Clsd tx/patellar fx without manip 27520 at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$885.60
Cash price 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.
$1,107.00
Gross charge 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.
$163.75 with UPMC_Medicaid vs $1,616.00 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 →
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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 ?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 ?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 | $163.75 | ↓ -82% |
| Geisinger_Medicaid | All_Plans | $163.75 | ↓ -82% |
| Health_Partners_Medicaid | All_Other_Plans | $163.75 | ↓ -82% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $163.75 | ↓ -82% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $163.75 | ↓ -82% |
| Amerihealth_Caritas_Medicaid | All_Plans | $186.02 | ↓ -79% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $236.96 | ↓ -73% |
| Highmark_Medicare | All_Plans | $239.33 | ↓ -73% |
| Aetna_Medicare | All_Plans | $244.07 | ↓ -72% |
| Aetna_Advantra_Medicare | All_Plans | $244.07 | ↓ -72% |
| Geisinger_Gold_Medicare | All_Plans | $248.81 | ↓ -72% |
| United_Medicare | ISNP_DSNP_Plans | $248.81 | ↓ -72% |
| Devoted_Medicare | All_Plans | $248.81 | ↓ -72% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $249.87 | ↓ -72% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $249.99 | ↓ -72% |
| Amerihealth_Medicare | All_Plans | $249.99 | ↓ -72% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $249.99 | ↓ -72% |
| PA_Health_&_Wellness_Medicare | All_Plans | $255.92 | ↓ -71% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $255.92 | ↓ -71% |
| Highmark | Higmark_Healthy_Kids | $367.29 | ↓ -59% |
| Health_Partners_Medicaid | Kidz_Partners | $390.98 | ↓ -56% |
| United_Medicaid | Community_Plan_For_Kids | $414.68 | ↓ -53% |
| Aetna_Better_Health_Kids | All_Plans | $445.40 | ↓ -50% |
| WellSpan_Capital_Blue_Cross | All_Plans | $664.20 | ↓ -25% |
| UPMC | Employees_And_Dependents | $664.20 | ↓ -25% |
| UPMC | UPMC_For_Kids | $664.20 | ↓ -25% |
| Geisinger | All_Plans | $664.20 | ↓ -25% |
| Cigna | All_Plans | $706.49 | ↓ -20% |
| Highmark | Performance_Blue | $716.73 | ↓ -19% |
| Highmark | Blue_Cross_High_Performance_Network | $716.73 | ↓ -19% |
| Highmark | Choice_Blue_PPO | $716.73 | ↓ -19% |
| Highmark | All_Other_Plans | $863.55 | ↓ -2% |
| PHC | All_Plans | $885.60 | ↑ +0% |
| Aetna | All_Plans | $898.88 | ↑ +1% |
| First_Health_Network | All_Plans | $988.55 | ↑ +12% |
| United_Healthcare | All_Plans | $1,038.37 | ↑ +17% |
| Blue_Cross | Capital_Cares_4_kids | $1,131.20 | ↑ +28% |
| Blue_Cross | Capital_Blue_Performance_PPO | $1,209.00 | ↑ +37% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $1,292.80 | ↑ +46% |
| Blue_Cross | All_Other_Plans | $1,616.00 | ↑ +82% |
Visitor-reported prices
Comments
Clsd tx/patellar fx without manip 27520 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $759.00 | $166.37 – $1,075.25 |
| UPMC Cole | Coudersport | $1,266.00 | $71.24 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $759.00 | $166.37 – $1,714.89 |
| UPMC Hanover | Hanover | $759.00 | $166.37 – $587.97 |
| UPMC Lititz | Lititz | $759.00 | $166.37 – $647.58 |
| UPMC Memorial | York | $759.00 | $166.37 – $587.97 |
| UPMC Muncy | Muncy | $825.60 | $144.10 – $718.44 |
| UPMC Somerset | Somerset | $759.00 | $144.10 – $618.80 |