Established Patient Office Visit (level 2) 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

$675.20

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.

Full explanation →

What you pay up front if you don't use insurance.

$844.00

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.

$29.40 with Health_Partners_Medicaid vs $463.92 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
Health_Partners_Medicaid Kidz_Partners $29.40 ↓ -96%
Geisinger_Medicaid All_Plans $50.00 ↓ -93%
Health_Partners_Medicaid All_Other_Plans $50.00 ↓ -93%
PA_Health_&_Wellness_Medicaid All_Plans $50.00 ↓ -93%
Highmark_Wholecare_Gateway_Medicaid All_Plans $50.00 ↓ -93%
UPMC_Medicaid All_Plans $50.00 ↓ -93%
Amerihealth_Caritas_Medicaid All_Plans $56.80 ↓ -92%
WellSpan_Capital_Blue_Cross All_Plans $58.80 ↓ -91%
UPMC UPMC_For_Kids $58.80 ↓ -91%
Geisinger All_Plans $58.80 ↓ -91%
UPMC Employees_And_Dependents $58.80 ↓ -91%
PHC All_Plans $78.40 ↓ -88%
United_Healthcare All_Plans $91.92 ↓ -86%
Blue_Cross_BlueJourney_Medicare All_Plans $127.30 ↓ -81%
Highmark_Medicare All_Plans $128.57 ↓ -81%
Aetna_Medicare All_Plans $131.12 ↓ -81%
Aetna_Advantra_Medicare All_Plans $131.12 ↓ -81%
United_Medicare ISNP_DSNP_Plans $133.67 ↓ -80%
Devoted_Medicare All_Plans $133.67 ↓ -80%
Geisinger_Gold_Medicare All_Plans $133.67 ↓ -80%
Highmark_Wholecare_Gateway_Medicare All_Plans $134.24 ↓ -80%
Amerihealth_Medicare All_Plans $134.30 ↓ -80%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $134.30 ↓ -80%
UPMC_Medicare UPMC_for_Life_Complete_Care $134.30 ↓ -80%
Aetna_Better_Health_Kids All_Plans $136.00 ↓ -80%
PA_Health_&_Wellness_Medicare All_Plans $137.48 ↓ -80%
Jefferson_Health_Medicare_Advantage All_Plans $137.48 ↓ -80%
Highmark Higmark_Healthy_Kids $197.32 ↓ -71%
United_Medicaid Community_Plan_For_Kids $222.78 ↓ -67%
Highmark Performance_Blue $385.04 ↓ -43%
Highmark Blue_Cross_High_Performance_Network $385.04 ↓ -43%
Highmark Choice_Blue_PPO $385.04 ↓ -43%
Highmark All_Other_Plans $463.92 ↓ -31%

Visitor-reported prices

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Established Patient Office Visit (level 2) at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $207.00 $20.00 – $276.00
UPMC Bedford Everett $104.40 $27.30 – $156.60
UPMC Cole Coudersport $110.40 $27.30 – $96.80
UPMC Community Osteopathic Harrisburg $174.00 $20.60 – $215.42
UPMC East Monroeville $138.60 $28.60 – $184.80
UPMC Hamot Erie $138.60 $28.60 – $151.40
UPMC Northwest Seneca $145.80 $28.60 – $71.93
UPMC Hanover Hanover $61.80 $33.02 – $61.62

All Pennsylvania hospitals for this procedure →