ER Visit (level 5, high severity) at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$1,844.80
Cash price 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.
$2,306.00
Gross charge 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.
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The hospital's undiscounted list price — almost no one pays this.
$241.25 with Health_Partners_Medicaid vs $4,869.00 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 →
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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 ?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 ?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 |
|---|---|---|---|
| Health_Partners_Medicaid | All_Other_Plans | $241.25 | ↓ -87% |
| UPMC_Medicaid | All_Plans | $241.25 | ↓ -87% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $241.25 | ↓ -87% |
| Geisinger_Medicaid | All_Plans | $241.25 | ↓ -87% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $255.03 | ↓ -86% |
| Amerihealth_Caritas_Medicaid | All_Plans | $274.06 | ↓ -85% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $605.63 | ↓ -67% |
| Highmark_Medicare | All_Plans | $611.69 | ↓ -67% |
| Aetna_Advantra_Medicare | All_Plans | $623.80 | ↓ -66% |
| Aetna_Medicare | All_Plans | $623.80 | ↓ -66% |
| Geisinger_Gold_Medicare | All_Plans | $635.91 | ↓ -66% |
| Devoted_Medicare | All_Plans | $635.91 | ↓ -66% |
| United_Medicare | ISNP_DSNP_Plans | $635.91 | ↓ -66% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $638.64 | ↓ -65% |
| Amerihealth_Medicare | All_Plans | $638.94 | ↓ -65% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $638.94 | ↓ -65% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $638.94 | ↓ -65% |
| PA_Health_&_Wellness_Medicare | All_Plans | $654.08 | ↓ -65% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $654.08 | ↓ -65% |
| Aetna_Better_Health_Kids | All_Plans | $656.20 | ↓ -64% |
| Highmark | Higmark_Healthy_Kids | $938.73 | ↓ -49% |
| Health_Partners_Medicaid | Kidz_Partners | $999.29 | ↓ -46% |
| United_Medicaid | Community_Plan_For_Kids | $1,059.85 | ↓ -43% |
| Cigna | All_Plans | $1,250.00 | ↓ -32% |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,383.60 | ↓ -25% |
| UPMC | Employees_And_Dependents | $1,383.60 | ↓ -25% |
| UPMC | UPMC_For_Kids | $1,383.60 | ↓ -25% |
| Geisinger | All_Plans | $1,383.60 | ↓ -25% |
| Highmark | Performance_Blue | $1,831.85 | ↓ -1% |
| Highmark | Blue_Cross_High_Performance_Network | $1,831.85 | ↓ -1% |
| Highmark | Choice_Blue_PPO | $1,831.85 | ↓ -1% |
| United_Healthcare | All_Plans | $1,836.00 | ↓ -0% |
| PHC | All_Plans | $1,844.80 | ↑ +0% |
| Aetna | All_Plans | $1,872.47 | ↑ +1% |
| First_Health_Network | All_Plans | $2,059.26 | ↑ +12% |
| Highmark | All_Other_Plans | $2,207.10 | ↑ +20% |
| Blue_Cross | Capital_Cares_4_kids | $3,408.30 | ↑ +85% |
| Blue_Cross | Capital_Blue_Performance_PPO | $3,744.00 | ↑ +103% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $3,895.20 | ↑ +111% |
| Blue_Cross | All_Other_Plans | $4,869.00 | ↑ +164% |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,449.00 | $174.21 – $1,932.00 |
| UPMC Bedford | Everett | $903.60 | $145.68 – $1,355.40 |
| UPMC Carlisle | Carlisle | $1,828.80 | $65.00 – $2,590.80 |
| UPMC Cole | Coudersport | $630.00 | $56.38 – $553.93 |
| UPMC Community Osteopathic | Harrisburg | $1,828.80 | $65.00 – $645.31 |
| UPMC East | Monroeville | $1,371.00 | $152.61 – $1,828.00 |
| UPMC Hamot | Erie | $2,165.40 | $152.61 – $728.58 |
| UPMC Northwest | Seneca | $703.20 | $152.61 – $613.75 |