| Procedure | Wellspan Waynesboro Hospital | Jefferson Medical Center | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $158 | $57 | $51 |
| Abdominal fluid drain (paracentesis) | $2,605 | $691 | $284 |
| Abdominal ultrasound | $1,109 | $241 | $100 |
| Abdominal ultrasound (complete) | $1,272 | $241 | $114 |
| Abdominal ultrasound (limited) | $946 | $236 | $86 |
| Abscess drainage (complex or multiple) | $866 | $390 | $220 |
| Abscess drainage (simple) | $630 | $153 | $129 |
| Abscess incision and drainage | $748 | $193 | $174 |
| Albumin blood test | $21 | $19 | $5 |
| Aldosterone test | $204 | $24 | $41 |
| Alkaline phosphatase test | $26 | $25 | $5 |
| Alpha-fetoprotein (AFP) test | $70 | $49 | $17 |
| ALT liver enzyme test | $26 | $45 | $5 |
| Ammonia blood test | $61 | $30 | $15 |
| Amylase test | $26 | $143 | $6 |
| Antinuclear antibody (ANA) test | $50 | $66 | $12 |
| Arterial blood gas (ABG) | $130 | $100 | $26 |
| AST liver enzyme test | $22 | $49 | $5 |
| Barium swallow study | $535 | $366 | $107 |
| Bartholin cyst removal | $702 | $197 | $182 |
| Basic metabolic panel | $20 | $39 | $8 |
| Bilirubin blood test | $10 | $25 | $5 |
| Blood clotting test (PT/INR) | $15 | $43 | $4 |
| Blood crossmatch | $654 | $140 | — |
| Blood glucose test | $18 | $24 | $5 |
| Blood transfusion | $1,714 | $646 | $47 |
| Blood type and screen | $209 | $65 | $10 |
| Blood type test | $95 | $25 | $3 |
| Blood type test (ABO group) | $146 | $27 | $3 |
| Blood type test (Rh/D antigen) | $43 | $25 | $3 |
| BNP (heart failure) test | $80 | $73 | $39 |
| Bone density scan (DEXA) | $237 | $168 | $39 |
| Bone scan (nuclear) | $1,714 | $352 | $259 |
| Breast biopsy | $4,006 | $584 | $478 |
| Breast ultrasound | $516 | $154 | $92 |
| Breast ultrasound (complete) | $541 | $154 | $100 |
| Breast ultrasound (limited) | $492 | $154 | $84 |
| Breathing tube insertion (intubation) | $878 | $481 | $133 |
| Burn dressing and debridement (small) | $457 | $201 | $93 |
| Burn treatment | $457 | $116 | $129 |
| C-reactive protein (CRP) | $20 | $41 | $5 |
| CA 19-9 tumor marker test | $85 | $91 | $21 |
| CA-125 ovarian marker test | $85 | $91 | $21 |
| Calcium blood test | $26 | $21 | $5 |
| Cardiac stress test | $1,102 | $78 | $39 |
| Cardioversion | $1,271 | $580 | $155 |
| CEA tumor marker test | $65 | $140 | $19 |
| Celiac disease test | $58 | $34 | $12 |
| Chemotherapy infusion | $539 | $310 | $81 |
| Chemotherapy infusion (each additional) | $283 | $149 | $28 |
| Chemotherapy infusion (first hour) | $795 | $471 | $133 |
| Chest fluid drain (thoracentesis) | $2,428 | $513 | $311 |
| Chest tube insertion | $2,181 | $836 | $143 |
| Chest X-ray | $369 | $93 | $37 |
| Chest X-ray (1 view) | $293 | $92 | $25 |
| Chest X-ray (2 views) | $322 | $93 | $33 |
| CK-MB heart enzyme test | $58 | $17 | $12 |
| Clotting time test (PTT) | $30 | $54 | $6 |
| Complete blood count (CBC) | $15 | $57 | $7 |
| Complete blood count (CBC) (complete) | $15 | $50 | $8 |
| Comprehensive metabolic panel | $25 | $49 | $11 |
| Copper blood test | $51 | $8 | $12 |
| Cortisol test | $68 | $32 | $16 |
| CPAP titration study | $1,038 | $345 | $69 |
| Creatine kinase (CK) test | $33 | $29 | $7 |
| CT angiography of the chest | $532 | $672 | $281 |
| CT angiography of the head | $538 | $581 | $274 |
| CT scan of the abdomen | $469 | $393 | $230 |
| CT scan of the abdomen and pelvis | $438 | $803 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $525 | $1,059 | $338 |
| CT scan of the abdomen and pelvis with contrast | $438 | $916 | $300 |
| CT scan of the abdomen and pelvis without contrast | $243 | $795 | $183 |
| CT scan of the abdomen with and without contrast | $560 | $547 | $259 |
| CT scan of the abdomen with contrast | $469 | $459 | $230 |
