Embo or occlude vascular venous 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

$20,976.00

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.

$26,220.00

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.

$457.78 with PA_Health_&_Wellness_Medicaid vs $40,825.05 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 $457.78 ↓ -98%
Highmark_Wholecare_Gateway_Medicaid All_Plans $457.78 ↓ -98%
Geisinger_Medicaid All_Plans $457.78 ↓ -98%
UPMC_Medicaid All_Plans $457.78 ↓ -98%
Health_Partners_Medicaid All_Other_Plans $457.78 ↓ -98%
Amerihealth_Caritas_Medicaid All_Plans $520.03 ↓ -98%
Aetna_Better_Health_Kids All_Plans $1,245.15 ↓ -94%
Blue_Cross_BlueJourney_Medicare All_Plans $11,202.44 ↓ -47%
Highmark_Medicare All_Plans $11,314.46 ↓ -46%
Aetna_Medicare All_Plans $11,538.51 ↓ -45%
Aetna_Advantra_Medicare All_Plans $11,538.51 ↓ -45%
Devoted_Medicare All_Plans $11,762.56 ↓ -44%
United_Medicare ISNP_DSNP_Plans $11,762.56 ↓ -44%
Geisinger_Gold_Medicare All_Plans $11,762.56 ↓ -44%
Highmark_Wholecare_Gateway_Medicare All_Plans $11,812.97 ↓ -44%
Amerihealth_Medicare All_Plans $11,818.57 ↓ -44%
UPMC_Medicare UPMC_for_Life_Complete_Care $11,818.57 ↓ -44%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $11,818.57 ↓ -44%
Jefferson_Health_Medicare_Advantage All_Plans $12,098.64 ↓ -42%
PA_Health_&_Wellness_Medicare All_Plans $12,098.64 ↓ -42%
Aetna All_Plans $14,683.20 ↓ -30%
Geisinger All_Plans $15,732.00 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $15,732.00 ↓ -25%
UPMC Employees_And_Dependents $15,732.00 ↓ -25%
UPMC UPMC_For_Kids $15,732.00 ↓ -25%
First_Health_Network All_Plans $16,151.52 ↓ -23%
Cigna All_Plans $16,733.60 ↓ -20%
Highmark Higmark_Healthy_Kids $17,363.78 ↓ -17%
Health_Partners_Medicaid Kidz_Partners $18,484.03 ↓ -12%
United_Medicaid Community_Plan_For_Kids $19,604.27 ↓ -7%
PHC All_Plans $20,976.00 ↑ +0%
United_Healthcare All_Plans $24,594.36 ↑ +17%
Blue_Cross Capital_Blue_Performance_PPO $28,500.00 ↑ +36%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $30,452.00 ↑ +45%
Highmark Blue_Cross_High_Performance_Network $33,884.02 ↑ +62%
Highmark Choice_Blue_PPO $33,884.02 ↑ +62%
Highmark Performance_Blue $33,884.02 ↑ +62%
Blue_Cross All_Other_Plans $38,065.00 ↑ +81%
Highmark All_Other_Plans $40,825.05 ↑ +95%

Visitor-reported prices

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

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $20,701.20 $366.22 – $27,601.60
UPMC Carlisle Carlisle $22,274.40 $465.10 – $31,555.40
UPMC Community Osteopathic Harrisburg $22,274.40 $465.10 – $31,555.40
UPMC East Monroeville $12,721.80 $402.84 – $16,962.40
UPMC Hamot Erie $12,810.60 $402.84 – $15,725.10
UPMC Hanover Hanover $22,274.40 $465.10 – $17,333.84
UPMC Lititz Lititz $22,274.40 $465.10 – $17,427.46
UPMC Magee Pittsburgh $12,001.80 $402.84 – $11,676.82

All Pennsylvania hospitals for this procedure →