Emb without cervical dilation 58100 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

$529.60

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.

$662.00

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.

$63.75 with PA_Health_&_Wellness_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.

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
PA_Health_&_Wellness_Medicaid All_Plans $63.75 ↓ -88%
Health_Partners_Medicaid All_Other_Plans $63.75 ↓ -88%
Highmark_Wholecare_Gateway_Medicaid All_Plans $63.75 ↓ -88%
Geisinger_Medicaid All_Plans $63.75 ↓ -88%
UPMC_Medicaid All_Plans $63.75 ↓ -88%
Amerihealth_Caritas_Medicaid All_Plans $72.42 ↓ -86%
Aetna_Better_Health_Kids All_Plans $173.40 ↓ -67%
Blue_Cross_BlueJourney_Medicare All_Plans $198.72 ↓ -62%
Highmark_Medicare All_Plans $200.71 ↓ -62%
Aetna_Advantra_Medicare All_Plans $204.68 ↓ -61%
Aetna_Medicare All_Plans $204.68 ↓ -61%
Devoted_Medicare All_Plans $208.66 ↓ -61%
Geisinger_Gold_Medicare All_Plans $208.66 ↓ -61%
United_Medicare ISNP_DSNP_Plans $208.66 ↓ -61%
Highmark_Wholecare_Gateway_Medicare All_Plans $209.55 ↓ -60%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $209.65 ↓ -60%
UPMC_Medicare UPMC_for_Life_Complete_Care $209.65 ↓ -60%
Amerihealth_Medicare All_Plans $209.65 ↓ -60%
PA_Health_&_Wellness_Medicare All_Plans $214.62 ↓ -59%
Jefferson_Health_Medicare_Advantage All_Plans $214.62 ↓ -59%
Highmark Higmark_Healthy_Kids $308.02 ↓ -42%
Health_Partners_Medicaid Kidz_Partners $327.89 ↓ -38%
United_Medicaid Community_Plan_For_Kids $347.76 ↓ -34%
Aetna All_Plans $370.72 ↓ -30%
Geisinger All_Plans $397.20 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $397.20 ↓ -25%
UPMC Employees_And_Dependents $397.20 ↓ -25%
UPMC UPMC_For_Kids $397.20 ↓ -25%
First_Health_Network All_Plans $407.79 ↓ -23%
Cigna All_Plans $422.49 ↓ -20%
PHC All_Plans $529.60 ↑ +0%
Highmark Blue_Cross_High_Performance_Network $601.07 ↑ +13%
Highmark Performance_Blue $601.07 ↑ +13%
Highmark Choice_Blue_PPO $601.07 ↑ +13%
United_Healthcare All_Plans $620.96 ↑ +17%
Highmark All_Other_Plans $724.20 ↑ +37%
Blue_Cross Capital_Cares_4_kids $1,131.20 ↑ +114%
Blue_Cross Capital_Blue_Performance_PPO $1,209.00 ↑ +128%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,292.80 ↑ +144%
Blue_Cross All_Other_Plans $1,616.00 ↑ +205%

Visitor-reported prices

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Emb without cervical dilation 58100 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $128.40 $51.00 – $334.58
UPMC Community Osteopathic Harrisburg $378.00 $64.77 – $1,065.46
UPMC Hamot Erie $1,928.40 $56.10 – $334.58
UPMC Northwest Seneca $2,193.00 $56.10 – $201.38
UPMC Hanover Hanover $378.00 $64.77 – $956.30
UPMC Kane Kane $379.80 $56.10 – $428.67
UPMC Magee Pittsburgh $1,057.80 $56.10 – $337.77
UPMC Memorial York $378.00 $64.77 – $956.30

All Pennsylvania hospitals for this procedure →