In-111 pentetreotide 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

$5,104.80

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.

$6,381.00

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.

$1,148.58 with Aetna_Better_Health_Kids vs $13,815.90 with Cigna — 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
Aetna_Better_Health_Kids All_Plans $1,148.58 ↓ -78%
Highmark_Wholecare_Gateway_Medicaid All_Plans $1,435.96 ↓ -72%
Health_Partners_Medicaid All_Other_Plans $1,914.61 ↓ -62%
Blue_Cross_BlueJourney_Medicare All_Plans $1,914.61 ↓ -62%
Highmark_Medicare All_Plans $1,933.76 ↓ -62%
Aetna_Advantra_Medicare All_Plans $1,972.05 ↓ -61%
Aetna_Medicare All_Plans $1,972.05 ↓ -61%
Devoted_Medicare All_Plans $2,010.34 ↓ -61%
United_Medicare ISNP_DSNP_Plans $2,010.34 ↓ -61%
Geisinger_Gold_Medicare All_Plans $2,010.34 ↓ -61%
Highmark_Wholecare_Gateway_Medicare All_Plans $2,018.96 ↓ -60%
Amerihealth_Medicare All_Plans $2,019.91 ↓ -60%
UPMC_Medicare UPMC_for_Life_Complete_Care $2,019.91 ↓ -60%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $2,019.91 ↓ -60%
PA_Health_&_Wellness_Medicare All_Plans $2,067.78 ↓ -59%
Jefferson_Health_Medicare_Advantage All_Plans $2,067.78 ↓ -59%
WellSpan_Capital_Blue_Cross All_Plans $2,359.60 ↓ -54%
Blue_Cross Capital_Cares_4_kids $2,609.19 ↓ -49%
Highmark Higmark_Healthy_Kids $2,967.65 ↓ -42%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $2,981.84 ↓ -42%
Health_Partners_Medicaid Kidz_Partners $3,159.11 ↓ -38%
United_Medicaid Community_Plan_For_Kids $3,350.57 ↓ -34%
Blue_Cross All_Other_Plans $3,727.14 ↓ -27%
Geisinger All_Plans $3,828.60 ↓ -25%
UPMC Employees_And_Dependents $3,828.60 ↓ -25%
UPMC UPMC_For_Kids $3,828.60 ↓ -25%
PHC All_Plans $5,104.80 ↑ +0%
Aetna All_Plans $5,181.37 ↑ +1%
First_Health_Network All_Plans $5,698.23 ↑ +12%
Highmark Choice_Blue_PPO $5,791.12 ↑ +13%
Highmark Blue_Cross_High_Performance_Network $5,791.12 ↑ +13%
Highmark Performance_Blue $5,791.12 ↑ +13%
United_Healthcare All_Plans $6,126.75 ↑ +20%
Highmark All_Other_Plans $6,977.41 ↑ +37%
Cigna All_Plans $13,815.90 ↑ +171%

Visitor-reported prices

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In-111 pentetreotide at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $18,255.00 $1,053.04 – $25,861.25
UPMC Community Osteopathic Harrisburg $18,255.00 $1,895.46 – $25,861.25
UPMC Hanover Hanover $18,255.00 $1,895.46 – $4,692.07
UPMC Jameson New Castle $265.20 $1,914.61 – $5,391.06
UPMC Lititz Lititz $18,255.00 $1,895.46 – $4,692.07
UPMC Magee Pittsburgh $12,179.40 $1,791.88 – $5,348.02
UPMC Memorial York $18,255.00 $1,996.94 – $4,692.07
UPMC Muncy Muncy $3,477.00 $869.25 – $5,215.50

All Pennsylvania hospitals for this procedure →