Coagulation time activated teg 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

$28.80

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.

$36.00

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.

$4.28 with Blue_Cross_BlueJourney_Medicare vs $76.02 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
Blue_Cross_BlueJourney_Medicare All_Plans $4.28 ↓ -85%
Highmark_Medicare All_Plans $4.32 ↓ -85%
Aetna_Medicare All_Plans $4.41 ↓ -85%
Aetna_Advantra_Medicare All_Plans $4.41 ↓ -85%
Devoted_Medicare All_Plans $4.49 ↓ -84%
United_Medicare ISNP_DSNP_Plans $4.49 ↓ -84%
Geisinger_Gold_Medicare All_Plans $4.49 ↓ -84%
Highmark_Wholecare_Gateway_Medicare All_Plans $4.51 ↓ -84%
Amerihealth_Medicare All_Plans $4.52 ↓ -84%
UPMC_Medicare UPMC_for_Life_Complete_Care $4.52 ↓ -84%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $4.52 ↓ -84%
Jefferson_Health_Medicare_Advantage All_Plans $4.62 ↓ -84%
PA_Health_&_Wellness_Medicare All_Plans $4.62 ↓ -84%
Highmark_Wholecare_Gateway_Medicaid All_Plans $6.59 ↓ -77%
UPMC_Medicaid All_Plans $6.59 ↓ -77%
PA_Health_&_Wellness_Medicaid All_Plans $6.59 ↓ -77%
Geisinger_Medicaid All_Plans $6.59 ↓ -77%
Health_Partners_Medicaid All_Other_Plans $6.59 ↓ -77%
Highmark Higmark_Healthy_Kids $6.63 ↓ -77%
Health_Partners_Medicaid Kidz_Partners $7.06 ↓ -75%
Amerihealth_Caritas_Medicaid All_Plans $7.48 ↓ -74%
United_Medicaid Community_Plan_For_Kids $7.49 ↓ -74%
United_Healthcare All_Plans $12.84 ↓ -55%
Highmark Blue_Cross_High_Performance_Network $12.95 ↓ -55%
Highmark Performance_Blue $12.95 ↓ -55%
Highmark Choice_Blue_PPO $12.95 ↓ -55%
Highmark All_Other_Plans $15.60 ↓ -46%
Aetna All_Plans $17.68 ↓ -39%
Aetna_Better_Health_Kids All_Plans $17.92 ↓ -38%
First_Health_Network All_Plans $19.43 ↓ -33%
Geisinger All_Plans $21.60 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $21.60 ↓ -25%
UPMC Employees_And_Dependents $21.60 ↓ -25%
UPMC UPMC_For_Kids $21.60 ↓ -25%
Blue_Cross Capital_Cares_4_kids $27.73 ↓ -4%
PHC All_Plans $28.80 ↑ +0%
Cigna All_Plans $30.05 ↑ +4%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $31.69 ↑ +10%
Blue_Cross All_Other_Plans $39.62 ↑ +38%
Blue_Cross Capital_Blue_Performance_PPO $76.02 ↑ +164%

Visitor-reported prices

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Coagulation time activated teg at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $25.20 $4.23 – $33.60
UPMC Carlisle Carlisle $13.20 $2.19 – $13.60
UPMC Community Osteopathic Harrisburg $13.20 $3.20 – $39.54
UPMC East Monroeville $43.80 $4.23 – $58.40
UPMC Hamot Erie $36.00 $4.23 – $11.56
UPMC Hanover Hanover $13.20 $4.24 – $7.18
UPMC Jameson New Castle $47.40 $4.23 – $11.77
UPMC Lititz Lititz $13.20 $4.24 – $7.18

All Pennsylvania hospitals for this procedure →