Mayo mycophenolic acid therapeutic drug level 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

$89.60

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.

$112.00

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.

$18.05 with Blue_Cross_BlueJourney_Medicare vs $156.87 with Blue_Cross — 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
Blue_Cross_BlueJourney_Medicare All_Plans $18.05 ↓ -80%
Highmark_Medicare All_Plans $18.23 ↓ -80%
Aetna_Advantra_Medicare All_Plans $18.59 ↓ -79%
Aetna_Medicare All_Plans $18.59 ↓ -79%
United_Medicare ISNP_DSNP_Plans $18.95 ↓ -79%
Devoted_Medicare All_Plans $18.95 ↓ -79%
Geisinger_Gold_Medicare All_Plans $18.95 ↓ -79%
Highmark_Wholecare_Gateway_Medicare All_Plans $19.03 ↓ -79%
Amerihealth_Medicare All_Plans $19.04 ↓ -79%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $19.04 ↓ -79%
UPMC_Medicare UPMC_for_Life_Complete_Care $19.04 ↓ -79%
PA_Health_&_Wellness_Medicare All_Plans $19.49 ↓ -78%
Jefferson_Health_Medicare_Advantage All_Plans $19.49 ↓ -78%
Health_Partners_Medicaid All_Other_Plans $24.63 ↓ -73%
Blue_Cross Capital_Blue_Performance_PPO $24.63 ↓ -73%
Highmark_Wholecare_Gateway_Medicaid All_Plans $24.63 ↓ -73%
PA_Health_&_Wellness_Medicaid All_Plans $24.63 ↓ -73%
UPMC_Medicaid All_Plans $24.63 ↓ -73%
Geisinger_Medicaid All_Plans $24.63 ↓ -73%
Amerihealth_Caritas_Medicaid All_Plans $27.97 ↓ -69%
Highmark Higmark_Healthy_Kids $27.98 ↓ -69%
Health_Partners_Medicaid Kidz_Partners $29.78 ↓ -67%
United_Medicaid Community_Plan_For_Kids $31.59 ↓ -65%
United_Healthcare All_Plans $54.15 ↓ -40%
Highmark Blue_Cross_High_Performance_Network $54.60 ↓ -39%
Highmark Choice_Blue_PPO $54.60 ↓ -39%
Highmark Performance_Blue $54.60 ↓ -39%
Highmark All_Other_Plans $65.78 ↓ -27%
Aetna_Better_Health_Kids All_Plans $66.98 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $67.20 ↓ -25%
UPMC Employees_And_Dependents $67.20 ↓ -25%
UPMC UPMC_For_Kids $67.20 ↓ -25%
Geisinger All_Plans $67.20 ↓ -25%
Aetna All_Plans $74.55 ↓ -17%
First_Health_Network All_Plans $81.95 ↓ -9%
PHC All_Plans $89.60 ↑ +0%
Cigna All_Plans $93.48 ↑ +4%
Blue_Cross Capital_Cares_4_kids $109.81 ↑ +23%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $125.49 ↑ +40%
Blue_Cross All_Other_Plans $156.87 ↑ +75%

Visitor-reported prices

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Mayo mycophenolic acid therapeutic drug level at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $169.20 $17.84 – $225.60
UPMC Bedford Everett $108.00 $6.51 – $162.00
UPMC Carlisle Carlisle $46.20 $10.55 – $65.45
UPMC Community Osteopathic Harrisburg $46.20 $15.40 – $117.54
UPMC East Monroeville $370.80 $17.84 – $494.40
UPMC Hamot Erie $127.80 $17.84 – $27.38
UPMC Northwest Seneca $163.80 $16.37 – $22.66
UPMC Hanover Hanover $46.20 $17.87 – $28.88

All Pennsylvania hospitals for this procedure →