Pt evaluation high complexity patient/family at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$518.40
Cash price 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.
$648.00
Gross charge 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.
$72.60 with Blue_Cross vs $607.82 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 →
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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 ?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 ?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 | Capital_Blue_Performance_PPO | $72.60 | ↓ -86% |
| Health_Partners_Medicaid | All_Other_Plans | $79.51 | ↓ -85% |
| UPMC_Medicaid | All_Plans | $79.51 | ↓ -85% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $79.51 | ↓ -85% |
| Geisinger_Medicaid | All_Plans | $79.51 | ↓ -85% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $79.51 | ↓ -85% |
| Amerihealth_Caritas_Medicaid | All_Plans | $90.33 | ↓ -83% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $94.49 | ↓ -82% |
| Highmark_Medicare | All_Plans | $95.43 | ↓ -82% |
| Aetna_Medicare | All_Plans | $97.32 | ↓ -81% |
| Aetna_Advantra_Medicare | All_Plans | $97.32 | ↓ -81% |
| Devoted_Medicare | All_Plans | $99.21 | ↓ -81% |
| United_Medicare | ISNP_DSNP_Plans | $99.21 | ↓ -81% |
| Geisinger_Gold_Medicare | All_Plans | $99.21 | ↓ -81% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $99.64 | ↓ -81% |
| Amerihealth_Medicare | All_Plans | $99.69 | ↓ -81% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $99.69 | ↓ -81% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $99.69 | ↓ -81% |
| PA_Health_&_Wellness_Medicare | All_Plans | $102.05 | ↓ -80% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $102.05 | ↓ -80% |
| Highmark | Higmark_Healthy_Kids | $146.46 | ↓ -72% |
| Health_Partners_Medicaid | Kidz_Partners | $155.91 | ↓ -70% |
| United_Medicaid | Community_Plan_For_Kids | $165.36 | ↓ -68% |
| Aetna_Better_Health_Kids | All_Plans | $216.27 | ↓ -58% |
| Blue_Cross | Capital_Cares_4_kids | $264.97 | ↓ -49% |
| Highmark | Performance_Blue | $285.80 | ↓ -45% |
| Highmark | Choice_Blue_PPO | $285.80 | ↓ -45% |
| Highmark | Blue_Cross_High_Performance_Network | $285.80 | ↓ -45% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $302.81 | ↓ -42% |
| Highmark | All_Other_Plans | $344.35 | ↓ -34% |
| Blue_Cross | All_Other_Plans | $378.50 | ↓ -27% |
| WellSpan_Capital_Blue_Cross | All_Plans | $388.80 | ↓ -25% |
| UPMC | Employees_And_Dependents | $388.80 | ↓ -25% |
| UPMC | UPMC_For_Kids | $388.80 | ↓ -25% |
| Geisinger | All_Plans | $388.80 | ↓ -25% |
| Cigna | All_Plans | $413.55 | ↓ -20% |
| PHC | All_Plans | $518.40 | ↑ +0% |
| Aetna | All_Plans | $526.18 | ↑ +2% |
| First_Health_Network | All_Plans | $578.66 | ↑ +12% |
| United_Healthcare | All_Plans | $607.82 | ↑ +17% |
Visitor-reported prices
Comments
Pt evaluation high complexity patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $216.00 | $51.56 – $288.00 |
| UPMC Bedford | Everett | $299.40 | $124.75 – $449.10 |
| UPMC Carlisle | Carlisle | $363.00 | $82.89 – $514.25 |
| UPMC Cole | Coudersport | $281.40 | $84.11 – $375.20 |
| UPMC Community Osteopathic | Harrisburg | $363.00 | $83.33 – $514.25 |
| UPMC East | Monroeville | $411.60 | $52.05 – $548.80 |
| UPMC Hamot | Erie | $304.80 | $51.56 – $177.27 |
| UPMC Northwest | Seneca | $320.40 | $127.65 – $269.30 |