Sclerotherapy fluid collection pq w/img 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

$980.00

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.

$1,225.00

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.

$220.50 with Aetna_Better_Health_Kids vs $5,870.00 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
Aetna_Better_Health_Kids All_Plans $220.50 ↓ -78%
Aetna All_Plans $686.00 ↓ -30%
UPMC UPMC_For_Kids $735.00 ↓ -25%
Geisinger All_Plans $735.00 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $735.00 ↓ -25%
UPMC Employees_And_Dependents $735.00 ↓ -25%
First_Health_Network All_Plans $754.60 ↓ -23%
Cigna All_Plans $781.80 ↓ -20%
PHC All_Plans $980.00 ↑ +0%
United_Healthcare All_Plans $1,149.05 ↑ +17%
Highmark_Wholecare_Gateway_Medicaid All_Plans $1,215.18 ↑ +24%
Blue_Cross_BlueJourney_Medicare All_Plans $1,600.51 ↑ +63%
Health_Partners_Medicaid All_Other_Plans $1,600.51 ↑ +63%
Highmark_Medicare All_Plans $1,616.52 ↑ +65%
Aetna_Medicare All_Plans $1,648.53 ↑ +68%
Aetna_Advantra_Medicare All_Plans $1,648.53 ↑ +68%
Geisinger_Gold_Medicare All_Plans $1,680.54 ↑ +71%
Devoted_Medicare All_Plans $1,680.54 ↑ +71%
United_Medicare ISNP_DSNP_Plans $1,680.54 ↑ +71%
Highmark_Wholecare_Gateway_Medicare All_Plans $1,687.74 ↑ +72%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $1,688.54 ↑ +72%
UPMC_Medicare UPMC_for_Life_Complete_Care $1,688.54 ↑ +72%
Amerihealth_Medicare All_Plans $1,688.54 ↑ +72%
Jefferson_Health_Medicare_Advantage All_Plans $1,728.55 ↑ +76%
PA_Health_&_Wellness_Medicare All_Plans $1,728.55 ↑ +76%
Highmark Higmark_Healthy_Kids $2,480.79 ↑ +153%
Health_Partners_Medicaid Kidz_Partners $2,640.84 ↑ +169%
United_Medicaid Community_Plan_For_Kids $2,800.89 ↑ +186%
Blue_Cross Capital_Blue_Performance_PPO $4,396.00 ↑ +349%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $4,696.00 ↑ +379%
Highmark Choice_Blue_PPO $4,841.06 ↑ +394%
Highmark Blue_Cross_High_Performance_Network $4,841.06 ↑ +394%
Highmark Performance_Blue $4,841.06 ↑ +394%
Blue_Cross Capital_Cares_4_kids $5,670.70 ↑ +479%
Highmark All_Other_Plans $5,832.74 ↑ +495%
Blue_Cross All_Other_Plans $5,870.00 ↑ +499%

Visitor-reported prices

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Sclerotherapy fluid collection pq w/img at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Carlisle Carlisle $2,643.60 $603.62 – $3,745.10
UPMC Community Osteopathic Harrisburg $2,643.60 $881.20 – $3,745.10
UPMC Hamot Erie $3,801.60 $661.62 – $2,246.66
UPMC Hanover Hanover $2,643.60 $1,198.30 – $2,476.51
UPMC Lititz Lititz $2,643.60 $1,198.30 – $2,489.89
UPMC Magee Pittsburgh $2,901.00 $667.92 – $1,699.17
UPMC Memorial York $2,643.60 $539.25 – $2,485.84
UPMC Mercy Pittsburgh $2,754.60 $661.62 – $1,699.17

All Pennsylvania hospitals for this procedure →