Injection for ureter x-ray at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$963.20
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.
$1,204.00
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.
$53.75 with Highmark_Wholecare_Gateway_Medicaid vs $1,129.35 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 |
|---|---|---|---|
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $53.75 | ↓ -94% |
| UPMC_Medicaid | All_Plans | $53.75 | ↓ -94% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $53.75 | ↓ -94% |
| Geisinger_Medicaid | All_Plans | $53.75 | ↓ -94% |
| Health_Partners_Medicaid | All_Other_Plans | $53.75 | ↓ -94% |
| Amerihealth_Caritas_Medicaid | All_Plans | $61.06 | ↓ -94% |
| Aetna_Better_Health_Kids | All_Plans | $146.20 | ↓ -85% |
| Blue_Cross | Capital_Cares_4_kids | $492.32 | ↓ -49% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $562.63 | ↓ -42% |
| Aetna | All_Plans | $674.24 | ↓ -30% |
| Blue_Cross | All_Other_Plans | $703.26 | ↓ -27% |
| WellSpan_Capital_Blue_Cross | All_Plans | $722.40 | ↓ -25% |
| Geisinger | All_Plans | $722.40 | ↓ -25% |
| UPMC | UPMC_For_Kids | $722.40 | ↓ -25% |
| UPMC | Employees_And_Dependents | $722.40 | ↓ -25% |
| First_Health_Network | All_Plans | $741.66 | ↓ -23% |
| Cigna | All_Plans | $768.39 | ↓ -20% |
| PHC | All_Plans | $963.20 | ↑ +0% |
| United_Healthcare | All_Plans | $1,129.35 | ↑ +17% |
Visitor-reported prices
Comments
Injection for ureter x-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,540.80 | $54.61 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $1,540.80 | $56.33 – $2,249.82 |
| UPMC Hamot | Erie | $3,021.60 | $47.30 – $545.04 |
| UPMC Hanover | Hanover | $1,540.80 | $54.61 – $157.10 |
| UPMC Horizon-Greenville | Greenville | $2,431.20 | $45.15 – $1,060.34 |
| UPMC Lititz | Lititz | $1,540.80 | $54.61 – $156.48 |
| UPMC Magee | Pittsburgh | $1,757.40 | $47.30 – $550.23 |
| UPMC Memorial | York | $1,540.80 | $54.61 – $444.23 |