Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$164.80
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.
$206.00
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.
$41.25 with UPMC_Medicaid vs $193.23 with United_Healthcare — 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 | $41.25 | ↓ -75% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $41.25 | ↓ -75% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $41.25 | ↓ -75% |
| Health_Partners_Medicaid | All_Other_Plans | $41.25 | ↓ -75% |
| Geisinger_Medicaid | All_Plans | $41.25 | ↓ -75% |
| Amerihealth_Caritas_Medicaid | All_Plans | $46.86 | ↓ -72% |
| Blue_Cross | Capital_Cares_4_kids | $84.23 | ↓ -49% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $96.26 | ↓ -42% |
| Aetna_Better_Health_Kids | All_Plans | $112.20 | ↓ -32% |
| Aetna | All_Plans | $115.36 | ↓ -30% |
| Blue_Cross | All_Other_Plans | $120.32 | ↓ -27% |
| WellSpan_Capital_Blue_Cross | All_Plans | $123.60 | ↓ -25% |
| Geisinger | All_Plans | $123.60 | ↓ -25% |
| UPMC | UPMC_For_Kids | $123.60 | ↓ -25% |
| UPMC | Employees_And_Dependents | $123.60 | ↓ -25% |
| First_Health_Network | All_Plans | $126.90 | ↓ -23% |
| Cigna | All_Plans | $131.47 | ↓ -20% |
| PHC | All_Plans | $164.80 | ↑ +0% |
| United_Healthcare | All_Plans | $193.23 | ↑ +17% |
Visitor-reported prices
Comments
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $294.60 | $130.12 – $419.66 |
| UPMC Bedford | Everett | $808.20 | $133.29 – $1,212.30 |
| UPMC Carlisle | Carlisle | $461.40 | $105.35 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $461.40 | $141.08 – $1,016.56 |
| UPMC East | Monroeville | $543.60 | $131.35 – $724.80 |
| UPMC Hamot | Erie | $566.40 | $130.12 – $521.03 |
| UPMC Northwest | Seneca | $450.00 | $134.81 – $337.70 |
| UPMC Hanover | Hanover | $461.40 | $141.08 – $1,016.56 |