Embo or occlude vascular arterial s&i 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

$29,632.80

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.

$37,041.00

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.

$511.18 with PA_Health_&_Wellness_Medicaid vs $64,642.63 with Highmark — 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 $511.18 ↓ -98%
Highmark_Wholecare_Gateway_Medicaid All_Plans $511.18 ↓ -98%
Geisinger_Medicaid All_Plans $511.18 ↓ -98%
UPMC_Medicaid All_Plans $511.18 ↓ -98%
Health_Partners_Medicaid All_Other_Plans $511.18 ↓ -98%
Amerihealth_Caritas_Medicaid All_Plans $580.69 ↓ -98%
Aetna_Better_Health_Kids All_Plans $1,390.40 ↓ -95%
Blue_Cross_BlueJourney_Medicare All_Plans $17,738.01 ↓ -40%
Highmark_Medicare All_Plans $17,915.39 ↓ -40%
Aetna_Medicare All_Plans $18,270.15 ↓ -38%
Aetna_Advantra_Medicare All_Plans $18,270.15 ↓ -38%
Devoted_Medicare All_Plans $18,624.91 ↓ -37%
United_Medicare ISNP_DSNP_Plans $18,624.91 ↓ -37%
Geisinger_Gold_Medicare All_Plans $18,624.91 ↓ -37%
Highmark_Wholecare_Gateway_Medicare All_Plans $18,704.73 ↓ -37%
Amerihealth_Medicare All_Plans $18,713.60 ↓ -37%
UPMC_Medicare UPMC_for_Life_Complete_Care $18,713.60 ↓ -37%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $18,713.60 ↓ -37%
Jefferson_Health_Medicare_Advantage All_Plans $19,157.05 ↓ -35%
PA_Health_&_Wellness_Medicare All_Plans $19,157.05 ↓ -35%
Aetna All_Plans $20,742.96 ↓ -30%
Geisinger All_Plans $22,224.60 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $22,224.60 ↓ -25%
UPMC Employees_And_Dependents $22,224.60 ↓ -25%
UPMC UPMC_For_Kids $22,224.60 ↓ -25%
First_Health_Network All_Plans $22,817.26 ↓ -23%
Cigna All_Plans $23,639.57 ↓ -20%
Highmark Higmark_Healthy_Kids $27,493.92 ↓ -7%
Blue_Cross Capital_Blue_Performance_PPO $28,500.00 ↓ -4%
Health_Partners_Medicaid Kidz_Partners $29,267.72 ↓ -1%
PHC All_Plans $29,632.80 ↑ +0%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $30,452.00 ↑ +3%
United_Medicaid Community_Plan_For_Kids $31,041.52 ↑ +5%
United_Healthcare All_Plans $34,744.46 ↑ +17%
Blue_Cross All_Other_Plans $38,065.00 ↑ +28%
Highmark Blue_Cross_High_Performance_Network $53,652.16 ↑ +81%
Highmark Choice_Blue_PPO $53,652.16 ↑ +81%
Highmark Performance_Blue $53,652.16 ↑ +81%
Highmark All_Other_Plans $64,642.63 ↑ +118%

Visitor-reported prices

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Embo or occlude vascular arterial s&i at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $11,728.80 $408.94 – $15,638.40
UPMC Carlisle Carlisle $25,921.80 $519.35 – $36,722.55
UPMC Community Osteopathic Harrisburg $25,921.80 $552.07 – $36,722.55
UPMC East Monroeville $12,721.80 $449.83 – $17,975.56
UPMC Hamot Erie $12,810.60 $449.83 – $21,338.79
UPMC Hanover Hanover $25,921.80 $519.35 – $27,446.48
UPMC Jameson New Castle $25,714.80 $449.83 – $23,111.43
UPMC Lititz Lititz $25,921.80 $519.35 – $27,594.74

All Pennsylvania hospitals for this procedure →