Scope uretscp lithovue dig disp 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

$4,632.00

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.

$5,790.00

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.

$1,256.43 with Health_Partners_Medicaid vs $5,431.02 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
Health_Partners_Medicaid All_Other_Plans $1,256.43 ↓ -73%
Blue_Cross_BlueJourney_Medicare All_Plans $1,256.43 ↓ -73%
Highmark_Medicare All_Plans $1,268.99 ↓ -73%
Aetna_Advantra_Medicare All_Plans $1,294.12 ↓ -72%
Aetna_Medicare All_Plans $1,294.12 ↓ -72%
United_Medicare ISNP_DSNP_Plans $1,319.25 ↓ -72%
Devoted_Medicare All_Plans $1,319.25 ↓ -72%
Geisinger_Gold_Medicare All_Plans $1,319.25 ↓ -72%
Highmark_Wholecare_Gateway_Medicare All_Plans $1,324.91 ↓ -71%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $1,325.53 ↓ -71%
UPMC_Medicare UPMC_for_Life_Complete_Care $1,325.53 ↓ -71%
Amerihealth_Medicare All_Plans $1,325.53 ↓ -71%
Jefferson_Health_Medicare_Advantage All_Plans $1,356.94 ↓ -71%
PA_Health_&_Wellness_Medicare All_Plans $1,356.94 ↓ -71%
Geisinger_Medicaid All_Plans $1,447.50 ↓ -69%
UPMC_Medicaid All_Plans $1,447.50 ↓ -69%
PA_Health_&_Wellness_Medicaid All_Plans $1,447.50 ↓ -69%
Highmark Higmark_Healthy_Kids $1,947.47 ↓ -58%
Health_Partners_Medicaid Kidz_Partners $2,073.11 ↓ -55%
United_Medicaid Community_Plan_For_Kids $2,198.75 ↓ -53%
Highmark_Wholecare_Gateway_Medicaid All_Plans $2,316.00 ↓ -50%
Blue_Cross Capital_Cares_4_kids $2,367.53 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $2,705.67 ↓ -42%
Blue_Cross All_Other_Plans $3,381.94 ↓ -27%
Geisinger All_Plans $3,474.00 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $3,474.00 ↓ -25%
UPMC UPMC_For_Kids $3,474.00 ↓ -25%
UPMC Employees_And_Dependents $3,474.00 ↓ -25%
Cigna All_Plans $3,695.18 ↓ -20%
Highmark Blue_Cross_High_Performance_Network $3,800.32 ↓ -18%
Highmark Choice_Blue_PPO $3,800.32 ↓ -18%
Highmark Performance_Blue $3,800.32 ↓ -18%
Aetna_Better_Health_Kids All_Plans $4,053.00 ↓ -13%
Highmark All_Other_Plans $4,578.81 ↓ -1%
PHC All_Plans $4,632.00 ↑ +0%
Aetna All_Plans $4,701.48 ↑ +2%
First_Health_Network All_Plans $5,170.47 ↑ +12%
United_Healthcare All_Plans $5,431.02 ↑ +17%

Visitor-reported prices

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Scope uretscp lithovue dig disp at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Presbyterian Pittsburgh $3,816.00 $763.20 – $5,406.00
Uniontown Hospital Uniontown $4,270.00 not published
WellSpan Gettysburg Hospital Gettysburg $5,652.00 $1,427.13 – $2,497.48

All Pennsylvania hospitals for this procedure →