Relocation skin pocket aicd 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

$7,968.00

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.

$9,960.00

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.

$1,806.95 with Blue_Cross_BlueJourney_Medicare vs $9,342.48 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 →

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 $1,806.95 ↓ -77%
Highmark_Medicare All_Plans $1,825.02 ↓ -77%
Health_Partners_Medicaid All_Other_Plans $1,829.23 ↓ -77%
Aetna_Medicare All_Plans $1,861.16 ↓ -77%
Aetna_Advantra_Medicare All_Plans $1,861.16 ↓ -77%
Geisinger_Gold_Medicare All_Plans $1,897.30 ↓ -76%
United_Medicare ISNP_DSNP_Plans $1,897.30 ↓ -76%
Devoted_Medicare All_Plans $1,897.30 ↓ -76%
Highmark_Wholecare_Gateway_Medicare All_Plans $1,905.43 ↓ -76%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $1,906.33 ↓ -76%
Amerihealth_Medicare All_Plans $1,906.33 ↓ -76%
UPMC_Medicare UPMC_for_Life_Complete_Care $1,906.33 ↓ -76%
PA_Health_&_Wellness_Medicare All_Plans $1,951.51 ↓ -76%
Jefferson_Health_Medicare_Advantage All_Plans $1,951.51 ↓ -76%
Highmark Higmark_Healthy_Kids $2,800.77 ↓ -65%
Health_Partners_Medicaid Kidz_Partners $2,981.47 ↓ -63%
United_Medicaid Community_Plan_For_Kids $3,162.16 ↓ -60%
Blue_Cross Capital_Blue_Performance_PPO $4,396.00 ↓ -45%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $4,696.00 ↓ -41%
Highmark Blue_Cross_High_Performance_Network $5,465.48 ↓ -31%
Highmark Performance_Blue $5,465.48 ↓ -31%
Highmark Choice_Blue_PPO $5,465.48 ↓ -31%
Aetna All_Plans $5,577.60 ↓ -30%
Blue_Cross Capital_Cares_4_kids $5,670.70 ↓ -29%
Blue_Cross All_Other_Plans $5,870.00 ↓ -26%
Geisinger All_Plans $5,976.00 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $5,976.00 ↓ -25%
UPMC Employees_And_Dependents $5,976.00 ↓ -25%
UPMC UPMC_For_Kids $5,976.00 ↓ -25%
First_Health_Network All_Plans $6,135.36 ↓ -23%
Cigna All_Plans $6,356.47 ↓ -20%
Aetna_Better_Health_Kids All_Plans $6,420.00 ↓ -19%
Highmark All_Other_Plans $6,585.07 ↓ -17%
PHC All_Plans $7,968.00 ↑ +0%
United_Healthcare All_Plans $9,342.48 ↑ +17%

Visitor-reported prices

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Relocation skin pocket aicd at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $2,644.20 $785.10 – $3,525.60
UPMC Carlisle Carlisle $3,487.20 $796.24 – $4,940.20
UPMC Community Osteopathic Harrisburg $3,487.20 $1,016.56 – $4,940.20
UPMC East Monroeville $3,284.40 $792.58 – $4,379.20
UPMC Hamot Erie $3,516.60 $785.10 – $2,536.45
UPMC Hanover Hanover $3,487.20 $1,016.56 – $2,795.94
UPMC Lititz Lititz $3,487.20 $1,016.56 – $2,811.04
UPMC Memorial York $3,487.20 $639.89 – $2,806.48

All Pennsylvania hospitals for this procedure →