Pt application of modality >=1 area ultrasound each 15 minutes 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

$164.00

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.

$205.00

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.

$13.39 with Blue_Cross_BlueJourney_Medicare vs $421.00 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
Blue_Cross_BlueJourney_Medicare All_Plans $13.39 ↓ -92%
Highmark_Medicare All_Plans $13.52 ↓ -92%
Aetna_Medicare All_Plans $13.79 ↓ -92%
Aetna_Advantra_Medicare All_Plans $13.79 ↓ -92%
United_Medicare ISNP_DSNP_Plans $14.06 ↓ -91%
Devoted_Medicare All_Plans $14.06 ↓ -91%
Geisinger_Gold_Medicare All_Plans $14.06 ↓ -91%
Highmark_Wholecare_Gateway_Medicare All_Plans $14.12 ↓ -91%
UPMC_Medicare UPMC_for_Life_Complete_Care $14.13 ↓ -91%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $14.13 ↓ -91%
Amerihealth_Medicare All_Plans $14.13 ↓ -91%
PA_Health_&_Wellness_Medicare All_Plans $14.46 ↓ -91%
Jefferson_Health_Medicare_Advantage All_Plans $14.46 ↓ -91%
Highmark Higmark_Healthy_Kids $20.75 ↓ -87%
United_Medicaid Community_Plan_For_Kids $23.43 ↓ -86%
Highmark Performance_Blue $40.50 ↓ -75%
Highmark Choice_Blue_PPO $40.50 ↓ -75%
Highmark Blue_Cross_High_Performance_Network $40.50 ↓ -75%
Highmark All_Other_Plans $48.80 ↓ -70%
Geisinger_Medicaid All_Plans $50.00 ↓ -70%
Highmark_Wholecare_Gateway_Medicaid All_Plans $50.00 ↓ -70%
UPMC_Medicaid All_Plans $50.00 ↓ -70%
PA_Health_&_Wellness_Medicaid All_Plans $50.00 ↓ -70%
Health_Partners_Medicaid All_Other_Plans $50.00 ↓ -70%
Amerihealth_Caritas_Medicaid All_Plans $56.80 ↓ -65%
Health_Partners_Medicaid Kidz_Partners $61.50 ↓ -63%
WellSpan_Capital_Blue_Cross All_Plans $123.00 ↓ -25%
UPMC Employees_And_Dependents $123.00 ↓ -25%
UPMC UPMC_For_Kids $123.00 ↓ -25%
Geisinger All_Plans $123.00 ↓ -25%
Cigna All_Plans $130.83 ↓ -20%
Aetna_Better_Health_Kids All_Plans $136.00 ↓ -17%
PHC All_Plans $164.00 ↑ +0%
Aetna All_Plans $166.46 ↑ +2%
First_Health_Network All_Plans $183.07 ↑ +12%
United_Healthcare All_Plans $192.29 ↑ +17%
Blue_Cross Capital_Cares_4_kids $294.70 ↑ +80%
Blue_Cross Capital_Blue_Performance_PPO $323.00 ↑ +97%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $393.60 ↑ +140%
Blue_Cross All_Other_Plans $421.00 ↑ +157%

Visitor-reported prices

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Pt application of modality >=1 area ultrasound each 15 minutes at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $155.40 $13.69 – $387.00
UPMC Cole Coudersport $96.00 $14.78 – $128.00
UPMC East Monroeville $102.00 $25.73 – $136.00
UPMC Hanover Hanover $132.00 $13.69 – $148.00
UPMC Kane Kane $90.60 $27.94 – $60.68
UPMC Lititz Lititz $132.00 $9.85 – $148.00
UPMC Memorial York $132.00 $9.85 – $148.00
UPMC Muncy Muncy $101.40 $13.38 – $31.80

All Pennsylvania hospitals for this procedure →