Hc fl sm bowel enteroclss tube w kub double contrast at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$867.20
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.
?
What you pay up front if you don't use insurance.
$1,084.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$79.06 with PA_Health_&_Wellness_Medicaid vs $1,006.60 with United_Healthcare — 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 →
?
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 |
|---|---|---|---|
| PA_Health_&_Wellness_Medicaid | All_Plans | $79.06 | ↓ -91% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $79.06 | ↓ -91% |
| UPMC_Medicaid | All_Plans | $79.06 | ↓ -91% |
| Health_Partners_Medicaid | All_Other_Plans | $79.06 | ↓ -91% |
| Geisinger_Medicaid | All_Plans | $79.06 | ↓ -91% |
| Amerihealth_Caritas_Medicaid | All_Plans | $89.82 | ↓ -90% |
| Blue_Cross | Capital_Blue_Performance_PPO | $132.34 | ↓ -85% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $175.85 | ↓ -80% |
| Highmark_Medicare | All_Plans | $177.61 | ↓ -80% |
| Aetna_Advantra_Medicare | All_Plans | $181.13 | ↓ -79% |
| Aetna_Medicare | All_Plans | $181.13 | ↓ -79% |
| United_Medicare | ISNP_DSNP_Plans | $184.64 | ↓ -79% |
| Devoted_Medicare | All_Plans | $184.64 | ↓ -79% |
| Geisinger_Gold_Medicare | All_Plans | $184.64 | ↓ -79% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $185.43 | ↓ -79% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $185.52 | ↓ -79% |
| Amerihealth_Medicare | All_Plans | $185.52 | ↓ -79% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $185.52 | ↓ -79% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $189.92 | ↓ -78% |
| PA_Health_&_Wellness_Medicare | All_Plans | $189.92 | ↓ -78% |
| Aetna_Better_Health_Kids | All_Plans | $215.05 | ↓ -75% |
| Highmark | Higmark_Healthy_Kids | $272.57 | ↓ -69% |
| Health_Partners_Medicaid | Kidz_Partners | $290.15 | ↓ -67% |
| United_Medicaid | Community_Plan_For_Kids | $307.74 | ↓ -65% |
| Highmark | Choice_Blue_PPO | $531.89 | ↓ -39% |
| Highmark | Performance_Blue | $531.89 | ↓ -39% |
| Highmark | Blue_Cross_High_Performance_Network | $531.89 | ↓ -39% |
| Blue_Cross | Capital_Cares_4_kids | $607.15 | ↓ -30% |
| Cigna | All_Plans | $638.58 | ↓ -26% |
| Highmark | All_Other_Plans | $640.85 | ↓ -26% |
| WellSpan_Capital_Blue_Cross | All_Plans | $650.40 | ↓ -25% |
| UPMC | Employees_And_Dependents | $650.40 | ↓ -25% |
| UPMC | UPMC_For_Kids | $650.40 | ↓ -25% |
| Geisinger | All_Plans | $650.40 | ↓ -25% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $693.89 | ↓ -20% |
| PHC | All_Plans | $867.20 | ↑ +0% |
| Blue_Cross | All_Other_Plans | $867.36 | ↑ +0% |
| Aetna | All_Plans | $880.21 | ↑ +2% |
| First_Health_Network | All_Plans | $968.01 | ↑ +12% |
| United_Healthcare | All_Plans | $1,006.60 | ↑ +16% |
Visitor-reported prices
Comments
Hc fl sm bowel enteroclss tube w kub double contrast at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Kane | Kane | $606.00 | $69.58 – $727.29 |
| UPMC Muncy | Muncy | $1,272.60 | $50.42 – $199.24 |
| UPMC Wellsboro | Wellsboro | $1,539.20 | $50.42 – $172.10 |
| Uniontown Hospital | Uniontown | $418.50 | $40.15 – $353.11 |
| WellSpan Gettysburg Hospital | Gettysburg | $867.20 | $49.24 – $1,006.60 |