Plc pq device breast ea addl lesion Ultrasound guide 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

$129.60

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.

$162.00

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.

$42.48 with UPMC_Medicaid vs $151.96 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 $42.48 ↓ -67%
PA_Health_&_Wellness_Medicaid All_Plans $42.48 ↓ -67%
Highmark_Wholecare_Gateway_Medicaid All_Plans $42.48 ↓ -67%
Health_Partners_Medicaid All_Other_Plans $42.48 ↓ -67%
Geisinger_Medicaid All_Plans $42.48 ↓ -67%
Amerihealth_Caritas_Medicaid All_Plans $48.25 ↓ -63%
Blue_Cross Capital_Cares_4_kids $66.24 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $75.70 ↓ -42%
Aetna All_Plans $90.72 ↓ -30%
Blue_Cross All_Other_Plans $94.62 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $97.20 ↓ -25%
Geisinger All_Plans $97.20 ↓ -25%
UPMC UPMC_For_Kids $97.20 ↓ -25%
UPMC Employees_And_Dependents $97.20 ↓ -25%
First_Health_Network All_Plans $99.79 ↓ -23%
Cigna All_Plans $103.39 ↓ -20%
Aetna_Better_Health_Kids All_Plans $115.53 ↓ -11%
PHC All_Plans $129.60 ↑ +0%
United_Healthcare All_Plans $151.96 ↑ +17%

Visitor-reported prices

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Plc pq device breast ea addl lesion Ultrasound guide at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $592.20 $33.98 – $789.60
UPMC Bedford Everett $3,631.80 $35.68 – $5,447.70
UPMC Carlisle Carlisle $969.00 $43.15 – $9,539.00
UPMC Cole Coudersport $76.80 $35.48 – $771.51
UPMC Community Osteopathic Harrisburg $969.00 $44.51 – $1,372.75
UPMC Hamot Erie $1,438.20 $37.38 – $515.71
UPMC Hanover Hanover $969.00 $43.15 – $539.69
UPMC Horizon-Greenville Greenville $1,337.40 $35.68 – $526.81

All Pennsylvania hospitals for this procedure →