Renal venogram bil s&i 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

$6,960.00

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.

$8,700.00

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.

$46.88 with UPMC_Medicaid vs $17,462.81 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
UPMC_Medicaid All_Plans $46.88 ↓ -99%
Health_Partners_Medicaid All_Other_Plans $46.88 ↓ -99%
Geisinger_Medicaid All_Plans $46.88 ↓ -99%
PA_Health_&_Wellness_Medicaid All_Plans $46.88 ↓ -99%
Highmark_Wholecare_Gateway_Medicaid All_Plans $46.88 ↓ -99%
Amerihealth_Caritas_Medicaid All_Plans $53.25 ↓ -99%
Aetna_Better_Health_Kids All_Plans $127.50 ↓ -98%
Blue_Cross Capital_Blue_Performance_PPO $208.50 ↓ -97%
Blue_Cross Capital_Cares_4_kids $956.56 ↓ -86%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,093.21 ↓ -84%
Blue_Cross All_Other_Plans $1,366.51 ↓ -80%
Blue_Cross_BlueJourney_Medicare All_Plans $3,109.16 ↓ -55%
Highmark_Medicare All_Plans $3,140.25 ↓ -55%
Aetna_Medicare All_Plans $3,202.43 ↓ -54%
Aetna_Advantra_Medicare All_Plans $3,202.43 ↓ -54%
Devoted_Medicare All_Plans $3,264.62 ↓ -53%
United_Medicare ISNP_DSNP_Plans $3,264.62 ↓ -53%
Geisinger_Gold_Medicare All_Plans $3,264.62 ↓ -53%
Highmark_Wholecare_Gateway_Medicare All_Plans $3,278.61 ↓ -53%
UPMC_Medicare UPMC_for_Life_Complete_Care $3,280.16 ↓ -53%
Amerihealth_Medicare All_Plans $3,280.16 ↓ -53%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $3,280.16 ↓ -53%
Jefferson_Health_Medicare_Advantage All_Plans $3,357.89 ↓ -52%
PA_Health_&_Wellness_Medicare All_Plans $3,357.89 ↓ -52%
Highmark Higmark_Healthy_Kids $4,819.20 ↓ -31%
Cigna All_Plans $5,125.17 ↓ -26%
Health_Partners_Medicaid Kidz_Partners $5,130.11 ↓ -26%
WellSpan_Capital_Blue_Cross All_Plans $5,220.00 ↓ -25%
UPMC Employees_And_Dependents $5,220.00 ↓ -25%
Geisinger All_Plans $5,220.00 ↓ -25%
UPMC UPMC_For_Kids $5,220.00 ↓ -25%
United_Medicaid Community_Plan_For_Kids $5,441.03 ↓ -22%
PHC All_Plans $6,960.00 ↑ +0%
Aetna All_Plans $7,064.40 ↑ +2%
First_Health_Network All_Plans $7,769.10 ↑ +12%
Highmark Performance_Blue $9,404.28 ↑ +35%
Highmark Choice_Blue_PPO $9,404.28 ↑ +35%
Highmark Blue_Cross_High_Performance_Network $9,404.28 ↑ +35%
Highmark All_Other_Plans $11,330.71 ↑ +63%
United_Healthcare All_Plans $17,462.81 ↑ +151%

Visitor-reported prices

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Renal venogram bil s&i at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $5,906.40 $29.48 – $8,367.40
UPMC Community Osteopathic Harrisburg $5,906.40 $29.48 – $8,367.40
UPMC Hanover Hanover $5,906.40 $29.48 – $4,810.90
UPMC Lititz Lititz $5,906.40 $29.48 – $4,836.88
UPMC Magee Pittsburgh $2,653.80 $41.25 – $3,240.82
UPMC Memorial York $5,906.40 $29.48 – $4,829.02
UPMC Presbyterian Pittsburgh $9,606.00 $27.00 – $3,300.84
UPMC Somerset Somerset $5,906.40 $25.88 – $3,000.76

All Pennsylvania hospitals for this procedure →