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 |
|---|---|---|---|---|
| Metabolic panel ionized ca CPT 80047 | $89.60 | $112.00 | $11.91 – $56.70 | 25 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $4.60 | $5.75 | $0.19 – $0.70 | 9 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $849.00 | $1,061.25 | $10.29 – $1,257.60 | 19 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $8.40 | $10.50 | $0.11 – $0.84 | 8 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $97.60 | $122.00 | $4.76 – $15.40 | 24 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $128.60 | $160.75 | $1.68 – $7.00 | 24 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $30.40 | $38.00 | $1.03 – $3.96 | 9 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $44.40 | $55.50 | $0.62 – $2.08 | 8 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $36.40 | $45.50 | $1.35 – $5.25 | 9 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $211.40 | $264.25 | $25.60 – $99.20 | 9 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $48.20 | $60.25 | $0.31 – $1.02 | 9 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $311.40 | $389.25 | $5.82 – $21.98 | 9 |
| Mnpj anes sho jt fixj aprats CPT 23700 | not published | not published | $708.75 – $1,101.92 | 6 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $143.20 | $179.00 | $2.18 – $16.21 | 9 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $35.00 | $43.75 | $8.44 – $26.59 | 9 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $2,124.40 | $2,655.50 | $11.20 – $36.65 | 9 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $712.50 | $2,646.00 | $336.25 – $2,106.92 | 24 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $463.50 | $2,225.00 | $234.00 – $1,342.45 | 24 |
| Muscle-skin graft leg CPT 15738 | not published | not published | $970.00 – $6,202.19 | 21 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $3,104.20 | $3,880.25 | $0.16 – $0.53 | 9 |
| Mycophenolic acid HCPCS J7518 | $10.00 | $12.50 | $0.34 – $1.33 | 9 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $47.20 | $59.00 | $11.53 – $47.62 | 19 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $81.20 | $101.50 | $5.40 – $77.00 | 9 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $147.20 | $184.00 | $0.28 – $0.91 | 8 |
| Natriuretic peptide CPT 83880 | $80.00 | $240.00 | $37.94 – $162.14 | 25 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $282.00 | $1,462.00 | $102.95 – $602.31 | 24 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $701.50 | $2,646.00 | $336.25 – $2,106.92 | 24 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $454.00 | $2,225.00 | $234.00 – $1,342.45 | 24 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $79.80 | $99.75 | $57.40 – $101.76 | 2 |
| Nerve repair w/allograft CPT 64910 | not published | not published | $970.00 – $2,122.50 | 6 |
| Neuroplasty digital 1/both same digit CPT 64702 | not published | not published | $970.00 – $1,101.92 | 6 |
| Njx aa&/strd sc nrv nfs img CPT 64446 | not published | not published | $970.00 – $1,101.92 | 6 |
| No pt prsnt train initial 30 HCPCS G0541 | $201.60 | $252.00 | $43.74 – $76.55 | 16 |
| Nr lnr acclrtr tx max 5 sessions CPT 77373 | $4,364.80 | $5,456.00 | $1,250.00 – $3,400.00 | 22 |
| Nrv rpr w/nrv algrft 1st CPT 64912 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | $2,984.80 | $3,731.00 | $355.61 – $980.02 | 22 |
| Observation direct referral from physician office for admission HCPCS G0379 | $159.20 | $199.00 | $593.53 – $1,038.68 | 16 |
| Observation per hour HCPCS G0378 | $487.20 | $609.00 | $1,220.68 – $3,417.89 | 4 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $34.20 | $42.75 | $2.44 – $8.26 | 9 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $146.60 | $183.25 | $17.44 – $65.10 | 9 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $19.80 | $24.75 | $0.36 – $10.78 | 9 |
| Opn impltj crnl nrv nea&pg CPT 64568 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx medial ankle fx CPT 27766 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $970.00 – $1,101.92 | 6 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $970.00 – $1,502.50 | 6 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $136.80 | $171.00 | $289.86 – $599.56 | 17 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $469.60 | $587.00 | $400.22 – $700.39 | 17 |
