Inj nephrosto/ureterogram w/img exstng access at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$1,516.80
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.
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What you pay up front if you don't use insurance.
$1,896.00
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.
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The hospital's undiscounted list price — almost no one pays this.
$66.88 with UPMC_Medicaid vs $3,498.00 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 →
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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 ?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 |
|---|---|---|---|
| UPMC_Medicaid | All_Plans | $66.88 | ↓ -96% |
| Health_Partners_Medicaid | All_Other_Plans | $66.88 | ↓ -96% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $66.88 | ↓ -96% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $66.88 | ↓ -96% |
| Geisinger_Medicaid | All_Plans | $66.88 | ↓ -96% |
| Amerihealth_Caritas_Medicaid | All_Plans | $75.97 | ↓ -95% |
| Aetna_Better_Health_Kids | All_Plans | $181.90 | ↓ -88% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $659.34 | ↓ -57% |
| Highmark_Medicare | All_Plans | $665.93 | ↓ -56% |
| Aetna_Medicare | All_Plans | $679.12 | ↓ -55% |
| Aetna_Advantra_Medicare | All_Plans | $679.12 | ↓ -55% |
| Geisinger_Gold_Medicare | All_Plans | $692.31 | ↓ -54% |
| United_Medicare | ISNP_DSNP_Plans | $692.31 | ↓ -54% |
| Devoted_Medicare | All_Plans | $692.31 | ↓ -54% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $695.27 | ↓ -54% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $695.60 | ↓ -54% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $695.60 | ↓ -54% |
| Amerihealth_Medicare | All_Plans | $695.60 | ↓ -54% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $712.09 | ↓ -53% |
| PA_Health_&_Wellness_Medicare | All_Plans | $712.09 | ↓ -53% |
| Highmark | Higmark_Healthy_Kids | $1,021.98 | ↓ -33% |
| Aetna | All_Plans | $1,061.76 | ↓ -30% |
| Health_Partners_Medicaid | Kidz_Partners | $1,087.91 | ↓ -28% |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,137.60 | ↓ -25% |
| UPMC | Employees_And_Dependents | $1,137.60 | ↓ -25% |
| UPMC | UPMC_For_Kids | $1,137.60 | ↓ -25% |
| Geisinger | All_Plans | $1,137.60 | ↓ -25% |
| United_Medicaid | Community_Plan_For_Kids | $1,153.85 | ↓ -24% |
| First_Health_Network | All_Plans | $1,167.94 | ↓ -23% |
| Cigna | All_Plans | $1,210.03 | ↓ -20% |
| PHC | All_Plans | $1,516.80 | ↑ +0% |
| United_Healthcare | All_Plans | $1,778.45 | ↑ +17% |
| Highmark | Performance_Blue | $1,994.31 | ↑ +31% |
| Highmark | Choice_Blue_PPO | $1,994.31 | ↑ +31% |
| Highmark | Blue_Cross_High_Performance_Network | $1,994.31 | ↑ +31% |
| Highmark | All_Other_Plans | $2,402.83 | ↑ +58% |
| Blue_Cross | Capital_Cares_4_kids | $2,448.60 | ↑ +61% |
| Blue_Cross | Capital_Blue_Performance_PPO | $2,620.00 | ↑ +73% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $2,798.40 | ↑ +84% |
| Blue_Cross | All_Other_Plans | $3,498.00 | ↑ +131% |
Visitor-reported prices
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Inj nephrosto/ureterogram w/img exstng access at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,977.00 | $109.24 – $2,636.00 |
| UPMC Bedford | Everett | $2,092.80 | $209.24 – $3,139.20 |
| UPMC Carlisle | Carlisle | $1,266.00 | $218.97 – $1,793.50 |
| UPMC Community Osteopathic | Harrisburg | $1,266.00 | $218.97 – $1,793.50 |
| UPMC East | Monroeville | $2,092.80 | $110.28 – $2,790.40 |
| UPMC Hamot | Erie | $2,189.40 | $109.24 – $925.53 |
| UPMC Northwest | Seneca | $2,092.80 | $209.24 – $687.26 |
| UPMC Hanover | Hanover | $1,266.00 | $218.97 – $1,355.70 |