Ins/rpl pm w/tv ld atrl 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

$37,716.80

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.

$47,146.00

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.

$6,420.00 with Aetna_Better_Health_Kids vs $44,222.95 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 →

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 $6,420.00 ↓ -83%
Blue_Cross_BlueJourney_Medicare All_Plans $10,337.86 ↓ -73%
Highmark_Medicare All_Plans $10,441.24 ↓ -72%
Health_Partners_Medicaid All_Other_Plans $10,465.33 ↓ -72%
Aetna_Advantra_Medicare All_Plans $10,648.00 ↓ -72%
Aetna_Medicare All_Plans $10,648.00 ↓ -72%
United_Medicare ISNP_DSNP_Plans $10,854.75 ↓ -71%
Devoted_Medicare All_Plans $10,854.75 ↓ -71%
Geisinger_Gold_Medicare All_Plans $10,854.75 ↓ -71%
Highmark_Wholecare_Gateway_Medicare All_Plans $10,901.27 ↓ -71%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $10,906.44 ↓ -71%
Amerihealth_Medicare All_Plans $10,906.44 ↓ -71%
UPMC_Medicare UPMC_for_Life_Complete_Care $10,906.44 ↓ -71%
Jefferson_Health_Medicare_Advantage All_Plans $11,164.89 ↓ -70%
PA_Health_&_Wellness_Medicare All_Plans $11,164.89 ↓ -70%
Highmark Higmark_Healthy_Kids $16,023.68 ↓ -58%
Health_Partners_Medicaid Kidz_Partners $17,057.47 ↓ -55%
United_Medicaid Community_Plan_For_Kids $18,091.26 ↓ -52%
Aetna All_Plans $26,401.76 ↓ -30%
Geisinger All_Plans $28,287.60 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $28,287.60 ↓ -25%
UPMC Employees_And_Dependents $28,287.60 ↓ -25%
UPMC UPMC_For_Kids $28,287.60 ↓ -25%
Blue_Cross Capital_Blue_Performance_PPO $28,500.00 ↓ -24%
First_Health_Network All_Plans $29,041.94 ↓ -23%
Cigna All_Plans $30,088.58 ↓ -20%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $30,452.00 ↓ -19%
Highmark Choice_Blue_PPO $31,268.93 ↓ -17%
Highmark Blue_Cross_High_Performance_Network $31,268.93 ↓ -17%
Highmark Performance_Blue $31,268.93 ↓ -17%
Highmark All_Other_Plans $37,674.26 ↓ -0%
PHC All_Plans $37,716.80 ↑ +0%
Blue_Cross All_Other_Plans $38,065.00 ↑ +1%
United_Healthcare All_Plans $44,222.95 ↑ +17%

Visitor-reported prices

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Ins/rpl pm w/tv ld atrl at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $25,170.00 $1,016.56 – $35,657.50
UPMC Community Osteopathic Harrisburg $25,170.00 $1,016.56 – $35,657.50
UPMC East Monroeville $3,294.60 $793.97 – $10,775.64
UPMC Hamot Erie $10,378.80 $786.48 – $14,511.47
UPMC Lititz Lititz $25,170.00 $486.93 – $1,754.22
UPMC Memorial York $25,170.00 $486.93 – $1,766.45
UPMC Passavant-McCandless Pittsburgh $15,256.20 $793.97 – $10,975.18
UPMC Presbyterian Pittsburgh $17,949.60 $793.97 – $10,975.18

All Pennsylvania hospitals for this procedure →