Clsd tx wrist scaphoid fx without manip 25622 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

$1,369.60

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.

Full explanation →

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

$1,712.00

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.

Full explanation →

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

$152.50 with Highmark_Wholecare_Gateway_Medicaid vs $1,616.00 with Blue_Cross — same scan, same building. Share

Negotiated rates by payer
?

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
Highmark_Wholecare_Gateway_Medicaid All_Plans $152.50 ↓ -89%
Health_Partners_Medicaid All_Other_Plans $152.50 ↓ -89%
Geisinger_Medicaid All_Plans $152.50 ↓ -89%
PA_Health_&_Wellness_Medicaid All_Plans $152.50 ↓ -89%
UPMC_Medicaid All_Plans $152.50 ↓ -89%
Amerihealth_Caritas_Medicaid All_Plans $173.24 ↓ -87%
Blue_Cross_BlueJourney_Medicare All_Plans $236.96 ↓ -83%
Highmark_Medicare All_Plans $239.33 ↓ -83%
Aetna_Advantra_Medicare All_Plans $244.07 ↓ -82%
Aetna_Medicare All_Plans $244.07 ↓ -82%
Geisinger_Gold_Medicare All_Plans $248.81 ↓ -82%
Devoted_Medicare All_Plans $248.81 ↓ -82%
United_Medicare ISNP_DSNP_Plans $248.81 ↓ -82%
Highmark_Wholecare_Gateway_Medicare All_Plans $249.87 ↓ -82%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $249.99 ↓ -82%
Amerihealth_Medicare All_Plans $249.99 ↓ -82%
UPMC_Medicare UPMC_for_Life_Complete_Care $249.99 ↓ -82%
Jefferson_Health_Medicare_Advantage All_Plans $255.92 ↓ -81%
PA_Health_&_Wellness_Medicare All_Plans $255.92 ↓ -81%
Highmark Higmark_Healthy_Kids $367.29 ↓ -73%
Health_Partners_Medicaid Kidz_Partners $390.98 ↓ -71%
United_Medicaid Community_Plan_For_Kids $414.68 ↓ -70%
Aetna_Better_Health_Kids All_Plans $414.80 ↓ -70%
Highmark Blue_Cross_High_Performance_Network $716.73 ↓ -48%
Highmark Performance_Blue $716.73 ↓ -48%
Highmark Choice_Blue_PPO $716.73 ↓ -48%
Highmark All_Other_Plans $863.55 ↓ -37%
WellSpan_Capital_Blue_Cross All_Plans $1,027.20 ↓ -25%
UPMC Employees_And_Dependents $1,027.20 ↓ -25%
UPMC UPMC_For_Kids $1,027.20 ↓ -25%
Geisinger All_Plans $1,027.20 ↓ -25%
Cigna All_Plans $1,092.60 ↓ -20%
Blue_Cross Capital_Cares_4_kids $1,131.20 ↓ -17%
Blue_Cross Capital_Blue_Performance_PPO $1,209.00 ↓ -12%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,292.80 ↓ -6%
PHC All_Plans $1,369.60 ↑ +0%
Aetna All_Plans $1,390.14 ↑ +1%
First_Health_Network All_Plans $1,528.82 ↑ +12%
United_Healthcare All_Plans $1,605.86 ↑ +17%
Blue_Cross All_Other_Plans $1,616.00 ↑ +18%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Clsd tx wrist scaphoid fx without manip 25622 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Bedford Everett $484.80 $82.51 – $727.20
UPMC Carlisle Carlisle $520.80 $118.92 – $1,016.56
UPMC Cole Coudersport $957.60 $65.42 – $556.46
UPMC Community Osteopathic Harrisburg $520.80 $154.94 – $1,016.56
UPMC Hanover Hanover $520.80 $154.94 – $1,016.56
UPMC Kane Kane $397.80 $134.20 – $1,321.60
UPMC Lititz Lititz $520.80 $154.94 – $1,016.56
UPMC Memorial York $520.80 $106.05 – $1,016.56

All Pennsylvania hospitals for this procedure →