Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback 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

$165.00

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.

$206.25

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.

$1.93 with Blue_Cross vs $21.40 with PHC — 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.

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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
Blue_Cross Capital_Cares_4_kids $1.93 ↓ -99%
UPMC_Medicaid All_Plans $2.03 ↓ -99%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $2.20 ↓ -99%
Health_Partners_Medicaid All_Other_Plans $2.54 ↓ -98%
Highmark_Wholecare_Gateway_Medicaid All_Plans $2.54 ↓ -98%
Amerihealth_Caritas_Medicaid All_Plans $2.54 ↓ -98%
Geisinger_Medicaid All_Plans $2.54 ↓ -98%
Blue_Cross Capital_Blue_Performance_PPO $2.75 ↓ -98%
Blue_Cross All_Other_Plans $2.75 ↓ -98%
Cigna All_Plans $3.61 ↓ -98%
United_Healthcare All_Plans $6.27 ↓ -96%
Aetna All_Plans $7.72 ↓ -95%
First_Health_Network All_Plans $8.49 ↓ -95%
Geisinger All_Plans $16.05 ↓ -90%
UPMC UPMC_For_Kids $16.05 ↓ -90%
UPMC Employees_And_Dependents $16.05 ↓ -90%
WellSpan_Capital_Blue_Cross All_Plans $16.05 ↓ -90%
PHC All_Plans $21.40 ↓ -87%

Visitor-reported prices

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Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $229.80 $1.05 – $102.40
UPMC Bedford Everett $284.40 $1.05 – $142.20
UPMC Cole Coudersport $34.80 $1.05 – $17.60
UPMC Hamot Erie $455.40 $1.05 – $9.69
UPMC Horizon-Greenville Greenville $254.40 $1.05 – $93.80
UPMC Jameson New Castle $141.60 $1.05 – $37.45
UPMC Kane Kane $21.60 $2.54 – $9.69
UPMC Magee Pittsburgh $325.80 $1.02 – $37.15

All Pennsylvania hospitals for this procedure →