Ortho whf rigd without jnt cstm w/fit&adj 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

$152.80

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.

$191.00

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.

$78.10 with Blue_Cross vs $1,458.52 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
Blue_Cross Capital_Cares_4_kids $78.10 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $89.25 ↓ -42%
Blue_Cross All_Other_Plans $111.56 ↓ -27%
Geisinger All_Plans $114.60 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $114.60 ↓ -25%
UPMC UPMC_For_Kids $114.60 ↓ -25%
UPMC Employees_And_Dependents $114.60 ↓ -25%
Cigna All_Plans $121.90 ↓ -20%
PHC All_Plans $152.80 ↑ +0%
Aetna All_Plans $155.09 ↑ +1%
First_Health_Network All_Plans $170.56 ↑ +12%
United_Healthcare All_Plans $179.16 ↑ +17%
Highmark_Wholecare_Gateway_Medicaid All_Plans $210.51 ↑ +38%
Blue_Cross_BlueJourney_Medicare All_Plans $400.22 ↑ +162%
Health_Partners_Medicaid All_Other_Plans $400.22 ↑ +162%
Highmark_Medicare All_Plans $404.22 ↑ +165%
Aetna_Advantra_Medicare All_Plans $412.23 ↑ +170%
Aetna_Medicare All_Plans $412.23 ↑ +170%
Devoted_Medicare All_Plans $420.23 ↑ +175%
United_Medicare ISNP_DSNP_Plans $420.23 ↑ +175%
Geisinger_Gold_Medicare All_Plans $420.23 ↑ +175%
Highmark_Wholecare_Gateway_Medicare All_Plans $422.03 ↑ +176%
Amerihealth_Medicare All_Plans $422.23 ↑ +176%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $422.23 ↑ +176%
UPMC_Medicare UPMC_for_Life_Complete_Care $422.23 ↑ +176%
PA_Health_&_Wellness_Medicare All_Plans $432.24 ↑ +183%
Jefferson_Health_Medicare_Advantage All_Plans $432.24 ↑ +183%
Highmark Higmark_Healthy_Kids $620.34 ↑ +306%
Health_Partners_Medicaid Kidz_Partners $660.36 ↑ +332%
United_Medicaid Community_Plan_For_Kids $700.39 ↑ +358%
Highmark Performance_Blue $1,210.55 ↑ +692%
Highmark Blue_Cross_High_Performance_Network $1,210.55 ↑ +692%
Highmark Choice_Blue_PPO $1,210.55 ↑ +692%
Highmark All_Other_Plans $1,458.52 ↑ +855%

Visitor-reported prices

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Ortho whf rigd without jnt cstm w/fit&adj at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $702.00 $160.29 – $994.50
UPMC Cole Coudersport $1,635.00 $421.61 – $1,775.20
UPMC Community Osteopathic Harrisburg $702.00 $220.62 – $1,602.33
UPMC Hanover Hanover $702.00 $220.62 – $1,602.33
UPMC Lititz Lititz $702.00 $192.75 – $1,602.33
UPMC Memorial York $702.00 $192.75 – $1,602.33
UPMC Presbyterian Pittsburgh $1,574.40 $202.09 – $2,590.68
UPMC Somerset Somerset $702.00 $193.67 – $959.74

All Pennsylvania hospitals for this procedure →