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 |
|---|---|---|---|---|
| Sho arthrs srg rpr slap les CPT 29807 | not published | not published | $970.00 – $1,101.92 | 6 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | not published | not published | $970.00 – $1,165.00 | 6 |
| Shorten radius or ulna CPT 25390 | not published | not published | $970.00 – $1,101.92 | 6 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | not published | not published | $970.00 – $1,165.00 | 6 |
| Shoulder MRI (with and without contrast) CPT 73223 | $712.50 | $2,646.00 | $345.73 – $2,106.92 | 24 |
| Shoulder prosthesis removal CPT 23335 | not published | not published | $970.00 – $2,094.16 | 20 |
| Shoulder X-ray CPT 73030 | $330.40 | $413.00 | $20.63 – $497.84 | 24 |
| Sinus CT scan (without contrast) CPT 70486 | $295.00 | $1,462.00 | $96.88 – $602.31 | 24 |
| Sleeve fing rolyan med HCPCS L3933 | $316.00 | $395.00 | $184.76 – $399.56 | 17 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $22.40 | $28.00 | $3.00 – $22.26 | 25 |
| Smear gram stain CPT 87205 | $16.80 | $21.00 | $4.27 – $17.64 | 25 |
| Smear nasal eosinophil CPT 89190 | $24.00 | $30.00 | $5.79 – $23.91 | 25 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $24.80 | $31.00 | $4.50 – $24.74 | 25 |
| Sodium 24 hour urine CPT 84300 | $20.80 | $26.00 | $5.06 – $22.85 | 25 |
| Sodium serum/plasma/whole blood CPT 84295 | $25.60 | $32.00 | $4.81 – $22.10 | 25 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $1,007.60 | $1,259.50 | $1.04 – $372.00 | 3 |
| Sp bone algrft morsel add-on CPT 20930 | not published | not published | $970.00 – $1,101.92 | 6 |
| Spinal bone allograftstructural 20931 CPT 20931 | not published | not published | $970.00 – $1,101.92 | 6 |
| Spinal bone autograftlocal 20936 CPT 20936 | not published | not published | $970.00 – $1,101.92 | 5 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $552.80 | $691.00 | $471.24 – $850.00 | 17 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | not published | not published | $706.25 – $6,202.19 | 21 |
| Split blood or products CPT 86985 | $653.60 | $817.00 | $165.89 – $488.22 | 17 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $384.80 | $481.00 | $50.00 – $181.09 | 20 |
| Staph a dna amp probe CPT 87640 | $143.20 | $179.00 | $35.09 – $144.92 | 25 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $384.80 | $481.00 | $50.00 – $205.97 | 22 |
| Sterile water/saline, 10 ml HCPCS A4216 | $46.40 | $58.00 | $1.22 – $1.22 | 1 |
| St evaluate speech sound production CPT 92522 | $384.80 | $481.00 | $50.00 – $184.24 | 20 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $384.80 | $481.00 | $50.00 – $378.46 | 21 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $464.00 | $580.00 | $52.90 – $149.84 | 22 |
| St evaluation swallow function CPT 92610 | $404.80 | $506.00 | $50.00 – $140.75 | 22 |
| Stress test pulmonary CPT 94618 | $455.20 | $569.00 | $10.83 – $218.38 | 22 |
| St treatment speech individual CPT 92507 | $270.40 | $338.00 | $27.13 – $127.10 | 22 |
| St treatment swallow dysfunction/oral CPT 92526 | $296.80 | $371.00 | $50.00 – $162.32 | 22 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $55.00 | $68.75 | $132.09 – $524.03 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $102.40 | $128.00 | $1.88 – $85.11 | 25 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $102.40 | $128.00 | $6.25 – $129.10 | 25 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $204.80 | $256.00 | $8.13 – $167.80 | 25 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $218.40 | $273.00 | $11.25 – $283.77 | 25 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $1,124.00 | $1,405.00 | $14.38 – $1,142.81 | 25 |
| Susceptibility mic per plate CPT 87186 | $35.20 | $44.00 | $8.00 – $35.72 | 25 |
| T3 (triiodothyronine) free CPT 84481 | $70.40 | $88.00 | $16.94 – $79.59 | 25 |
| T3 (triiodothyronine) total CPT 84480 | $59.20 | $74.00 | $8.00 – $58.56 | 25 |
| T4 (thyroxine) free CPT 84439 | $35.00 | $46.00 | $8.00 – $37.25 | 26 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $9.00 | $11.25 | $5.49 – $19.01 | 9 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $4.40 | $5.50 | $0.16 – $0.67 | 9 |
| Tacrolimus therapeutic drug level CPT 80197 | $50.00 | $72.00 | $13.73 – $56.70 | 25 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $815.20 | $1,019.00 | $0.33 – $621.60 | 25 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $257.60 | $322.00 | $61.98 – $255.98 | 25 |
