Plcmnt ureteral stent pq w/img new w/cath 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

$6,046.40

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.

$7,558.00

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.

$364.48 with Highmark_Wholecare_Gateway_Medicaid vs $15,010.80 with Blue_Cross — 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
Highmark_Wholecare_Gateway_Medicaid All_Plans $364.48 ↓ -94%
Geisinger_Medicaid All_Plans $364.48 ↓ -94%
Health_Partners_Medicaid All_Other_Plans $364.48 ↓ -94%
UPMC_Medicaid All_Plans $364.48 ↓ -94%
PA_Health_&_Wellness_Medicaid All_Plans $364.48 ↓ -94%
Amerihealth_Caritas_Medicaid All_Plans $414.04 ↓ -93%
Aetna_Better_Health_Kids All_Plans $991.37 ↓ -84%
Blue_Cross_BlueJourney_Medicare All_Plans $3,406.96 ↓ -44%
Highmark_Medicare All_Plans $3,441.03 ↓ -43%
Aetna_Advantra_Medicare All_Plans $3,509.17 ↓ -42%
Aetna_Medicare All_Plans $3,509.17 ↓ -42%
Geisinger_Gold_Medicare All_Plans $3,577.31 ↓ -41%
United_Medicare ISNP_DSNP_Plans $3,577.31 ↓ -41%
Devoted_Medicare All_Plans $3,577.31 ↓ -41%
Highmark_Wholecare_Gateway_Medicare All_Plans $3,592.64 ↓ -41%
UPMC_Medicare UPMC_for_Life_Complete_Care $3,594.34 ↓ -41%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $3,594.34 ↓ -41%
Amerihealth_Medicare All_Plans $3,594.34 ↓ -41%
PA_Health_&_Wellness_Medicare All_Plans $3,679.52 ↓ -39%
Jefferson_Health_Medicare_Advantage All_Plans $3,679.52 ↓ -39%
Aetna All_Plans $4,232.48 ↓ -30%
Geisinger All_Plans $4,534.80 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $4,534.80 ↓ -25%
UPMC Employees_And_Dependents $4,534.80 ↓ -25%
UPMC UPMC_For_Kids $4,534.80 ↓ -25%
First_Health_Network All_Plans $4,655.73 ↓ -23%
Cigna All_Plans $4,823.52 ↓ -20%
Highmark Higmark_Healthy_Kids $5,280.79 ↓ -13%
Health_Partners_Medicaid Kidz_Partners $5,621.48 ↓ -7%
United_Medicaid Community_Plan_For_Kids $5,962.18 ↓ -1%
PHC All_Plans $6,046.40 ↑ +0%
United_Healthcare All_Plans $7,089.40 ↑ +17%
Blue_Cross Capital_Blue_Performance_PPO $7,441.00 ↑ +23%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $7,950.40 ↑ +31%
Blue_Cross All_Other_Plans $9,938.00 ↑ +64%
Highmark Blue_Cross_High_Performance_Network $10,305.03 ↑ +70%
Highmark Choice_Blue_PPO $10,305.03 ↑ +70%
Highmark Performance_Blue $10,305.03 ↑ +70%
Highmark All_Other_Plans $12,415.98 ↑ +105%
Blue_Cross Capital_Cares_4_kids $15,010.80 ↑ +148%

Visitor-reported prices

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Plcmnt ureteral stent pq w/img new w/cath at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
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 $13,146.00 $962.01 – $17,528.00
UPMC Hamot Erie $5,104.20 $952.93 – $4,782.42
UPMC Hanover Hanover $7,729.80 $1,016.56 – $5,271.68
UPMC Lititz Lititz $7,729.80 $1,016.56 – $5,300.16
UPMC Magee Pittsburgh $12,594.00 $962.01 – $3,617.00
UPMC McKeesport Mckeesport $13,761.00 $962.01 – $3,617.00

All Pennsylvania hospitals for this procedure →