Observation direct referral from physician office for admission 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

$156.80

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.

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

$196.00

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.

$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 →

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 $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

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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

All Pennsylvania hospitals for this procedure →