| CT scan of the abdomen without contrast | $274 | $388 | $136 |
| CT scan of the arm | $476 | $344 | $199 |
| CT scan of the arm with contrast | $476 | $456 | $199 |
| CT scan of the arm without contrast | $286 | $339 | $161 |
| CT scan of the chest | $470 | $400 | $167 |
| CT scan of the chest with and without contrast | $562 | $528 | $196 |
| CT scan of the chest with contrast | $470 | $458 | $167 |
| CT scan of the chest without contrast | $285 | $395 | $133 |
| CT scan of the head | $478 | $670 | $148 |
| CT scan of the head with and without contrast | $569 | $569 | $173 |
| CT scan of the head with contrast | $478 | $920 | $148 |
| CT scan of the head without contrast | $296 | $357 | $107 |
| CT scan of the leg | $476 | $346 | $166 |
| CT scan of the leg with contrast | $476 | $456 | $166 |
| CT scan of the leg without contrast | $286 | $340 | $130 |
| CT scan of the lower back (lumbar spine) | $472 | $341 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $569 | $500 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $472 | $457 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $286 | $334 | $130 |
| CT scan of the neck | $462 | $388 | $183 |
| CT scan of the neck (cervical spine) | $472 | $364 | $168 |
| CT scan of the neck (cervical spine) with contrast | $472 | $492 | $168 |
| CT scan of the neck (cervical spine) without contrast | $282 | $359 | $131 |
| CT scan of the neck with and without contrast | $558 | $577 | $220 |
| CT scan of the neck with contrast | $462 | $496 | $183 |
| CT scan of the neck without contrast | $268 | $379 | $150 |
| CT scan of the pelvis | $378 | $395 | $226 |
| CT scan of the pelvis with contrast | $476 | $456 | $226 |
| CT scan of the pelvis without contrast | $281 | $391 | $133 |
| CT scan of the sinuses | $494 | $665 | $152 |
| CT scan of the sinuses with and without contrast | $568 | $1,071 | $184 |
| CT scan of the sinuses with contrast | $494 | $489 | $152 |
| CT scan of the sinuses without contrast | $295 | $355 | $128 |
| D-dimer test | $163 | $66 | $10 |
| DHEA-sulfate test | $92 | $62 | $22 |
| Diagnostic mammogram | $215 | $132 | $140 |
| Drug screen (urine) | $258 | $100 | $17 |
| Echocardiogram with and without contrast | $1,781 | $184 | $101 |
| EKG / ECG (tracing only) | $326 | $117 | $7 |
| Electrocardiogram (EKG) | $326 | $63 | $8 |
| Electrolyte panel | $37 | $33 | $7 |
| Emergency department visit | $1,228 | $169 | $69 |
| Emergency department visit (level 1) | $511 | $76 | $11 |
| Emergency department visit (level 2) | $584 | $123 | $40 |
| Emergency department visit (level 3) | $1,228 | $176 | $69 |
| Emergency department visit (level 4) | $1,797 | $293 | $118 |
| Emergency department visit (level 5) | $2,531 | $440 | $171 |
| Estradiol (estrogen) test | $140 | $82 | $28 |
| Fallopian tube X-ray (HSG) | $530 | $60 | $164 |
| Fecal occult blood (stool) test | $26 | $26 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $15 | $21 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $36 | $31 | $16 |
| Ferritin (iron) test | $40 | $103 | $14 |
| Fibrinogen test | $106 | $55 | $10 |
| Folate (folic acid) test | $45 | $90 | $15 |
| Foreign body removal (skin) | $1,246 | $250 | $157 |
| Free T4 thyroid test | $35 | $58 | $9 |
| FSH hormone test | $78 | $56 | $19 |
| Gallbladder scan (HIDA) | $1,970 | $445 | $334 |
| GGT liver test | $30 | $22 | $7 |
| Glucose tolerance test | $42 | $81 | $8 |
| HDL cholesterol test | $34 | $35 | $8 |
| Hematocrit test | $35 | $5 | $2 |
| Hemoglobin A1c (diabetes test) | $25 | $53 | $10 |
| Hepatitis B test | $51 | $42 | $10 |
| Hepatitis C test | $55 | $87 | $14 |
| Iron blood test | $20 | $54 | $6 |
| IUD insertion | $131 | $112 | — |
| IUD removal | $1,266 | $180 | $112 |
| IV infusion therapy | $353 | $122 | $44 |
