New Patient Office Visit (level 4) 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

$388.80

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.

$486.00

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.

$50.00 with Highmark_Wholecare_Gateway_Medicaid vs $463.92 with Highmark — 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
Highmark_Wholecare_Gateway_Medicaid All_Plans $50.00 ↓ -87%
Geisinger_Medicaid All_Plans $50.00 ↓ -87%
Health_Partners_Medicaid All_Other_Plans $50.00 ↓ -87%
UPMC_Medicaid All_Plans $50.00 ↓ -87%
PA_Health_&_Wellness_Medicaid All_Plans $50.00 ↓ -87%
Amerihealth_Caritas_Medicaid All_Plans $56.80 ↓ -85%
Health_Partners_Medicaid Kidz_Partners $65.70 ↓ -83%
Blue_Cross_BlueJourney_Medicare All_Plans $127.30 ↓ -67%
Highmark_Medicare All_Plans $128.57 ↓ -67%
Aetna_Advantra_Medicare All_Plans $131.12 ↓ -66%
Aetna_Medicare All_Plans $131.12 ↓ -66%
WellSpan_Capital_Blue_Cross All_Plans $131.40 ↓ -66%
UPMC UPMC_For_Kids $131.40 ↓ -66%
Geisinger All_Plans $131.40 ↓ -66%
UPMC Employees_And_Dependents $131.40 ↓ -66%
Geisinger_Gold_Medicare All_Plans $133.67 ↓ -66%
United_Medicare ISNP_DSNP_Plans $133.67 ↓ -66%
Devoted_Medicare All_Plans $133.67 ↓ -66%
Highmark_Wholecare_Gateway_Medicare All_Plans $134.24 ↓ -65%
Amerihealth_Medicare All_Plans $134.30 ↓ -65%
UPMC_Medicare UPMC_for_Life_Complete_Care $134.30 ↓ -65%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $134.30 ↓ -65%
Aetna_Better_Health_Kids All_Plans $136.00 ↓ -65%
Jefferson_Health_Medicare_Advantage All_Plans $137.48 ↓ -65%
PA_Health_&_Wellness_Medicare All_Plans $137.48 ↓ -65%
PHC All_Plans $175.20 ↓ -55%
Highmark Higmark_Healthy_Kids $197.32 ↓ -49%
United_Healthcare All_Plans $205.42 ↓ -47%
United_Medicaid Community_Plan_For_Kids $222.78 ↓ -43%
Highmark Blue_Cross_High_Performance_Network $385.04 ↓ -1%
Highmark Choice_Blue_PPO $385.04 ↓ -1%
Highmark Performance_Blue $385.04 ↓ -1%
Highmark All_Other_Plans $463.92 ↑ +19%

Visitor-reported prices

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New Patient Office Visit (level 4) at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $274.20 $20.00 – $365.60
UPMC Bedford Everett $287.40 $36.08 – $431.10
UPMC Cole Coudersport $420.00 $61.30 – $300.00
UPMC Community Osteopathic Harrisburg $610.80 $42.00 – $658.70
UPMC East Monroeville $425.40 $36.08 – $567.20
UPMC Hamot Erie $297.00 $99.41 – $419.02
UPMC Northwest Seneca $358.80 $99.41 – $196.77
UPMC Hanover Hanover $126.00 $114.77 – $205.92

All Pennsylvania hospitals for this procedure →