Ntsty modul rad tx dlvr smpl 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

$4,231.20

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.

$5,289.00

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.

$126.55 with Blue_Cross vs $4,961.08 with United_Healthcare — 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_Blue_Performance_PPO $126.55 ↓ -97%
Highmark_Wholecare_Gateway_Medicaid All_Plans $336.00 ↓ -92%
UPMC_Medicaid All_Plans $336.00 ↓ -92%
Health_Partners_Medicaid All_Other_Plans $336.00 ↓ -92%
PA_Health_&_Wellness_Medicaid All_Plans $336.00 ↓ -92%
Geisinger_Medicaid All_Plans $336.00 ↓ -92%
Amerihealth_Caritas_Medicaid All_Plans $381.70 ↓ -91%
Blue_Cross_BlueJourney_Medicare All_Plans $571.42 ↓ -86%
Highmark_Medicare All_Plans $577.13 ↓ -86%
Aetna_Medicare All_Plans $588.56 ↓ -86%
Aetna_Advantra_Medicare All_Plans $588.56 ↓ -86%
Devoted_Medicare All_Plans $599.99 ↓ -86%
Geisinger_Gold_Medicare All_Plans $599.99 ↓ -86%
United_Medicare ISNP_DSNP_Plans $599.99 ↓ -86%
Highmark_Wholecare_Gateway_Medicare All_Plans $602.56 ↓ -86%
Amerihealth_Medicare All_Plans $602.85 ↓ -86%
UPMC_Medicare UPMC_for_Life_Complete_Care $602.85 ↓ -86%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $602.85 ↓ -86%
PA_Health_&_Wellness_Medicare All_Plans $617.13 ↓ -85%
Jefferson_Health_Medicare_Advantage All_Plans $617.13 ↓ -85%
Highmark Higmark_Healthy_Kids $885.70 ↓ -79%
Aetna_Better_Health_Kids All_Plans $913.92 ↓ -78%
Health_Partners_Medicaid Kidz_Partners $942.84 ↓ -78%
United_Medicaid Community_Plan_For_Kids $999.99 ↓ -76%
Highmark Blue_Cross_High_Performance_Network $1,728.37 ↓ -59%
Highmark Performance_Blue $1,728.37 ↓ -59%
Highmark Choice_Blue_PPO $1,728.37 ↓ -59%
Highmark All_Other_Plans $2,082.43 ↓ -51%
Blue_Cross Capital_Cares_4_kids $2,162.67 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $2,471.55 ↓ -42%
Cigna All_Plans $2,752.40 ↓ -35%
Blue_Cross All_Other_Plans $3,089.30 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $3,173.40 ↓ -25%
UPMC Employees_And_Dependents $3,173.40 ↓ -25%
UPMC UPMC_For_Kids $3,173.40 ↓ -25%
Geisinger All_Plans $3,173.40 ↓ -25%
PHC All_Plans $4,231.20 ↑ +0%
Aetna All_Plans $4,294.67 ↑ +2%
First_Health_Network All_Plans $4,723.08 ↑ +12%
United_Healthcare All_Plans $4,961.08 ↑ +17%

Visitor-reported prices

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Ntsty modul rad tx dlvr smpl at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $1,929.60 $268.80 – $2,572.80
UPMC Carlisle Carlisle $1,765.20 $341.38 – $2,500.70
UPMC Community Osteopathic Harrisburg $1,765.20 $341.38 – $2,500.70
UPMC East Monroeville $3,087.00 $295.68 – $4,116.00
UPMC Northwest Seneca $1,873.80 $295.68 – $579.08
UPMC Horizon-Greenville Greenville $1,873.80 $295.68 – $595.62
UPMC Lititz Lititz $1,765.20 $341.38 – $888.96
UPMC Magee Pittsburgh $3,846.60 $295.68 – $595.62

All Pennsylvania hospitals for this procedure →