Remove renal tube w/fluoro 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

$1,152.00

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.

$1,440.00

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.

$56.48 with Highmark_Wholecare_Gateway_Medicaid vs $3,498.00 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
Highmark_Wholecare_Gateway_Medicaid All_Plans $56.48 ↓ -95%
Geisinger_Medicaid All_Plans $56.48 ↓ -95%
Health_Partners_Medicaid All_Other_Plans $56.48 ↓ -95%
UPMC_Medicaid All_Plans $56.48 ↓ -95%
PA_Health_&_Wellness_Medicaid All_Plans $56.48 ↓ -95%
Amerihealth_Caritas_Medicaid All_Plans $64.16 ↓ -94%
Aetna_Better_Health_Kids All_Plans $153.61 ↓ -87%
Blue_Cross_BlueJourney_Medicare All_Plans $659.34 ↓ -43%
Highmark_Medicare All_Plans $665.93 ↓ -42%
Aetna_Advantra_Medicare All_Plans $679.12 ↓ -41%
Aetna_Medicare All_Plans $679.12 ↓ -41%
Geisinger_Gold_Medicare All_Plans $692.31 ↓ -40%
United_Medicare ISNP_DSNP_Plans $692.31 ↓ -40%
Devoted_Medicare All_Plans $692.31 ↓ -40%
Highmark_Wholecare_Gateway_Medicare All_Plans $695.27 ↓ -40%
UPMC_Medicare UPMC_for_Life_Complete_Care $695.60 ↓ -40%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $695.60 ↓ -40%
Amerihealth_Medicare All_Plans $695.60 ↓ -40%
PA_Health_&_Wellness_Medicare All_Plans $712.09 ↓ -38%
Jefferson_Health_Medicare_Advantage All_Plans $712.09 ↓ -38%
Aetna All_Plans $806.40 ↓ -30%
Geisinger All_Plans $864.00 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $864.00 ↓ -25%
UPMC Employees_And_Dependents $864.00 ↓ -25%
UPMC UPMC_For_Kids $864.00 ↓ -25%
First_Health_Network All_Plans $887.04 ↓ -23%
Cigna All_Plans $919.01 ↓ -20%
Highmark Higmark_Healthy_Kids $1,021.98 ↓ -11%
Health_Partners_Medicaid Kidz_Partners $1,087.91 ↓ -6%
PHC All_Plans $1,152.00 ↑ +0%
United_Medicaid Community_Plan_For_Kids $1,153.85 ↑ +0%
United_Healthcare All_Plans $1,350.72 ↑ +17%
Highmark Blue_Cross_High_Performance_Network $1,994.31 ↑ +73%
Highmark Choice_Blue_PPO $1,994.31 ↑ +73%
Highmark Performance_Blue $1,994.31 ↑ +73%
Highmark All_Other_Plans $2,402.83 ↑ +109%
Blue_Cross Capital_Cares_4_kids $2,448.60 ↑ +113%
Blue_Cross Capital_Blue_Performance_PPO $2,620.00 ↑ +127%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $2,798.40 ↑ +143%
Blue_Cross All_Other_Plans $3,498.00 ↑ +204%

Visitor-reported prices

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Remove renal tube w/fluoro at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $1,950.00 $648.95 – $2,600.00
UPMC Carlisle Carlisle $3,200.40 $351.19 – $4,533.90
UPMC Cole Coudersport $82.20 $37.98 – $806.66
UPMC Community Osteopathic Harrisburg $3,200.40 $650.01 – $4,533.90
UPMC East Monroeville $3,741.60 $638.07 – $4,988.80
UPMC Hamot Erie $1,914.60 $734.43 – $925.53
UPMC Northwest Seneca $1,830.00 $577.11 – $806.66
UPMC Hanover Hanover $3,200.40 $631.25 – $2,833.60

All Pennsylvania hospitals for this procedure →