| IV infusion therapy (each additional) | $154 | $99 | $21 |
| IV infusion therapy (initial) | $552 | $231 | $67 |
| Joint aspiration (small/intermediate) | $784 | $166 | $57 |
| Joint aspiration or injection (mid-size joint) | $1,042 | $166 | $57 |
| Joint aspiration or injection (small joint) | $526 | $165 | $56 |
| Kidney scan (nuclear) | $2,226 | $882 | $172 |
| Kidney ultrasound | $760 | $238 | $84 |
| Kidney ultrasound (limited) | $626 | $234 | $61 |
| Knee joint injection | $1,049 | $294 | $69 |
| Lactate test | $75 | $73 | $12 |
| Laryngoscopy | $541 | $113 | $189 |
| LDH test | $25 | $21 | $6 |
| LDL cholesterol test | $44 | $20 | $11 |
| Leg vein ultrasound (Doppler) | $985 | $352 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $823 | $345 | $116 |
| LH hormone test | $78 | $38 | $19 |
| Lipase test | $42 | $35 | $7 |
| Lipid (cholesterol) panel | $40 | $63 | $13 |
| Liver function panel | $25 | $38 | $8 |
| Lung function test (PFT) | $668 | $101 | $37 |
| Lung scan (V/Q) | $2,226 | $847 | $291 |
| Magnesium blood test | $30 | $20 | $7 |
| MRI of the abdomen | $640 | $660 | $300 |
| MRI of the abdomen without contrast | $457 | $640 | $194 |
| MRI of the ankle | $588 | $659 | $261 |
| MRI of the ankle without contrast | $463 | $638 | $222 |
| MRI of the brain | $636 | $662 | $269 |
| MRI of the brain without contrast | $455 | $641 | $195 |
| MRI of the chest | $582 | $956 | $371 |
| MRI of the chest without contrast | $706 | $1,837 | $466 |
| MRI of the knee | $645 | $1,207 | $315 |
| MRI of the knee with contrast | $645 | $1,382 | $315 |
| MRI of the knee without contrast | $462 | $639 | $204 |
| MRI of the lower back (lumbar spine) | $636 | $662 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $454 | $641 | $192 |
| MRI of the mid-back (thoracic spine) | $634 | $662 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $701 | $987 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $454 | $641 | $190 |
| MRI of the neck (cervical spine) | $634 | $662 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $702 | $987 | $318 |
| MRI of the neck (cervical spine) without contrast | $454 | $641 | $191 |
| MRI of the pelvis | $639 | $640 | $268 |
| MRI of the pelvis without contrast | $456 | $621 | $227 |
| MRI of the shoulder | $646 | $1,206 | $313 |
| MRI of the shoulder with contrast | $646 | $1,382 | $313 |
| MRI of the shoulder without contrast | $462 | $638 | $205 |
| MRI of the wrist | $588 | $659 | $330 |
| MRI of the wrist without contrast | $464 | $638 | $303 |
| Nebulizer breathing treatment | $252 | $68 | $9 |
| Nerve conduction study | $1,118 | $74 | $118 |
| Nuclear cardiac stress test | $6,240 | $1,536 | $428 |
| Occupational therapy evaluation | $440 | $175 | $101 |
| Occupational therapy evaluation (high complexity) | $576 | $175 | $101 |
| Occupational therapy evaluation (low complexity) | $335 | $175 | $101 |
| Occupational therapy evaluation (moderate complexity) | $440 | $175 | $101 |
| Office visit (established patient) | $488 | $84 | $115 |
| Office visit (new patient) | $608 | $114 | $177 |
| Office visit, established patient (level 3) | $422 | $69 | $95 |
| Office visit, established patient (level 4) | $554 | $101 | $136 |
| Office visit, new patient (level 3) | $467 | $88 | $118 |
| Office visit, new patient (level 4) | $608 | $135 | $177 |
| Office visit, new patient (level 5) | $754 | $185 | $237 |
| Pap smear (cervical screening) | $102 | $59 | $20 |
| Parathyroid hormone (PTH) test | $249 | $114 | $41 |
| Pelvic ultrasound | $493 | $155 | $78 |
| Pelvic ultrasound (complete) | $518 | $239 | $105 |
| Pelvic ultrasound (limited) | $468 | $150 | $51 |
| Phosphorus blood test | $15 | $40 | $5 |
| Physical therapy evaluation | $302 | $174 | $98 |
| Physical therapy evaluation (high complexity) | $340 | $174 | $98 |
