Established Patient Office Visit (level 3) 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

$445.60

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.

Full explanation →

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

$557.00

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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$39.00 with Health_Partners_Medicaid vs $463.92 with Highmark — same scan, same building. Share

Negotiated rates by payer
?

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 Kidz_Partners $39.00 ↓ -91%
Geisinger_Medicaid All_Plans $50.00 ↓ -89%
Health_Partners_Medicaid All_Other_Plans $50.00 ↓ -89%
PA_Health_&_Wellness_Medicaid All_Plans $50.00 ↓ -89%
Highmark_Wholecare_Gateway_Medicaid All_Plans $50.00 ↓ -89%
UPMC_Medicaid All_Plans $50.00 ↓ -89%
Amerihealth_Caritas_Medicaid All_Plans $56.80 ↓ -87%
WellSpan_Capital_Blue_Cross All_Plans $78.00 ↓ -82%
UPMC UPMC_For_Kids $78.00 ↓ -82%
Geisinger All_Plans $78.00 ↓ -82%
UPMC Employees_And_Dependents $78.00 ↓ -82%
PHC All_Plans $104.00 ↓ -77%
United_Healthcare All_Plans $121.94 ↓ -73%
Blue_Cross_BlueJourney_Medicare All_Plans $127.30 ↓ -71%
Highmark_Medicare All_Plans $128.57 ↓ -71%
Aetna_Medicare All_Plans $131.12 ↓ -71%
Aetna_Advantra_Medicare All_Plans $131.12 ↓ -71%
United_Medicare ISNP_DSNP_Plans $133.67 ↓ -70%
Devoted_Medicare All_Plans $133.67 ↓ -70%
Geisinger_Gold_Medicare All_Plans $133.67 ↓ -70%
Highmark_Wholecare_Gateway_Medicare All_Plans $134.24 ↓ -70%
Amerihealth_Medicare All_Plans $134.30 ↓ -70%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $134.30 ↓ -70%
UPMC_Medicare UPMC_for_Life_Complete_Care $134.30 ↓ -70%
Aetna_Better_Health_Kids All_Plans $136.00 ↓ -69%
PA_Health_&_Wellness_Medicare All_Plans $137.48 ↓ -69%
Jefferson_Health_Medicare_Advantage All_Plans $137.48 ↓ -69%
Highmark Higmark_Healthy_Kids $197.32 ↓ -56%
United_Medicaid Community_Plan_For_Kids $222.78 ↓ -50%
Highmark Performance_Blue $385.04 ↓ -14%
Highmark Blue_Cross_High_Performance_Network $385.04 ↓ -14%
Highmark Choice_Blue_PPO $385.04 ↓ -14%
Highmark All_Other_Plans $463.92 ↑ +4%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Established Patient Office Visit (level 3) at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $230.40 $20.00 – $307.20
UPMC Bedford Everett $121.20 $36.08 – $181.80
UPMC Cole Coudersport $183.00 $36.75 – $128.00
UPMC Community Osteopathic Harrisburg $240.60 $20.60 – $288.22
UPMC East Monroeville $186.60 $36.08 – $248.80
UPMC Hamot Erie $156.60 $38.50 – $151.40
UPMC Northwest Seneca $186.60 $38.50 – $92.67
UPMC Hanover Hanover $61.80 $44.45 – $88.44

All Pennsylvania hospitals for this procedure →