Pet fdg brain metoblic eval sb 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

$5,280.00

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.

$6,600.00

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.

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The hospital's undiscounted list price — almost no one pays this.

$853.86 with UPMC_Medicaid vs $8,570.95 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
UPMC_Medicaid All_Plans $853.86 ↓ -84%
Highmark_Wholecare_Gateway_Medicaid All_Plans $853.86 ↓ -84%
Health_Partners_Medicaid All_Other_Plans $853.86 ↓ -84%
Geisinger_Medicaid All_Plans $853.86 ↓ -84%
PA_Health_&_Wellness_Medicaid All_Plans $853.86 ↓ -84%
Amerihealth_Caritas_Medicaid All_Plans $969.99 ↓ -82%
Blue_Cross Capital_Blue_Performance_PPO $972.09 ↓ -82%
Blue_Cross_BlueJourney_Medicare All_Plans $1,440.82 ↓ -73%
Highmark_Medicare All_Plans $1,455.23 ↓ -72%
Aetna_Medicare All_Plans $1,484.04 ↓ -72%
Aetna_Advantra_Medicare All_Plans $1,484.04 ↓ -72%
Devoted_Medicare All_Plans $1,512.86 ↓ -71%
United_Medicare ISNP_DSNP_Plans $1,512.86 ↓ -71%
Geisinger_Gold_Medicare All_Plans $1,512.86 ↓ -71%
Highmark_Wholecare_Gateway_Medicare All_Plans $1,519.34 ↓ -71%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $1,520.07 ↓ -71%
UPMC_Medicare UPMC_for_Life_Complete_Care $1,520.07 ↓ -71%
Amerihealth_Medicare All_Plans $1,520.07 ↓ -71%
PA_Health_&_Wellness_Medicare All_Plans $1,556.09 ↓ -71%
Jefferson_Health_Medicare_Advantage All_Plans $1,556.09 ↓ -71%
Highmark Higmark_Healthy_Kids $2,233.27 ↓ -58%
Aetna_Better_Health_Kids All_Plans $2,322.51 ↓ -56%
Health_Partners_Medicaid Kidz_Partners $2,377.35 ↓ -55%
United_Medicaid Community_Plan_For_Kids $2,521.44 ↓ -52%
Cigna All_Plans $3,434.64 ↓ -35%
WellSpan_Capital_Blue_Cross All_Plans $3,960.00 ↓ -25%
UPMC Employees_And_Dependents $3,960.00 ↓ -25%
UPMC UPMC_For_Kids $3,960.00 ↓ -25%
Geisinger All_Plans $3,960.00 ↓ -25%
Highmark Choice_Blue_PPO $4,358.05 ↓ -17%
Highmark Blue_Cross_High_Performance_Network $4,358.05 ↓ -17%
Highmark Performance_Blue $4,358.05 ↓ -17%
Blue_Cross Capital_Cares_4_kids $4,459.75 ↓ -16%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $5,096.86 ↓ -3%
Highmark All_Other_Plans $5,250.78 ↓ -1%
PHC All_Plans $5,280.00 ↑ +0%
Aetna All_Plans $5,359.20 ↑ +2%
First_Health_Network All_Plans $5,893.80 ↑ +12%
Blue_Cross All_Other_Plans $6,371.08 ↑ +21%
United_Healthcare All_Plans $8,570.95 ↑ +62%

Visitor-reported prices

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Pet fdg brain metoblic eval sb at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $4,077.60 $613.27 – $5,436.80
UPMC Carlisle Carlisle $5,639.40 $800.00 – $7,989.15
UPMC Cole Coudersport $6,180.00 $717.24 – $8,240.00
UPMC Community Osteopathic Harrisburg $5,639.40 $803.38 – $10,683.53
UPMC Hanover Hanover $5,639.40 $800.00 – $7,584.17
UPMC Kane Kane $4,480.80 $751.40 – $5,997.30
UPMC Lititz Lititz $5,639.40 $800.00 – $7,584.17
UPMC Magee Pittsburgh $7,773.00 $751.40 – $2,453.09

All Pennsylvania hospitals for this procedure →