Mayo vitamin k 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

$57.60

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.

Full explanation →

What you pay up front if you don't use insurance.

$72.00

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.

$12.96 with Aetna_Better_Health_Kids vs $127.44 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
Aetna_Better_Health_Kids All_Plans $12.96 ↓ -78%
Blue_Cross_BlueJourney_Medicare All_Plans $13.72 ↓ -76%
Highmark_Medicare All_Plans $13.86 ↓ -76%
Aetna_Advantra_Medicare All_Plans $14.13 ↓ -75%
Aetna_Medicare All_Plans $14.13 ↓ -75%
Geisinger_Gold_Medicare All_Plans $14.41 ↓ -75%
Devoted_Medicare All_Plans $14.41 ↓ -75%
United_Medicare ISNP_DSNP_Plans $14.41 ↓ -75%
UPMC_Medicare UPMC_for_Life_Complete_Care $14.47 ↓ -75%
Amerihealth_Medicare All_Plans $14.47 ↓ -75%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $14.47 ↓ -75%
Highmark_Wholecare_Gateway_Medicare All_Plans $14.47 ↓ -75%
Jefferson_Health_Medicare_Advantage All_Plans $14.82 ↓ -74%
PA_Health_&_Wellness_Medicare All_Plans $14.82 ↓ -74%
Blue_Cross Capital_Blue_Performance_PPO $20.01 ↓ -65%
Highmark Higmark_Healthy_Kids $21.27 ↓ -63%
Health_Partners_Medicaid Kidz_Partners $22.64 ↓ -61%
United_Medicaid Community_Plan_For_Kids $24.01 ↓ -58%
United_Healthcare All_Plans $41.16 ↓ -29%
Highmark Blue_Cross_High_Performance_Network $41.50 ↓ -28%
Highmark Performance_Blue $41.50 ↓ -28%
Highmark Choice_Blue_PPO $41.50 ↓ -28%
WellSpan_Capital_Blue_Cross All_Plans $43.20 ↓ -25%
UPMC Employees_And_Dependents $43.20 ↓ -25%
Geisinger All_Plans $43.20 ↓ -25%
UPMC UPMC_For_Kids $43.20 ↓ -25%
Highmark All_Other_Plans $50.00 ↓ -13%
Aetna All_Plans $56.66 ↓ -2%
PHC All_Plans $57.60 ↑ +0%
Cigna All_Plans $60.09 ↑ +4%
First_Health_Network All_Plans $62.29 ↑ +8%
Blue_Cross Capital_Cares_4_kids $89.21 ↑ +55%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $101.95 ↑ +77%
Blue_Cross All_Other_Plans $127.44 ↑ +121%

Visitor-reported prices

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Mayo vitamin k at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $241.20 $13.55 – $321.60
UPMC Bedford Everett $83.40 $4.95 – $125.10
UPMC Carlisle Carlisle $69.60 $7.55 – $98.60
UPMC Community Osteopathic Harrisburg $69.60 $10.96 – $116.59
UPMC East Monroeville $287.40 $13.55 – $383.20
UPMC Hamot Erie $231.00 $13.55 – $37.27
UPMC Northwest Seneca $126.60 $12.44 – $14.82
UPMC Hanover Hanover $69.60 $10.96 – $116.59

All Pennsylvania hospitals for this procedure →