Clsd tx toe dislocation without anes28660 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

$610.40

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.

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

$763.00

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.

$60.63 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.

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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 $60.63 ↓ -90%
Health_Partners_Medicaid All_Other_Plans $60.63 ↓ -90%
Highmark_Wholecare_Gateway_Medicaid All_Plans $60.63 ↓ -90%
PA_Health_&_Wellness_Medicaid All_Plans $60.63 ↓ -90%
Geisinger_Medicaid All_Plans $60.63 ↓ -90%
Amerihealth_Caritas_Medicaid All_Plans $68.87 ↓ -89%
Aetna_Better_Health_Kids All_Plans $164.90 ↓ -73%
Blue_Cross_BlueJourney_Medicare All_Plans $236.96 ↓ -61%
Highmark_Medicare All_Plans $239.33 ↓ -61%
Aetna_Medicare All_Plans $244.07 ↓ -60%
Aetna_Advantra_Medicare All_Plans $244.07 ↓ -60%
Geisinger_Gold_Medicare All_Plans $248.81 ↓ -59%
Devoted_Medicare All_Plans $248.81 ↓ -59%
United_Medicare ISNP_DSNP_Plans $248.81 ↓ -59%
Highmark_Wholecare_Gateway_Medicare All_Plans $249.87 ↓ -59%
UPMC_Medicare UPMC_for_Life_Complete_Care $249.99 ↓ -59%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $249.99 ↓ -59%
Amerihealth_Medicare All_Plans $249.99 ↓ -59%
Jefferson_Health_Medicare_Advantage All_Plans $255.92 ↓ -58%
PA_Health_&_Wellness_Medicare All_Plans $255.92 ↓ -58%
Highmark Higmark_Healthy_Kids $367.29 ↓ -40%
Health_Partners_Medicaid Kidz_Partners $390.98 ↓ -36%
United_Medicaid Community_Plan_For_Kids $414.68 ↓ -32%
WellSpan_Capital_Blue_Cross All_Plans $457.80 ↓ -25%
UPMC Employees_And_Dependents $457.80 ↓ -25%
UPMC UPMC_For_Kids $457.80 ↓ -25%
Geisinger All_Plans $457.80 ↓ -25%
Cigna All_Plans $486.95 ↓ -20%
PHC All_Plans $610.40 ↑ +0%
Aetna All_Plans $619.56 ↑ +2%
First_Health_Network All_Plans $681.36 ↑ +12%
United_Healthcare All_Plans $715.69 ↑ +17%
Highmark Performance_Blue $716.73 ↑ +17%
Highmark Choice_Blue_PPO $716.73 ↑ +17%
Highmark Blue_Cross_High_Performance_Network $716.73 ↑ +17%
Highmark All_Other_Plans $863.55 ↑ +41%
Blue_Cross Capital_Cares_4_kids $1,131.20 ↑ +85%
Blue_Cross Capital_Blue_Performance_PPO $1,209.00 ↑ +98%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,292.80 ↑ +112%
Blue_Cross All_Other_Plans $1,616.00 ↑ +165%

Visitor-reported prices

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Clsd tx toe dislocation without anes28660 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $530.40 $48.50 – $707.20
UPMC Carlisle Carlisle $520.80 $61.59 – $737.80
UPMC Cole Coudersport $373.80 $28.27 – $197.21
UPMC Community Osteopathic Harrisburg $520.80 $61.59 – $737.80
UPMC East Monroeville $513.00 $53.35 – $684.00
UPMC Hamot Erie $541.20 $53.35 – $332.62
UPMC Northwest Seneca $763.20 $53.35 – $240.13
UPMC Hanover Hanover $520.80 $61.59 – $366.66

All Pennsylvania hospitals for this procedure →