H pylori (c-13) breath 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

$280.00

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.

$350.00

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.

$63.39 with Blue_Cross vs $403.73 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 →

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 $63.39 ↓ -77%
Blue_Cross_BlueJourney_Medicare All_Plans $67.36 ↓ -76%
Highmark_Medicare All_Plans $68.03 ↓ -76%
Aetna_Advantra_Medicare All_Plans $69.38 ↓ -75%
Aetna_Medicare All_Plans $69.38 ↓ -75%
Devoted_Medicare All_Plans $70.73 ↓ -75%
Geisinger_Gold_Medicare All_Plans $70.73 ↓ -75%
United_Medicare ISNP_DSNP_Plans $70.73 ↓ -75%
Highmark_Wholecare_Gateway_Medicare All_Plans $71.03 ↓ -75%
Amerihealth_Medicare All_Plans $71.06 ↓ -75%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $71.06 ↓ -75%
UPMC_Medicare UPMC_for_Life_Complete_Care $71.06 ↓ -75%
Jefferson_Health_Medicare_Advantage All_Plans $72.75 ↓ -74%
PA_Health_&_Wellness_Medicare All_Plans $72.75 ↓ -74%
Geisinger_Medicaid All_Plans $75.13 ↓ -73%
PA_Health_&_Wellness_Medicaid All_Plans $75.13 ↓ -73%
Highmark_Wholecare_Gateway_Medicaid All_Plans $75.13 ↓ -73%
UPMC_Medicaid All_Plans $75.13 ↓ -73%
Health_Partners_Medicaid All_Other_Plans $75.13 ↓ -73%
Amerihealth_Caritas_Medicaid All_Plans $85.34 ↓ -70%
Highmark Higmark_Healthy_Kids $104.41 ↓ -63%
Health_Partners_Medicaid Kidz_Partners $111.14 ↓ -60%
United_Medicaid Community_Plan_For_Kids $117.88 ↓ -58%
United_Healthcare All_Plans $202.08 ↓ -28%
Highmark Choice_Blue_PPO $203.74 ↓ -27%
Highmark Blue_Cross_High_Performance_Network $203.74 ↓ -27%
Highmark Performance_Blue $203.74 ↓ -27%
Aetna_Better_Health_Kids All_Plans $204.34 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $210.00 ↓ -25%
UPMC Employees_And_Dependents $210.00 ↓ -25%
UPMC UPMC_For_Kids $210.00 ↓ -25%
Geisinger All_Plans $210.00 ↓ -25%
Highmark All_Other_Plans $245.48 ↓ -12%
Aetna All_Plans $278.20 ↓ -1%
PHC All_Plans $280.00 ↑ +0%
Blue_Cross Capital_Cares_4_kids $282.61 ↑ +1%
Cigna All_Plans $292.11 ↑ +4%
First_Health_Network All_Plans $305.81 ↑ +9%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $322.98 ↑ +15%
Blue_Cross All_Other_Plans $403.73 ↑ +44%

Visitor-reported prices

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H pylori (c-13) breath at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $341.40 $60.10 – $455.20
UPMC Bedford Everett $256.80 $24.30 – $385.20
UPMC Carlisle Carlisle $340.80 $32.27 – $482.80
UPMC Community Osteopathic Harrisburg $340.80 $60.10 – $482.80
UPMC Hamot Erie $642.60 $60.10 – $115.25
UPMC Northwest Seneca $346.80 $61.09 – $72.75
UPMC Hanover Hanover $340.80 $32.27 – $107.78
UPMC Horizon-Greenville Greenville $338.40 $60.10 – $126.40

All Pennsylvania hospitals for this procedure →