Facial bones <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

$224.00

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.

Full explanation →

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

$280.00

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.

$18.91 with Blue_Cross vs $497.84 with United_Healthcare — 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
Blue_Cross Capital_Blue_Performance_PPO $18.91 ↓ -92%
Geisinger_Medicaid All_Plans $34.30 ↓ -85%
Health_Partners_Medicaid All_Other_Plans $34.30 ↓ -85%
Highmark_Wholecare_Gateway_Medicaid All_Plans $34.30 ↓ -85%
UPMC_Medicaid All_Plans $34.30 ↓ -85%
PA_Health_&_Wellness_Medicaid All_Plans $34.30 ↓ -85%
Amerihealth_Caritas_Medicaid All_Plans $38.96 ↓ -83%
Blue_Cross Capital_Cares_4_kids $86.76 ↓ -61%
Blue_Cross_BlueJourney_Medicare All_Plans $86.98 ↓ -61%
Highmark_Medicare All_Plans $87.85 ↓ -61%
Aetna_Advantra_Medicare All_Plans $89.59 ↓ -60%
Aetna_Medicare All_Plans $89.59 ↓ -60%
Geisinger_Gold_Medicare All_Plans $91.33 ↓ -59%
United_Medicare ISNP_DSNP_Plans $91.33 ↓ -59%
Devoted_Medicare All_Plans $91.33 ↓ -59%
Highmark_Wholecare_Gateway_Medicare All_Plans $91.72 ↓ -59%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $91.76 ↓ -59%
Amerihealth_Medicare All_Plans $91.76 ↓ -59%
UPMC_Medicare UPMC_for_Life_Complete_Care $91.76 ↓ -59%
Aetna_Better_Health_Kids All_Plans $93.30 ↓ -58%
PA_Health_&_Wellness_Medicare All_Plans $93.94 ↓ -58%
Jefferson_Health_Medicare_Advantage All_Plans $93.94 ↓ -58%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $99.15 ↓ -56%
WellSpan_Capital_Blue_Cross All_Plans $110.00 ↓ -51%
Blue_Cross All_Other_Plans $123.94 ↓ -45%
Highmark Higmark_Healthy_Kids $134.82 ↓ -40%
Health_Partners_Medicaid Kidz_Partners $143.52 ↓ -36%
United_Medicaid Community_Plan_For_Kids $152.22 ↓ -32%
Cigna All_Plans $164.95 ↓ -26%
UPMC Employees_And_Dependents $168.00 ↓ -25%
UPMC UPMC_For_Kids $168.00 ↓ -25%
Geisinger All_Plans $168.00 ↓ -25%
PHC All_Plans $224.00 ↑ +0%
Aetna All_Plans $227.36 ↑ +2%
First_Health_Network All_Plans $250.04 ↑ +12%
Highmark Blue_Cross_High_Performance_Network $263.09 ↑ +17%
Highmark Choice_Blue_PPO $263.09 ↑ +17%
Highmark Performance_Blue $263.09 ↑ +17%
Highmark All_Other_Plans $316.98 ↑ +42%
United_Healthcare All_Plans $497.84 ↑ +122%

Visitor-reported prices

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Facial bones <3 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $188.40 $23.72 – $266.90
UPMC Cole Coudersport $145.80 $28.81 – $194.40
UPMC Community Osteopathic Harrisburg $188.40 $23.72 – $266.90
UPMC East Monroeville $436.20 $30.18 – $581.60
UPMC Hamot Erie $340.20 $23.94 – $118.50
UPMC Northwest Seneca $288.60 $30.18 – $88.15
UPMC Hanover Hanover $188.40 $23.72 – $134.58
UPMC Horizon-Greenville Greenville $189.00 $28.81 – $90.67

All Pennsylvania hospitals for this procedure →