Assay of urine sulfate 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

$22.40

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.

Full explanation →

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

$28.00

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.

Full explanation →

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

$5.04 with Aetna_Better_Health_Kids vs $44.14 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
Aetna_Better_Health_Kids All_Plans $5.04 ↓ -78%
Blue_Cross_BlueJourney_Medicare All_Plans $5.49 ↓ -75%
Highmark_Medicare All_Plans $5.54 ↓ -75%
Aetna_Advantra_Medicare All_Plans $5.65 ↓ -75%
Aetna_Medicare All_Plans $5.65 ↓ -75%
Geisinger_Gold_Medicare All_Plans $5.76 ↓ -74%
Devoted_Medicare All_Plans $5.76 ↓ -74%
United_Medicare ISNP_DSNP_Plans $5.76 ↓ -74%
UPMC_Medicare UPMC_for_Life_Complete_Care $5.79 ↓ -74%
Amerihealth_Medicare All_Plans $5.79 ↓ -74%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $5.79 ↓ -74%
Highmark_Wholecare_Gateway_Medicare All_Plans $5.79 ↓ -74%
PA_Health_&_Wellness_Medicare All_Plans $5.93 ↓ -74%
Jefferson_Health_Medicare_Advantage All_Plans $5.93 ↓ -74%
Blue_Cross Capital_Blue_Performance_PPO $6.93 ↓ -69%
Highmark Higmark_Healthy_Kids $8.51 ↓ -62%
Health_Partners_Medicaid Kidz_Partners $9.06 ↓ -60%
United_Medicaid Community_Plan_For_Kids $9.61 ↓ -57%
United_Healthcare All_Plans $16.47 ↓ -26%
Highmark Choice_Blue_PPO $16.61 ↓ -26%
Highmark Performance_Blue $16.61 ↓ -26%
Highmark Blue_Cross_High_Performance_Network $16.61 ↓ -26%
WellSpan_Capital_Blue_Cross All_Plans $16.80 ↓ -25%
UPMC Employees_And_Dependents $16.80 ↓ -25%
Geisinger All_Plans $16.80 ↓ -25%
UPMC UPMC_For_Kids $16.80 ↓ -25%
Highmark All_Other_Plans $20.01 ↓ -11%
PHC All_Plans $22.40 ↑ +0%
Aetna All_Plans $22.67 ↑ +1%
Cigna All_Plans $23.37 ↑ +4%
First_Health_Network All_Plans $24.92 ↑ +11%
Blue_Cross Capital_Cares_4_kids $30.90 ↑ +38%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $35.31 ↑ +58%
Blue_Cross All_Other_Plans $44.14 ↑ +97%

Visitor-reported prices

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Assay of urine sulfate at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $35.40 $5.43 – $47.20
UPMC Bedford Everett $80.40 $1.98 – $120.60
UPMC Carlisle Carlisle $27.60 $3.02 – $39.10
UPMC Community Osteopathic Harrisburg $27.60 $4.39 – $28.05
UPMC East Monroeville $99.60 $5.43 – $132.80
UPMC Hamot Erie $72.60 $5.43 – $12.90
UPMC Northwest Seneca $43.80 $4.98 – $5.93
UPMC Hanover Hanover $27.60 $4.39 – $27.50

All Pennsylvania hospitals for this procedure →