Bx breast pq tomo guide 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

$2,471.20

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.

$3,089.00

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.

$157.32 with Aetna_Better_Health_Kids vs $13,785.07 with Highmark — 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 $157.32 ↓ -94%
Aetna All_Plans $489.44 ↓ -80%
UPMC UPMC_For_Kids $524.40 ↓ -79%
Geisinger All_Plans $524.40 ↓ -79%
WellSpan_Capital_Blue_Cross All_Plans $524.40 ↓ -79%
UPMC Employees_And_Dependents $524.40 ↓ -79%
First_Health_Network All_Plans $538.38 ↓ -78%
Cigna All_Plans $557.79 ↓ -77%
PHC All_Plans $699.20 ↓ -72%
United_Healthcare All_Plans $819.81 ↓ -67%
Highmark_Wholecare_Gateway_Medicaid All_Plans $2,871.96 ↑ +16%
Blue_Cross_BlueJourney_Medicare All_Plans $3,782.64 ↑ +53%
Health_Partners_Medicaid All_Other_Plans $3,782.64 ↑ +53%
Highmark_Medicare All_Plans $3,820.47 ↑ +55%
Aetna_Medicare All_Plans $3,896.12 ↑ +58%
Aetna_Advantra_Medicare All_Plans $3,896.12 ↑ +58%
Geisinger_Gold_Medicare All_Plans $3,971.77 ↑ +61%
Devoted_Medicare All_Plans $3,971.77 ↑ +61%
United_Medicare ISNP_DSNP_Plans $3,971.77 ↑ +61%
Highmark_Wholecare_Gateway_Medicare All_Plans $3,988.79 ↑ +61%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $3,990.69 ↑ +61%
Amerihealth_Medicare All_Plans $3,990.69 ↑ +61%
UPMC_Medicare UPMC_for_Life_Complete_Care $3,990.69 ↑ +61%
Jefferson_Health_Medicare_Advantage All_Plans $4,085.25 ↑ +65%
PA_Health_&_Wellness_Medicare All_Plans $4,085.25 ↑ +65%
Highmark Higmark_Healthy_Kids $5,863.09 ↑ +137%
Blue_Cross Capital_Blue_Performance_PPO $6,066.00 ↑ +145%
Health_Partners_Medicaid Kidz_Partners $6,241.36 ↑ +153%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $6,480.80 ↑ +162%
United_Medicaid Community_Plan_For_Kids $6,619.62 ↑ +168%
Blue_Cross Capital_Cares_4_kids $6,956.60 ↑ +182%
Blue_Cross All_Other_Plans $8,101.00 ↑ +228%
Highmark Performance_Blue $11,441.35 ↑ +363%
Highmark Blue_Cross_High_Performance_Network $11,441.35 ↑ +363%
Highmark Choice_Blue_PPO $11,441.35 ↑ +363%
Highmark All_Other_Plans $13,785.07 ↑ +458%

Visitor-reported prices

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Bx breast pq tomo guide at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $7,249.80 $47.21 – $10,270.55
UPMC Community Osteopathic Harrisburg $7,249.80 $47.21 – $10,270.55
UPMC Hanover Hanover $7,249.80 $47.21 – $5,852.98
UPMC Lititz Lititz $7,249.80 $47.21 – $5,884.59
UPMC Memorial York $7,249.80 $15.15 – $5,875.04
UPMC Somerset Somerset $7,249.80 $18.40 – $3,942.46
WellSpan Ephrata Community Hospital Ephrata $2,424.80 $2,871.96 – $2,871.96
WellSpan Evangelical Community Hospital Lewisburg $9,758.40 $86.34 – $86.34

All Pennsylvania hospitals for this procedure →