Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr 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

$67.60

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.

$84.50

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.

$0.83 with Blue_Cross vs $50.70 with WellSpan_Capital_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 Capital_Cares_4_kids $0.83 ↓ -99%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $0.94 ↓ -99%
UPMC_Medicaid All_Plans $1.03 ↓ -98%
Geisinger_Medicaid All_Plans $1.09 ↓ -98%
Amerihealth_Caritas_Medicaid All_Plans $1.09 ↓ -98%
Highmark_Wholecare_Gateway_Medicaid All_Plans $1.09 ↓ -98%
Health_Partners_Medicaid All_Other_Plans $1.09 ↓ -98%
Blue_Cross Capital_Blue_Performance_PPO $1.18 ↓ -98%
Blue_Cross All_Other_Plans $1.18 ↓ -98%
United_Healthcare All_Plans $3.20 ↓ -95%
Aetna All_Plans $3.30 ↓ -95%
First_Health_Network All_Plans $3.63 ↓ -95%
Cigna All_Plans $3.96 ↓ -94%
UPMC Employees_And_Dependents $16.05 ↓ -76%
Geisinger All_Plans $16.05 ↓ -76%
UPMC UPMC_For_Kids $16.05 ↓ -76%
PHC All_Plans $21.40 ↓ -68%
WellSpan_Capital_Blue_Cross All_Plans $50.70 ↓ -25%

Visitor-reported prices

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Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $5.40 $0.57 – $4.80
UPMC Bedford Everett $10.40 $0.57 – $11.70
UPMC Cole Coudersport $1.80 $0.83 – $2.40
UPMC East Monroeville $11.60 $0.57 – $11.20
UPMC Hamot Erie $79.60 $0.57 – $2.97
UPMC Northwest Seneca $11.00 $0.60 – $5.21
UPMC Horizon-Greenville Greenville $13.00 $0.57 – $5.12
UPMC Jameson New Castle $7.00 $0.69 – $2.04

All Pennsylvania hospitals for this procedure →