Plcmnt ureteral stent pq w/img exstng trct 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

$5,650.40

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.

$7,063.00

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.

$222.03 with Health_Partners_Medicaid vs $12,415.98 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
Health_Partners_Medicaid All_Other_Plans $222.03 ↓ -96%
Geisinger_Medicaid All_Plans $222.03 ↓ -96%
Highmark_Wholecare_Gateway_Medicaid All_Plans $222.03 ↓ -96%
UPMC_Medicaid All_Plans $222.03 ↓ -96%
PA_Health_&_Wellness_Medicaid All_Plans $222.03 ↓ -96%
Amerihealth_Caritas_Medicaid All_Plans $252.22 ↓ -96%
Aetna_Better_Health_Kids All_Plans $603.91 ↓ -89%
Blue_Cross_BlueJourney_Medicare All_Plans $3,406.96 ↓ -40%
Highmark_Medicare All_Plans $3,441.03 ↓ -39%
Aetna_Advantra_Medicare All_Plans $3,509.17 ↓ -38%
Aetna_Medicare All_Plans $3,509.17 ↓ -38%
Geisinger_Gold_Medicare All_Plans $3,577.31 ↓ -37%
United_Medicare ISNP_DSNP_Plans $3,577.31 ↓ -37%
Devoted_Medicare All_Plans $3,577.31 ↓ -37%
Highmark_Wholecare_Gateway_Medicare All_Plans $3,592.64 ↓ -36%
UPMC_Medicare UPMC_for_Life_Complete_Care $3,594.34 ↓ -36%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $3,594.34 ↓ -36%
Amerihealth_Medicare All_Plans $3,594.34 ↓ -36%
Jefferson_Health_Medicare_Advantage All_Plans $3,679.52 ↓ -35%
PA_Health_&_Wellness_Medicare All_Plans $3,679.52 ↓ -35%
Aetna All_Plans $3,955.28 ↓ -30%
WellSpan_Capital_Blue_Cross All_Plans $4,237.80 ↓ -25%
UPMC Employees_And_Dependents $4,237.80 ↓ -25%
Geisinger All_Plans $4,237.80 ↓ -25%
UPMC UPMC_For_Kids $4,237.80 ↓ -25%
First_Health_Network All_Plans $4,350.81 ↓ -23%
Cigna All_Plans $4,507.61 ↓ -20%
Highmark Higmark_Healthy_Kids $5,280.79 ↓ -7%
Health_Partners_Medicaid Kidz_Partners $5,621.48 ↓ -1%
PHC All_Plans $5,650.40 ↑ +0%
United_Medicaid Community_Plan_For_Kids $5,962.18 ↑ +6%
United_Healthcare All_Plans $6,625.09 ↑ +17%
Blue_Cross Capital_Blue_Performance_PPO $7,441.00 ↑ +32%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $7,950.40 ↑ +41%
Blue_Cross All_Other_Plans $9,938.00 ↑ +76%
Highmark Blue_Cross_High_Performance_Network $10,305.03 ↑ +82%
Highmark Choice_Blue_PPO $10,305.03 ↑ +82%
Highmark Performance_Blue $10,305.03 ↑ +82%
Blue_Cross Capital_Cares_4_kids $11,224.50 ↑ +99%
Highmark All_Other_Plans $12,415.98 ↑ +120%

Visitor-reported prices

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Plcmnt ureteral stent pq w/img exstng trct at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $4,641.60 $707.65 – $6,188.80
UPMC Carlisle Carlisle $7,729.80 $1,016.56 – $10,950.55
UPMC Community Osteopathic Harrisburg $7,729.80 $1,016.56 – $10,950.55
UPMC East Monroeville $4,879.80 $714.38 – $6,506.40
UPMC Hamot Erie $5,139.60 $707.65 – $4,782.42
UPMC Northwest Seneca $4,913.40 $1,355.34 – $3,551.23
UPMC Hanover Hanover $7,729.80 $1,016.56 – $5,271.68
UPMC Jameson New Castle $3,688.80 $720.13 – $4,439.04

All Pennsylvania hospitals for this procedure →