Pr application splint static short arm 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

$452.80

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.

$566.00

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.

$32.50 with UPMC_Medicaid vs $1,616.00 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
UPMC_Medicaid All_Plans $32.50 ↓ -93%
Health_Partners_Medicaid All_Other_Plans $32.50 ↓ -93%
Highmark_Wholecare_Gateway_Medicaid All_Plans $32.50 ↓ -93%
PA_Health_&_Wellness_Medicaid All_Plans $32.50 ↓ -93%
Geisinger_Medicaid All_Plans $32.50 ↓ -93%
Amerihealth_Caritas_Medicaid All_Plans $36.92 ↓ -92%
Aetna_Better_Health_Kids All_Plans $88.40 ↓ -80%
Blue_Cross_BlueJourney_Medicare All_Plans $127.33 ↓ -72%
Highmark_Medicare All_Plans $128.60 ↓ -72%
Aetna_Medicare All_Plans $131.15 ↓ -71%
Aetna_Advantra_Medicare All_Plans $131.15 ↓ -71%
Geisinger_Gold_Medicare All_Plans $133.70 ↓ -70%
Devoted_Medicare All_Plans $133.70 ↓ -70%
United_Medicare ISNP_DSNP_Plans $133.70 ↓ -70%
Highmark_Wholecare_Gateway_Medicare All_Plans $134.27 ↓ -70%
UPMC_Medicare UPMC_for_Life_Complete_Care $134.33 ↓ -70%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $134.33 ↓ -70%
Amerihealth_Medicare All_Plans $134.33 ↓ -70%
Jefferson_Health_Medicare_Advantage All_Plans $137.52 ↓ -70%
PA_Health_&_Wellness_Medicare All_Plans $137.52 ↓ -70%
Highmark Higmark_Healthy_Kids $197.36 ↓ -56%
Health_Partners_Medicaid Kidz_Partners $210.09 ↓ -54%
United_Medicaid Community_Plan_For_Kids $222.83 ↓ -51%
WellSpan_Capital_Blue_Cross All_Plans $339.60 ↓ -25%
UPMC Employees_And_Dependents $339.60 ↓ -25%
UPMC UPMC_For_Kids $339.60 ↓ -25%
Geisinger All_Plans $339.60 ↓ -25%
Cigna All_Plans $361.22 ↓ -20%
Highmark Blue_Cross_High_Performance_Network $385.14 ↓ -15%
Highmark Choice_Blue_PPO $385.14 ↓ -15%
Highmark Performance_Blue $385.14 ↓ -15%
PHC All_Plans $452.80 ↑ +0%
Aetna All_Plans $459.59 ↑ +1%
Highmark All_Other_Plans $464.03 ↑ +2%
First_Health_Network All_Plans $505.44 ↑ +12%
United_Healthcare All_Plans $530.91 ↑ +17%
Blue_Cross Capital_Cares_4_kids $1,131.20 ↑ +150%
Blue_Cross Capital_Blue_Performance_PPO $1,209.00 ↑ +167%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,292.80 ↑ +186%
Blue_Cross All_Other_Plans $1,616.00 ↑ +257%

Visitor-reported prices

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Pr application splint static short arm at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $262.80 $26.00 – $350.40
UPMC Bedford Everett $210.00 $27.30 – $315.00
UPMC Carlisle Carlisle $406.20 $33.02 – $575.45
UPMC Cole Coudersport $220.20 $13.03 – $98.03
UPMC Community Osteopathic Harrisburg $406.20 $33.02 – $575.45
UPMC East Monroeville $388.80 $28.60 – $518.40
UPMC Hamot Erie $407.40 $28.60 – $178.73
UPMC Northwest Seneca $213.00 $28.60 – $129.03

All Pennsylvania hospitals for this procedure →