| Oscillation chest wall mechanical per session CPT 94669 | $193.60 | $242.00 | $196.90 – $344.58 | 16 |
| Osmolality blood CPT 83930 | $27.20 | $34.00 | $3.00 – $27.30 | 25 |
| Osmolality urine CPT 83935 | $28.00 | $35.00 | $3.00 – $28.17 | 25 |
| Ot evaluation high complexity patient/family CPT 97167 | $312.80 | $391.00 | $77.16 – $209.88 | 22 |
| Ot evaluation low complexity patient/family CPT 97165 | $335.20 | $419.00 | $77.16 – $209.88 | 22 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $312.80 | $391.00 | $77.16 – $209.88 | 22 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $76.00 | $95.00 | $47.61 – $83.32 | 21 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $118.40 | $148.00 | $43.76 – $76.58 | 21 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $118.40 | $148.00 | $26.20 – $71.50 | 22 |
| Ot re-evaluation patient/family CPT 97168 | $206.40 | $258.00 | $50.86 – $138.35 | 22 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $118.40 | $148.00 | $33.12 – $57.96 | 22 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $118.40 | $148.00 | $20.32 – $136.00 | 22 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $118.40 | $148.00 | $20.97 – $64.77 | 19 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $118.40 | $148.00 | $27.75 – $56.80 | 22 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $118.40 | $148.00 | $30.87 – $56.95 | 22 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $118.40 | $148.00 | $15.38 – $53.81 | 21 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $106.60 | $133.25 | $9.64 – $48.58 | 9 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $25.80 | $32.25 | $16.24 – $30.53 | 2 |
| Parathormone (pth) intact CPT 83970 | $168.00 | $210.00 | $41.28 – $170.49 | 25 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $970.00 – $1,101.92 | 6 |
| Partial removal finger bone CPT 26236 | not published | not published | $970.00 – $1,101.92 | 6 |
| Partial removal of hand bone CPT 26230 | not published | not published | $970.00 – $1,101.92 | 6 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $8,513.41 | $10,641.76 | $2.54 – $8.93 | 5 |
| Part removal of metatarsal CPT 28110 | not published | not published | $970.00 – $1,130.00 | 6 |
| Passy muir valve metal trach HCPCS L8501 | $136.80 | $171.00 | $144.99 – $255.00 | 17 |
| Pelvic CT scan (without contrast) CPT 72192 | $281.00 | $1,462.00 | $84.38 – $602.31 | 24 |
| Pelvic MRI (without contrast) CPT 72195 | $455.50 | $2,225.00 | $234.00 – $1,342.45 | 24 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $995.20 | $1,244.00 | $69.11 – $293.16 | 8 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $970.00 – $1,101.92 | 6 |
| Ph body fluid CPT 83986 | $15.20 | $19.00 | $2.00 – $14.79 | 25 |
| Phenobarbital therapeutic drug level CPT 80184 | $64.00 | $80.00 | $15.30 – $63.19 | 25 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $39.00 | $48.75 | $1.00 – $17.50 | 9 |
| Phenytoin total therapeutic drug level CPT 80185 | $55.20 | $69.00 | $13.00 – $54.72 | 25 |
| Phosphorus CPT 84100 | $15.00 | $24.00 | $4.74 – $22.27 | 25 |
| Pin finger dislocation CPT 26776 | not published | not published | $970.00 – $1,101.92 | 6 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $127.20 | $159.00 | $3.21 – $11.76 | 9 |
| Place gastrostomy tube perc CPT 49440 | $3,048.80 | $3,811.00 | $220.67 – $600.24 | 7 |
| Platelet aggregation each agent teg CPT 85576 | $143.20 | $179.00 | $24.91 – $102.88 | 25 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $3,188.00 | $3,985.00 | $30.00 – $1,182.41 | 22 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $106.40 | $133.00 | $26.07 – $107.67 | 25 |
| Potassium 24 hour urine CPT 84133 | $20.00 | $25.00 | $4.73 – $20.20 | 25 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $121.00 | $151.25 | $0.11 – $3.68 | 9 |
| Potassium serum/plasma/whole blood CPT 84132 | $25.60 | $32.00 | $4.76 – $21.56 | 25 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $10,656.00 | $13,320.00 | $1,385.26 – $1,385.26 | 1 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | not published | not published | $657.50 – $1,101.92 | 6 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | not published | not published | $970.00 – $1,101.92 | 6 |
| Pr correction hammertoe CPT 28285 | not published | not published | $970.00 – $1,183.75 | 6 |
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.