IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour 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

$223.20

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.

$279.00

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.

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The hospital's undiscounted list price — almost no one pays this.

$24.05 with UPMC_Medicaid vs $261.70 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.

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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
UPMC_Medicaid All_Plans $24.05 ↓ -89%
Highmark_Wholecare_Gateway_Medicaid All_Plans $24.05 ↓ -89%
Health_Partners_Medicaid All_Other_Plans $24.05 ↓ -89%
Geisinger_Medicaid All_Plans $24.05 ↓ -89%
PA_Health_&_Wellness_Medicaid All_Plans $24.05 ↓ -89%
Amerihealth_Caritas_Medicaid All_Plans $27.32 ↓ -88%
Aetna_Better_Health_Kids All_Plans $65.42 ↓ -71%
Blue_Cross_BlueJourney_Medicare All_Plans $70.30 ↓ -69%
Highmark_Medicare All_Plans $71.00 ↓ -68%
Aetna_Medicare All_Plans $72.41 ↓ -68%
Aetna_Advantra_Medicare All_Plans $72.41 ↓ -68%
United_Medicare ISNP_DSNP_Plans $73.82 ↓ -67%
Geisinger_Gold_Medicare All_Plans $73.82 ↓ -67%
Devoted_Medicare All_Plans $73.82 ↓ -67%
Highmark_Wholecare_Gateway_Medicare All_Plans $74.13 ↓ -67%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $74.17 ↓ -67%
Amerihealth_Medicare All_Plans $74.17 ↓ -67%
UPMC_Medicare UPMC_for_Life_Complete_Care $74.17 ↓ -67%
PA_Health_&_Wellness_Medicare All_Plans $75.92 ↓ -66%
Jefferson_Health_Medicare_Advantage All_Plans $75.92 ↓ -66%
Highmark Higmark_Healthy_Kids $108.97 ↓ -51%
Blue_Cross Capital_Cares_4_kids $114.08 ↓ -49%
Health_Partners_Medicaid Kidz_Partners $116.00 ↓ -48%
United_Medicaid Community_Plan_For_Kids $123.03 ↓ -45%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $130.38 ↓ -42%
Blue_Cross All_Other_Plans $162.96 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $167.40 ↓ -25%
UPMC Employees_And_Dependents $167.40 ↓ -25%
UPMC UPMC_For_Kids $167.40 ↓ -25%
Geisinger All_Plans $167.40 ↓ -25%
Blue_Cross Capital_Blue_Performance_PPO $177.01 ↓ -21%
Cigna All_Plans $178.06 ↓ -20%
Highmark Performance_Blue $212.64 ↓ -5%
Highmark Choice_Blue_PPO $212.64 ↓ -5%
Highmark Blue_Cross_High_Performance_Network $212.64 ↓ -5%
PHC All_Plans $223.20 ↑ +0%
Aetna All_Plans $226.55 ↑ +2%
First_Health_Network All_Plans $249.15 ↑ +12%
Highmark All_Other_Plans $256.19 ↑ +15%
United_Healthcare All_Plans $261.70 ↑ +17%

Visitor-reported prices

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IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $220.80 $19.24 – $294.40
UPMC Bedford Everett $178.20 $20.20 – $267.30
UPMC Carlisle Carlisle $171.60 $24.43 – $243.10
UPMC Cole Coudersport $181.20 $20.20 – $84.56
UPMC Community Osteopathic Harrisburg $171.60 $24.43 – $243.10
UPMC East Monroeville $412.20 $21.16 – $549.60
UPMC Hamot Erie $305.40 $21.16 – $84.57
UPMC Northwest Seneca $228.60 $21.16 – $71.24

All Pennsylvania hospitals for this procedure →