Observation direct referral from physician office for admission at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$156.80
Cash price 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.
$196.00
Gross charge 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.
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The hospital's undiscounted list price — almost no one pays this.
$35.28 with Aetna_Better_Health_Kids vs $5,402.00 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 →
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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 ?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 ?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 | $35.28 | ↓ -78% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $91.59 | ↓ -42% |
| UPMC | UPMC_For_Kids | $117.60 | ↓ -25% |
| Geisinger | All_Plans | $117.60 | ↓ -25% |
| WellSpan_Capital_Blue_Cross | All_Plans | $117.60 | ↓ -25% |
| UPMC | Employees_And_Dependents | $117.60 | ↓ -25% |
| Cigna | All_Plans | $125.09 | ↓ -20% |
| PHC | All_Plans | $156.80 | ↑ +0% |
| Aetna | All_Plans | $159.15 | ↑ +1% |
| First_Health_Network | All_Plans | $175.03 | ↑ +12% |
| United_Healthcare | All_Plans | $183.85 | ↑ +17% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $459.83 | ↑ +193% |
| Health_Partners_Medicaid | All_Other_Plans | $605.63 | ↑ +286% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $605.63 | ↑ +286% |
| Highmark_Medicare | All_Plans | $611.69 | ↑ +290% |
| Aetna_Advantra_Medicare | All_Plans | $623.80 | ↑ +298% |
| Aetna_Medicare | All_Plans | $623.80 | ↑ +298% |
| Geisinger_Gold_Medicare | All_Plans | $635.91 | ↑ +306% |
| United_Medicare | ISNP_DSNP_Plans | $635.91 | ↑ +306% |
| Devoted_Medicare | All_Plans | $635.91 | ↑ +306% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $638.64 | ↑ +307% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $638.94 | ↑ +307% |
| Amerihealth_Medicare | All_Plans | $638.94 | ↑ +307% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $638.94 | ↑ +307% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $654.08 | ↑ +317% |
| PA_Health_&_Wellness_Medicare | All_Plans | $654.08 | ↑ +317% |
| Highmark | Higmark_Healthy_Kids | $938.73 | ↑ +499% |
| Health_Partners_Medicaid | Kidz_Partners | $999.29 | ↑ +537% |
| United_Medicaid | Community_Plan_For_Kids | $1,059.85 | ↑ +576% |
| Geisinger_Medicaid | All_Plans | $1,500.00 | ↑ +857% |
| UPMC_Medicaid | All_Plans | $1,500.00 | ↑ +857% |
| Highmark | Performance_Blue | $1,831.85 | ↑ +1068% |
| Highmark | Choice_Blue_PPO | $1,831.85 | ↑ +1068% |
| Highmark | Blue_Cross_High_Performance_Network | $1,831.85 | ↑ +1068% |
| Highmark | All_Other_Plans | $2,207.10 | ↑ +1308% |
| Blue_Cross | Capital_Cares_4_kids | $3,781.40 | ↑ +2312% |
| Blue_Cross | Capital_Blue_Performance_PPO | $4,155.00 | ↑ +2550% |
| Blue_Cross | All_Other_Plans | $5,402.00 | ↑ +3345% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $117.00 | $27.00 – $2,064.00 |
| UPMC Bedford | Everett | $166.20 | $31.88 – $2,207.16 |
| UPMC Carlisle | Carlisle | $420.00 | $95.90 – $2,064.00 |
| UPMC Cole | Coudersport | $84.00 | $38.81 – $112.00 |
| UPMC Community Osteopathic | Harrisburg | $420.00 | $169.40 – $3,000.00 |
| UPMC East | Monroeville | $130.20 | $31.88 – $2,207.16 |
| UPMC Hamot | Erie | $138.60 | $674.61 – $728.58 |
| UPMC Northwest | Seneca | $112.80 | $31.88 – $631.28 |