Dup scan/lwr xtr vasc stdy bilat 93924 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

$1,488.80

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.

$1,861.00

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.

$126.21 with Highmark_Wholecare_Gateway_Medicaid vs $1,745.62 with United_Healthcare — 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
Highmark_Wholecare_Gateway_Medicaid All_Plans $126.21 ↓ -92%
UPMC_Medicaid All_Plans $126.21 ↓ -92%
Geisinger_Medicaid All_Plans $126.21 ↓ -92%
Health_Partners_Medicaid All_Other_Plans $126.21 ↓ -92%
PA_Health_&_Wellness_Medicaid All_Plans $126.21 ↓ -92%
Amerihealth_Caritas_Medicaid All_Plans $143.38 ↓ -90%
Blue_Cross_BlueJourney_Medicare All_Plans $154.55 ↓ -90%
Highmark_Medicare All_Plans $156.10 ↓ -90%
Aetna_Advantra_Medicare All_Plans $159.19 ↓ -89%
Aetna_Medicare All_Plans $159.19 ↓ -89%
United_Medicare ISNP_DSNP_Plans $162.28 ↓ -89%
Devoted_Medicare All_Plans $162.28 ↓ -89%
Geisinger_Gold_Medicare All_Plans $162.28 ↓ -89%
Highmark_Wholecare_Gateway_Medicare All_Plans $162.97 ↓ -89%
Amerihealth_Medicare All_Plans $163.05 ↓ -89%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $163.05 ↓ -89%
UPMC_Medicare UPMC_for_Life_Complete_Care $163.05 ↓ -89%
Jefferson_Health_Medicare_Advantage All_Plans $166.91 ↓ -89%
PA_Health_&_Wellness_Medicare All_Plans $166.91 ↓ -89%
Highmark Higmark_Healthy_Kids $239.55 ↓ -84%
Health_Partners_Medicaid Kidz_Partners $255.01 ↓ -83%
United_Medicaid Community_Plan_For_Kids $270.46 ↓ -82%
Aetna_Better_Health_Kids All_Plans $343.30 ↓ -77%
Highmark Blue_Cross_High_Performance_Network $467.47 ↓ -69%
Highmark Performance_Blue $467.47 ↓ -69%
Highmark Choice_Blue_PPO $467.47 ↓ -69%
Highmark All_Other_Plans $563.23 ↓ -62%
Blue_Cross Capital_Cares_4_kids $760.96 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $869.65 ↓ -42%
Blue_Cross All_Other_Plans $1,087.01 ↓ -27%
Cigna All_Plans $1,096.32 ↓ -26%
WellSpan_Capital_Blue_Cross All_Plans $1,116.60 ↓ -25%
UPMC Employees_And_Dependents $1,116.60 ↓ -25%
UPMC UPMC_For_Kids $1,116.60 ↓ -25%
Geisinger All_Plans $1,116.60 ↓ -25%
PHC All_Plans $1,488.80 ↑ +0%
Aetna All_Plans $1,511.13 ↑ +1%
First_Health_Network All_Plans $1,661.87 ↑ +12%
United_Healthcare All_Plans $1,745.62 ↑ +17%

Visitor-reported prices

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Dup scan/lwr xtr vasc stdy bilat 93924 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $703.80 $76.59 – $938.40
UPMC Carlisle Carlisle $797.40 $100.33 – $1,129.65
UPMC Community Osteopathic Harrisburg $797.40 $37.20 – $409.55
UPMC Hamot Erie $241.20 $110.84 – $390.15
UPMC Hanover Hanover $797.40 $100.33 – $409.55
UPMC Horizon-Greenville Greenville $643.80 $111.07 – $391.35
UPMC Lititz Lititz $797.40 $100.33 – $367.36
UPMC Magee Pittsburgh $681.00 $111.07 – $390.15

All Pennsylvania hospitals for this procedure →