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $114.60 | $143.25 | $7.91 – $25.41 | 9 |
| Inj multihance HCPCS A9577 | $384.00 | $480.00 | $1.74 – $6.37 | 7 |
| Inj vasopressin (am reg) 1 u HCPCS J2599 | $198.20 | $247.75 | $9.80 – $93.10 | 9 |
| Inj w/fluor eval cv device CPT 36598 | $567.20 | $709.00 | $197.20 – $356.93 | 17 |
| Insertion catheter bladder non indwelling CPT 51701 | $150.40 | $188.00 | $31.81 – $218.38 | 22 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $549.60 | $687.00 | $109.24 – $297.13 | 7 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,868.80 | $2,336.00 | $87.20 – $237.18 | 7 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $4,737.60 | $5,922.00 | $1,085.69 – $1,085.69 | 1 |
| Ins/rplc spi npg/rcvr pocket CPT 63685 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ins/rpl prph sac/gstr npg/r CPT 64590 | not published | not published | $970.00 – $1,101.92 | 6 |
| Insrt/redo neurostim 1 array CPT 61885 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $2,836.00 | $3,545.00 | $331.88 – $902.70 | 7 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $55.20 | $69.00 | $0.45 – $1.44 | 5 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $566.40 | $708.00 | $0.15 – $0.49 | 5 |
| Iron CPT 83540 | $20.00 | $33.00 | $6.47 – $28.73 | 26 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $222.00 | $277.50 | $22.90 – $84.00 | 9 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $154.40 | $193.00 | $15.36 – $78.17 | 22 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $448.00 | $560.00 | $49.13 – $356.93 | 22 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $26.80 | $33.50 | $0.30 – $1.75 | 25 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $772.80 | $966.00 | $61.25 – $602.31 | 24 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $970.00 – $1,212.50 | 6 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $970.00 – $1,101.92 | 6 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $970.00 – $1,101.92 | 6 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $970.00 – $1,101.92 | 6 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $970.00 – $1,165.00 | 6 |
| Knee X-ray CPT 73564 | $442.40 | $553.00 | $28.02 – $602.31 | 24 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $50.20 | $62.75 | $0.34 – $24.96 | 9 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $813.40 | $1,016.75 | $140.00 – $140.00 | 1 |
| Lactate dehydrogenase (ldh) CPT 83615 | $25.00 | $31.00 | $6.04 – $24.95 | 25 |
| Lactated ringers intravenous solution HCPCS J7120 | $30.40 | $38.00 | $2.41 – $8.05 | 8 |
| Lactic acid CPT 83605 | $75.20 | $94.00 | $8.00 – $47.78 | 25 |
| Lactoferrin fecal qualitative CPT 83630 | $82.40 | $103.00 | $12.31 – $81.36 | 25 |
| Lam facetec & foramot crv CPT 63045 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lam facetec & foramot lumbar CPT 63047 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lat retinacular release open CPT 27425 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lead capillary CPT 83655 | $50.40 | $63.00 | $10.00 – $50.01 | 25 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $869.60 | $1,087.00 | $142.75 – $498.64 | 22 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $19.40 | $24.25 | $2.00 – $8.75 | 9 |
| Levetiracetam therapeutic drug level CPT 80177 | $55.20 | $69.00 | $13.25 – $54.72 | 25 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $136.40 | $170.50 | $4.06 – $15.43 | 9 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $621.00 | $776.25 | $68.72 – $254.10 | 9 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $91.20 | $114.00 | $1.75 – $19.20 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $121.00 | $151.25 | $6.00 – $70.00 | 24 |
| Lipase CPT 83690 | $28.00 | $35.00 | $5.00 – $28.46 | 25 |
| Lipoprotein direct measurement ldl CPT 83721 | $44.00 | $55.00 | $10.50 – $43.37 | 25 |
| Lithium therapeutic drug level CPT 80178 | $27.20 | $34.00 | $6.61 – $27.30 | 25 |
| Liver Function Test CPT 80076 | $25.00 | $42.00 | $8.17 – $33.74 | 25 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $840.00 – $1,101.92 | 6 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $373.80 | $467.25 | $0.96 – $5.76 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $25.80 | $32.25 | $1.36 – $5.50 | 9 |
| Low back disk surgery CPT 63030 | not published | not published | $970.00 – $1,101.92 | 6 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $472.00 | $2,350.00 | $117.50 – $2,106.92 | 24 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $286.00 | $1,462.00 | $102.95 – $602.31 | 24 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $700.50 | $2,646.00 | $336.25 – $2,106.92 | 24 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $454.00 | $2,225.00 | $234.00 – $1,342.45 | 24 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $339.20 | $424.00 | $28.13 – $602.31 | 24 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $970.00 – $1,101.92 | 6 |
| Magnesium CPT 83735 | $30.00 | $46.00 | $6.70 – $31.00 | 26 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $38.60 | $48.25 | $0.96 – $3.43 | 9 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $228.80 | $286.00 | $64.45 – $218.38 | 17 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $328.00 | $410.00 | $124.79 – $218.38 | 16 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $12,294.32 | $15,367.90 | $19.97 – $75.25 | 5 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $162.40 | $203.00 | $28.07 – $144.92 | 25 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $48.80 | $61.00 | $11.98 – $49.48 | 25 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $178.40 | $223.00 | $42.84 – $176.93 | 25 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $76.80 | $96.00 | $14.72 – $55.20 | 23 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $60.80 | $76.00 | $7.91 – $60.09 | 25 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $76.80 | $96.00 | $18.40 – $55.20 | 17 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $73.60 | $92.00 | $18.05 – $74.55 | 25 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $88.00 | $110.00 | $18.20 – $87.60 | 25 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $57.60 | $72.00 | $13.00 – $56.83 | 25 |
| Mayo psaft prostate specific antigen free CPT 84154 | $45.00 | $96.00 | $18.39 – $75.95 | 25 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $76.80 | $96.00 | $9.20 – $75.99 | 20 |
| Mayo repu protein electrophoresis urine CPT 84166 | $45.00 | $93.00 | $17.83 – $73.64 | 25 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $17.60 | $22.00 | $4.00 – $17.64 | 25 |
| Mayo thyroglobulin CPT 84432 | $66.40 | $83.00 | $16.06 – $73.98 | 25 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $56.80 | $71.00 | $13.54 – $55.92 | 25 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $53.00 | $66.25 | $2.11 – $7.53 | 9 |
| Metabolic Blood Panel (Basic) CPT 80048 | $20.00 | $69.00 | $8.46 – $34.94 | 26 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $25.00 | $88.00 | $10.56 – $43.61 | 26 |
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.