Platelets leukocytes reduced irradiated each unit 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

$1,183.20

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.

$1,479.00

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.

$37.50 with Health_Partners_Medicaid vs $1,387.30 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
Health_Partners_Medicaid All_Other_Plans $37.50 ↓ -97%
Geisinger_Medicaid All_Plans $37.50 ↓ -97%
PA_Health_&_Wellness_Medicaid All_Plans $37.50 ↓ -97%
Highmark_Wholecare_Gateway_Medicaid All_Plans $37.50 ↓ -97%
UPMC_Medicaid All_Plans $37.50 ↓ -97%
Amerihealth_Caritas_Medicaid All_Plans $42.60 ↓ -96%
Blue_Cross Capital_Blue_Performance_PPO $85.90 ↓ -93%
Aetna_Better_Health_Kids All_Plans $102.00 ↓ -91%
Blue_Cross_BlueJourney_Medicare All_Plans $205.39 ↓ -83%
Highmark_Medicare All_Plans $207.44 ↓ -82%
Aetna_Medicare All_Plans $211.55 ↓ -82%
Aetna_Advantra_Medicare All_Plans $211.55 ↓ -82%
Devoted_Medicare All_Plans $215.66 ↓ -82%
United_Medicare ISNP_DSNP_Plans $215.66 ↓ -82%
Geisinger_Gold_Medicare All_Plans $215.66 ↓ -82%
Highmark_Wholecare_Gateway_Medicare All_Plans $216.58 ↓ -82%
UPMC_Medicare UPMC_for_Life_Complete_Care $216.69 ↓ -82%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $216.69 ↓ -82%
Amerihealth_Medicare All_Plans $216.69 ↓ -82%
PA_Health_&_Wellness_Medicare All_Plans $221.82 ↓ -81%
Jefferson_Health_Medicare_Advantage All_Plans $221.82 ↓ -81%
Highmark Higmark_Healthy_Kids $318.35 ↓ -73%
Health_Partners_Medicaid Kidz_Partners $338.89 ↓ -71%
United_Medicaid Community_Plan_For_Kids $359.43 ↓ -70%
Blue_Cross Capital_Cares_4_kids $604.76 ↓ -49%
Highmark Choice_Blue_PPO $621.24 ↓ -47%
Highmark Performance_Blue $621.24 ↓ -47%
Highmark Blue_Cross_High_Performance_Network $621.24 ↓ -47%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $691.14 ↓ -42%
Highmark All_Other_Plans $748.50 ↓ -37%
Blue_Cross All_Other_Plans $863.88 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $887.40 ↓ -25%
UPMC Employees_And_Dependents $887.40 ↓ -25%
UPMC UPMC_For_Kids $887.40 ↓ -25%
Geisinger All_Plans $887.40 ↓ -25%
Cigna All_Plans $943.90 ↓ -20%
PHC All_Plans $1,183.20 ↑ +0%
Aetna All_Plans $1,200.95 ↑ +2%
First_Health_Network All_Plans $1,320.75 ↑ +12%
United_Healthcare All_Plans $1,387.30 ↑ +17%

Visitor-reported prices

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Platelets leukocytes reduced irradiated each unit at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $310.20 $70.83 – $439.45
UPMC Community Osteopathic Harrisburg $310.20 $103.40 – $733.54
UPMC East Monroeville $681.00 $196.34 – $908.00
UPMC Hanover Hanover $310.20 $194.25 – $733.54
UPMC Horizon-Greenville Greenville $664.20 $175.31 – $367.44
UPMC Jameson New Castle $201.00 $188.25 – $244.76
UPMC Lititz Lititz $310.20 $195.30 – $733.54
UPMC Magee Pittsburgh $664.20 $183.26 – $215.39

All Pennsylvania hospitals for this procedure →