| T cells absolute cd 4 count CPT 86361 | $111.20 | $139.00 | $26.78 – $110.60 | 25 |
| T cells total count CPT 86359 | $157.60 | $197.00 | $37.73 – $170.00 | 25 |
| Telethx isodose plan cplx CPT 77307 | $4,604.80 | $5,756.00 | $124.95 – $741.03 | 22 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $627.50 – $1,101.92 | 6 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $238.40 | $298.00 | $57.50 – $174.84 | 17 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $43.00 | $53.75 | $3.63 – $12.32 | 9 |
| Thyroglobulin antibody CPT 86800 | $66.40 | $83.00 | $15.91 – $65.71 | 25 |
| Thyroid (TSH) Test CPT 84443 | $40.00 | $112.00 | $16.80 – $78.91 | 26 |
| Tissue exam koh skin/hair/nails CPT 87220 | $17.60 | $22.00 | $3.90 – $17.64 | 25 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $849.60 | $1,062.00 | $35.60 – $118.08 | 9 |
| Tomosynthesis breast screen bilateral CPT 77063 | $88.80 | $111.00 | $21.59 – $149.70 | 24 |
| Total hip arthroplasty CPT 27132 | not published | not published | $900.00 – $1,101.92 | 6 |
| Total Hip Replacement CPT 27130 | not published | not published | $970.00 – $1,101.92 | 6 |
| Total Knee Replacement CPT 27447 | not published | not published | $970.00 – $1,101.92 | 6 |
| Toxoplasma antibody igg CPT 86777 | $60.00 | $75.00 | $14.39 – $67.42 | 25 |
| Toxoplasma antibody igm CPT 86778 | $60.00 | $75.00 | $14.41 – $67.66 | 25 |
| Transferrin CPT 84466 | $50.00 | $65.00 | $12.76 – $57.80 | 26 |
| Transfusion blood/blood component(s) CPT 36430 | $1,714.40 | $2,143.00 | $34.80 – $740.65 | 22 |
| Transplant forearm tendon CPT 25310 | not published | not published | $970.00 – $1,940.00 | 6 |
| Treat ankle dislocation CPT 27842 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat ankle fracture CPT 28445 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat big toe fracture CPT 28505 | not published | not published | $970.00 – $1,608.75 | 6 |
| Treat elbow dislocation CPT 24615 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat finger fracture each CPT 26727 | not published | not published | $970.00 – $1,125.00 | 6 |
| Treat foot dislocation CPT 28606 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat hand dislocation CPT 26685 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat hand dislocation CPT 26686 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat heel fracture CPT 28415 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat humerus fracture CPT 24545 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat humerus fracture CPT 24546 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat humerus fracture CPT 24575 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat kneecap fracture CPT 27524 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat lower leg fracture CPT 27827 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat lower leg fracture CPT 27828 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat lower leg joint CPT 27829 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah) CPT 25608 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah) CPT 25609 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment fx radial distal open w/internal fixation left (restricted method ii cah) CPT 25607 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $239.20 | $299.00 | $101.70 – $344.58 | 17 |
| Treatment of ankle fracture CPT 27792 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment of ankle fracture CPT 27814 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment of ankle fracture CPT 27822 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment of ankle fracture CPT 27823 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment of fibula fracture CPT 27784 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treatment of tibia fracture CPT 27756 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat metacarpal fracture CPT 26608 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat metacarpal fracture CPT 26615 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat metatarsal fracture CPT 28485 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat radius fracture CPT 24665 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat radius fracture CPT 24666 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat thumb fracture CPT 26650 | not published | not published | $970.00 – $1,101.92 | 6 |
| Treat thumb fracture CPT 26665 | not published | not published | $970.00 – $1,101.92 | 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.