Infectious agent antigen immunoassay ql/sq multi step rotavirus 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

$60.00

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.

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

$75.00

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.

$11.98 with Blue_Cross_BlueJourney_Medicare vs $136.98 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_BlueJourney_Medicare All_Plans $11.98 ↓ -80%
Highmark_Medicare All_Plans $12.10 ↓ -80%
Aetna_Medicare All_Plans $12.34 ↓ -79%
Aetna_Advantra_Medicare All_Plans $12.34 ↓ -79%
United_Medicare ISNP_DSNP_Plans $12.58 ↓ -79%
Geisinger_Gold_Medicare All_Plans $12.58 ↓ -79%
Devoted_Medicare All_Plans $12.58 ↓ -79%
Highmark_Wholecare_Gateway_Medicare All_Plans $12.63 ↓ -79%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $12.64 ↓ -79%
UPMC_Medicare UPMC_for_Life_Complete_Care $12.64 ↓ -79%
Amerihealth_Medicare All_Plans $12.64 ↓ -79%
Jefferson_Health_Medicare_Advantage All_Plans $12.94 ↓ -78%
PA_Health_&_Wellness_Medicare All_Plans $12.94 ↓ -78%
Aetna_Better_Health_Kids All_Plans $13.50 ↓ -78%
Highmark Higmark_Healthy_Kids $18.57 ↓ -69%
Health_Partners_Medicaid Kidz_Partners $19.77 ↓ -67%
United_Medicaid Community_Plan_For_Kids $20.97 ↓ -65%
United_Healthcare All_Plans $35.94 ↓ -40%
Highmark Performance_Blue $36.24 ↓ -40%
Highmark Choice_Blue_PPO $36.24 ↓ -40%
Highmark Blue_Cross_High_Performance_Network $36.24 ↓ -40%
Highmark All_Other_Plans $43.66 ↓ -27%
Geisinger All_Plans $45.00 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $45.00 ↓ -25%
UPMC UPMC_For_Kids $45.00 ↓ -25%
UPMC Employees_And_Dependents $45.00 ↓ -25%
Aetna All_Plans $49.48 ↓ -18%
First_Health_Network All_Plans $54.39 ↓ -9%
PHC All_Plans $60.00 ↑ +0%
Cigna All_Plans $62.60 ↑ +4%
Blue_Cross Capital_Cares_4_kids $71.69 ↑ +19%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $81.93 ↑ +37%
Blue_Cross All_Other_Plans $102.41 ↑ +71%
Blue_Cross Capital_Blue_Performance_PPO $136.98 ↑ +128%

Visitor-reported prices

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Infectious agent antigen immunoassay ql/sq multi step rotavirus at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $130.20 $11.84 – $173.60
UPMC Bedford Everett $223.20 $4.32 – $334.80
UPMC Carlisle Carlisle $66.60 $6.59 – $94.35
UPMC Cole Coudersport $111.60 $7.79 – $148.80
UPMC Community Osteopathic Harrisburg $66.60 $9.58 – $94.35
UPMC East Monroeville $152.40 $11.84 – $203.20
UPMC Hamot Erie $143.40 $11.84 – $31.36
UPMC Northwest Seneca $108.00 $10.86 – $12.94

All Pennsylvania hospitals for this procedure →