| Physical therapy evaluation (moderate complexity) | $302 | $174 | $98 |
| Platelet count | $65 | $49 | $4 |
| Pregnancy ultrasound | $867 | $448 | $126 |
| Pregnancy ultrasound (first trimester) | $846 | $466 | $117 |
| Pregnancy ultrasound (second or third trimester) | $889 | $250 | $136 |
| Procalcitonin test | $136 | $170 | $27 |
| Prolactin test | $81 | $50 | $19 |
| Prostate test (PSA) | $45 | $112 | $18 |
| Scoliosis spine X-ray | $373 | $96 | $58 |
| Scoliosis spine X-ray (1 view) | $373 | $95 | $44 |
| Screening mammogram | $225 | $192 | $126 |
| Scrotal ultrasound | $702 | $237 | $99 |
| Sedimentation rate (ESR) test | $20 | $24 | $3 |
| Semen analysis | $60 | $99 | $12 |
| Sex hormone binding globulin test | $108 | $14 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $535 | $169 | $114 |
| Simple wound stitches | $629 | $177 | $127 |
| Skin biopsy | $687 | $222 | $121 |
| Skin biopsy (punch) | $756 | $217 | $121 |
| Soft tissue ultrasound | $468 | $181 | $64 |
| Speech therapy | $305 | $143 | $76 |
| Spinal tap (lumbar puncture) | $1,392 | $603 | $165 |
| Spine fracture repair (kyphoplasty) | $27,863 | $2,680 | $5,803 |
| Spirometry (lung function test) | $495 | $100 | $30 |
| Spirometry with bronchodilator | $842 | $171 | $43 |
| Swallow study | $380 | $319 | $85 |
| T3 thyroid test | $59 | $88 | $14 |
| Testosterone test | $157 | $51 | $26 |
| Thyroid test (TSH) | $40 | $44 | $17 |
| Thyroid ultrasound | $635 | $235 | $109 |
| Total IgE allergy test | $68 | $53 | $16 |
| Total protein test | $15 | $38 | $4 |
| Transvaginal ultrasound | $709 | $239 | $118 |
| Trigger point injection | $549 | $170 | $56 |
| Trigger point injection (1-2 muscles) | $549 | $167 | $52 |
| Triglycerides test | $28 | $34 | $6 |
| Troponin (heart) test | $118 | $67 | $12 |
| Upper GI series (barium) | $811 | $321 | $128 |
| Uric acid (gout) test | $15 | $43 | $5 |
| Urinalysis | $10 | $19 | $3 |
| Urine microalbumin test | $28 | $16 | $5 |
| Urine pregnancy test | $43 | $35 | $9 |
| Vaccine administration | $143 | $23 | $19 |
| Vaccine administration (each additional) | $80 | $20 | $16 |
| Vitamin B12 test | $40 | $93 | $15 |
| Vitamin D test | $100 | $42 | $30 |
| Wound debridement | $1,498 | $160 | $186 |
| X-ray of the abdomen | $437 | $93 | $36 |
| X-ray of the ankle | $483 | $91 | $37 |
| X-ray of the collarbone | $292 | $91 | $33 |
| X-ray of the elbow | $453 | $91 | $33 |
| X-ray of the facial bones | $363 | $94 | $39 |
| X-ray of the foot | $460 | $91 | $34 |
| X-ray of the forearm | $392 | $91 | $29 |
| X-ray of the hand | $446 | $91 | $38 |
| X-ray of the hip | $430 | $92 | $49 |
| X-ray of the hip (1 view) | $370 | $91 | $34 |
| X-ray of the hip (3 views) | $490 | $94 | $49 |
| X-ray of the knee | $499 | $93 | $42 |
| X-ray of the knee (2 views) | $380 | $91 | $34 |
| X-ray of the knee (3 views) | $499 | $92 | $42 |
| X-ray of the knee (4+ views) | $737 | $93 | $49 |
| X-ray of the lower back (lumbar spine) | $687 | $119 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $650 | $117 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $724 | $157 | $53 |
| X-ray of the lower leg | $460 | $91 | $31 |
| X-ray of the mid-back (thoracic spine) (3 views) | $606 | $99 | $39 |
| X-ray of the neck (cervical spine) | $626 | $100 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $484 | $99 | $40 |
| X-ray of the pelvis (1 view) | $479 | $91 | $28 |
| X-ray of the ribs (2 views) | $400 | $92 | $36 |
| X-ray of the ribs (3 views) | $552 | $94 | $42 |
| X-ray of the shoulder | $470 | $94 | $36 |
| X-ray of the skull | $648 | $99 | $40 |
| X-ray of the upper arm | $421 | $93 | $32 |
| X-ray of the wrist | $444 | $91 | $43 |
| Zinc blood test | $47 | $6 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
