Diagnostic Mammogram (both breasts) 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

$208.00

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.

$564.00

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.

$100.45 with Blue_Cross_BlueJourney_Medicare vs $744.14 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 $100.45 ↓ -52%
Highmark_Medicare All_Plans $101.45 ↓ -51%
Aetna_Medicare All_Plans $103.46 ↓ -50%
Aetna_Advantra_Medicare All_Plans $103.46 ↓ -50%
Geisinger_Gold_Medicare All_Plans $105.47 ↓ -49%
United_Medicare ISNP_DSNP_Plans $105.47 ↓ -49%
Devoted_Medicare All_Plans $105.47 ↓ -49%
Highmark_Wholecare_Gateway_Medicare All_Plans $105.92 ↓ -49%
Amerihealth_Medicare All_Plans $105.97 ↓ -49%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $105.97 ↓ -49%
UPMC_Medicare UPMC_for_Life_Complete_Care $105.97 ↓ -49%
Jefferson_Health_Medicare_Advantage All_Plans $108.49 ↓ -48%
PA_Health_&_Wellness_Medicare All_Plans $108.49 ↓ -48%
Blue_Cross Capital_Blue_Performance_PPO $113.54 ↓ -45%
WellSpan_Capital_Blue_Cross All_Plans $140.00 ↓ -33%
Highmark Higmark_Healthy_Kids $155.70 ↓ -25%
PA_Health_&_Wellness_Medicaid All_Plans $162.31 ↓ -22%
Health_Partners_Medicaid All_Other_Plans $162.31 ↓ -22%
UPMC_Medicaid All_Plans $162.31 ↓ -22%
Highmark_Wholecare_Gateway_Medicaid All_Plans $162.31 ↓ -22%
Geisinger_Medicaid All_Plans $162.31 ↓ -22%
Health_Partners_Medicaid Kidz_Partners $165.74 ↓ -20%
United_Medicaid Community_Plan_For_Kids $175.79 ↓ -15%
Amerihealth_Caritas_Medicaid All_Plans $184.39 ↓ -11%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $263.56 ↑ +27%
Cigna All_Plans $293.51 ↑ +41%
Highmark Choice_Blue_PPO $303.83 ↑ +46%
Highmark Performance_Blue $303.83 ↑ +46%
Highmark Blue_Cross_High_Performance_Network $303.83 ↑ +46%
Geisinger All_Plans $338.40 ↑ +63%
UPMC Employees_And_Dependents $338.40 ↑ +63%
UPMC UPMC_For_Kids $338.40 ↑ +63%
Highmark All_Other_Plans $366.07 ↑ +76%
Aetna_Better_Health_Kids All_Plans $441.49 ↑ +112%
PHC All_Plans $451.20 ↑ +117%
Aetna All_Plans $457.97 ↑ +120%
First_Health_Network All_Plans $503.65 ↑ +142%
Blue_Cross Capital_Cares_4_kids $520.90 ↑ +150%
United_Healthcare All_Plans $632.62 ↑ +204%
Blue_Cross All_Other_Plans $744.14 ↑ +258%

Visitor-reported prices

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Diagnostic Mammogram (both breasts) at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $583.20 $73.61 – $777.60
UPMC Bedford Everett $609.00 $136.34 – $913.50
UPMC Carlisle Carlisle $310.20 $70.83 – $611.06
UPMC Cole Coudersport $458.40 $136.34 – $611.20
UPMC Community Osteopathic Harrisburg $310.20 $103.40 – $675.02
UPMC Hamot Erie $612.00 $73.61 – $221.29
UPMC Northwest Seneca $591.60 $142.84 – $221.29
UPMC Hanover Hanover $310.20 $118.99 – $611.06

All Pennsylvania hospitals for this procedure →