Administration vaccine pneumococcal at WellSpan Good Samaritan Hospital

252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 17, 2026

$161.60

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

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What you pay up front if you don't use insurance.

$202.00

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

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The hospital's undiscounted list price — almost no one pays this.

$12.50 with UPMC_Medicaid vs $216.01 with Blue_Cross — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
UPMC_Medicaid All_Plans $12.50 ↓ -92%
Highmark_Wholecare_Gateway_Medicaid All_Plans $12.50 ↓ -92%
Health_Partners_Medicaid All_Other_Plans $12.50 ↓ -92%
Geisinger_Medicaid All_Plans $12.50 ↓ -92%
PA_Health_&_Wellness_Medicaid All_Plans $12.50 ↓ -92%
Amerihealth_Caritas_Medicaid All_Plans $14.20 ↓ -91%
Aetna_Better_Health_Kids All_Plans $34.00 ↓ -79%
Blue_Cross_BlueJourney_Medicare All_Plans $45.58 ↓ -72%
Highmark_Medicare All_Plans $46.04 ↓ -72%
Aetna_Medicare All_Plans $46.95 ↓ -71%
Aetna_Advantra_Medicare All_Plans $46.95 ↓ -71%
United_Medicare ISNP_DSNP_Plans $47.86 ↓ -70%
Geisinger_Gold_Medicare All_Plans $47.86 ↓ -70%
Devoted_Medicare All_Plans $47.86 ↓ -70%
Highmark_Wholecare_Gateway_Medicare All_Plans $48.06 ↓ -70%
Amerihealth_Medicare All_Plans $48.09 ↓ -70%
UPMC_Medicare UPMC_for_Life_Complete_Care $48.09 ↓ -70%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $48.09 ↓ -70%
PA_Health_&_Wellness_Medicare All_Plans $49.23 ↓ -70%
Jefferson_Health_Medicare_Advantage All_Plans $49.23 ↓ -70%
Highmark Higmark_Healthy_Kids $70.65 ↓ -56%
Health_Partners_Medicaid Kidz_Partners $75.21 ↓ -53%
United_Medicaid Community_Plan_For_Kids $79.77 ↓ -51%
Blue_Cross Capital_Cares_4_kids $82.60 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $94.39 ↓ -42%
Blue_Cross All_Other_Plans $117.99 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $121.20 ↓ -25%
UPMC Employees_And_Dependents $121.20 ↓ -25%
UPMC UPMC_For_Kids $121.20 ↓ -25%
Geisinger All_Plans $121.20 ↓ -25%
Cigna All_Plans $128.92 ↓ -20%
Highmark Blue_Cross_High_Performance_Network $137.87 ↓ -15%
Highmark Performance_Blue $137.87 ↓ -15%
Highmark Choice_Blue_PPO $137.87 ↓ -15%
PHC All_Plans $161.60 ↑ +0%
Aetna All_Plans $164.02 ↑ +1%
Highmark All_Other_Plans $166.11 ↑ +3%
First_Health_Network All_Plans $180.39 ↑ +12%
United_Healthcare All_Plans $189.48 ↑ +17%
Blue_Cross Capital_Blue_Performance_PPO $216.01 ↑ +34%

Visitor-reported prices

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Administration vaccine pneumococcal at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $12.00 $7.53 – $17.04
UPMC Bedford Everett $12.00 $8.00 – $20.88
UPMC Carlisle Carlisle $72.60 $12.70 – $102.85
UPMC Cole Coudersport $86.40 $9.70 – $28.00
UPMC Community Osteopathic Harrisburg $72.60 $7.20 – $48.57
UPMC East Monroeville $12.00 $6.60 – $46.19
UPMC Hamot Erie $12.00 $4.05 – $54.83
UPMC Northwest Seneca $12.00 $11.00 – $46.19

All Pennsylvania hospitals for this procedure →