Pyridoxine hcl 100 mg 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

$131.60

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.

$164.50

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.

$4.59 with Blue_Cross vs $131.60 with PHC — 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 Capital_Cares_4_kids $4.59 ↓ -97%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $5.25 ↓ -96%
Highmark_Wholecare_Gateway_Medicaid All_Plans $6.05 ↓ -95%
Health_Partners_Medicaid All_Other_Plans $6.05 ↓ -95%
Geisinger_Medicaid All_Plans $6.05 ↓ -95%
Amerihealth_Caritas_Medicaid All_Plans $6.05 ↓ -95%
Blue_Cross All_Other_Plans $6.56 ↓ -95%
Blue_Cross Capital_Blue_Performance_PPO $6.56 ↓ -95%
UPMC_Medicaid All_Plans $13.28 ↓ -90%
Aetna All_Plans $18.38 ↓ -86%
First_Health_Network All_Plans $20.22 ↓ -85%
United_Healthcare All_Plans $40.96 ↓ -69%
Cigna All_Plans $44.00 ↓ -67%
UPMC Employees_And_Dependents $98.70 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $98.70 ↓ -25%
Geisinger All_Plans $98.70 ↓ -25%
UPMC UPMC_For_Kids $98.70 ↓ -25%
PHC All_Plans $131.60 ↑ +0%

Visitor-reported prices

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Pyridoxine hcl 100 mg at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $39.00 $0.91 – $47.34
UPMC Carlisle Carlisle $12.60 $1.10 – $20.90
UPMC Cole Coudersport $20.40 $6.05 – $27.20
UPMC Community Osteopathic Harrisburg $12.60 $1.52 – $7.44
UPMC East Monroeville $19.20 $0.92 – $19.20
UPMC Hamot Erie $82.40 $0.91 – $40.38
UPMC Northwest Seneca $21.60 $2.36 – $6.05
UPMC Hanover Hanover $12.60 $6.05 – $20.90

All Pennsylvania hospitals for this procedure →