Immune complex assay 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

$101.60

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.

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

$127.00

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.

$15.99 with Blue_Cross vs $226.67 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 $15.99 ↓ -84%
Blue_Cross_BlueJourney_Medicare All_Plans $24.37 ↓ -76%
Highmark_Medicare All_Plans $24.61 ↓ -76%
Aetna_Medicare All_Plans $25.10 ↓ -75%
Aetna_Advantra_Medicare All_Plans $25.10 ↓ -75%
Devoted_Medicare All_Plans $25.59 ↓ -75%
United_Medicare ISNP_DSNP_Plans $25.59 ↓ -75%
Geisinger_Gold_Medicare All_Plans $25.59 ↓ -75%
Highmark_Wholecare_Gateway_Medicare All_Plans $25.70 ↓ -75%
Amerihealth_Medicare All_Plans $25.71 ↓ -75%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $25.71 ↓ -75%
UPMC_Medicare UPMC_for_Life_Complete_Care $25.71 ↓ -75%
PA_Health_&_Wellness_Medicare All_Plans $26.32 ↓ -74%
Jefferson_Health_Medicare_Advantage All_Plans $26.32 ↓ -74%
Highmark_Wholecare_Gateway_Medicaid All_Plans $37.50 ↓ -63%
PA_Health_&_Wellness_Medicaid All_Plans $37.50 ↓ -63%
UPMC_Medicaid All_Plans $37.50 ↓ -63%
Geisinger_Medicaid All_Plans $37.50 ↓ -63%
Health_Partners_Medicaid All_Other_Plans $37.50 ↓ -63%
Highmark Higmark_Healthy_Kids $37.77 ↓ -63%
Health_Partners_Medicaid Kidz_Partners $40.21 ↓ -60%
Amerihealth_Caritas_Medicaid All_Plans $42.60 ↓ -58%
United_Medicaid Community_Plan_For_Kids $42.65 ↓ -58%
United_Healthcare All_Plans $73.11 ↓ -28%
Highmark Blue_Cross_High_Performance_Network $73.71 ↓ -27%
Highmark Choice_Blue_PPO $73.71 ↓ -27%
Highmark Performance_Blue $73.71 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $76.20 ↓ -25%
UPMC Employees_And_Dependents $76.20 ↓ -25%
UPMC UPMC_For_Kids $76.20 ↓ -25%
Geisinger All_Plans $76.20 ↓ -25%
Highmark All_Other_Plans $88.81 ↓ -13%
Aetna All_Plans $100.65 ↓ -1%
PHC All_Plans $101.60 ↑ +0%
Aetna_Better_Health_Kids All_Plans $102.00 ↑ +0%
Cigna All_Plans $105.99 ↑ +4%
First_Health_Network All_Plans $110.64 ↑ +9%
Blue_Cross Capital_Cares_4_kids $158.67 ↑ +56%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $181.34 ↑ +78%
Blue_Cross All_Other_Plans $226.67 ↑ +123%

Visitor-reported prices

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Immune complex assay at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $243.00 $24.09 – $324.00
UPMC Bedford Everett $338.40 $8.79 – $507.60
UPMC Carlisle Carlisle $88.80 $17.75 – $125.80
UPMC Cole Coudersport $178.20 $15.84 – $237.60
UPMC Community Osteopathic Harrisburg $88.80 $24.13 – $127.79
UPMC East Monroeville $306.00 $24.09 – $408.00
UPMC Hamot Erie $274.80 $24.09 – $47.10
UPMC Northwest Seneca $289.20 $22.10 – $34.50

All Pennsylvania hospitals for this procedure →