Sinus CT scan (without contrast) 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

$295.00

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.

$1,610.00

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.

$105.04 with Blue_Cross_BlueJourney_Medicare vs $1,288.00 with PHC — 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 $105.04 ↓ -64%
Highmark_Medicare All_Plans $106.09 ↓ -64%
Aetna_Medicare All_Plans $108.19 ↓ -63%
Aetna_Advantra_Medicare All_Plans $108.19 ↓ -63%
Devoted_Medicare All_Plans $110.29 ↓ -63%
United_Medicare ISNP_DSNP_Plans $110.29 ↓ -63%
Geisinger_Gold_Medicare All_Plans $110.29 ↓ -63%
Highmark_Wholecare_Gateway_Medicare All_Plans $110.76 ↓ -62%
Amerihealth_Medicare All_Plans $110.82 ↓ -62%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $110.82 ↓ -62%
UPMC_Medicare UPMC_for_Life_Complete_Care $110.82 ↓ -62%
Jefferson_Health_Medicare_Advantage All_Plans $113.44 ↓ -62%
PA_Health_&_Wellness_Medicare All_Plans $113.44 ↓ -62%
UPMC_Medicaid All_Plans $162.50 ↓ -45%
PA_Health_&_Wellness_Medicaid All_Plans $162.50 ↓ -45%
Geisinger_Medicaid All_Plans $162.50 ↓ -45%
Health_Partners_Medicaid All_Other_Plans $162.50 ↓ -45%
Highmark_Wholecare_Gateway_Medicaid All_Plans $162.50 ↓ -45%
Highmark Higmark_Healthy_Kids $162.81 ↓ -45%
Health_Partners_Medicaid Kidz_Partners $173.32 ↓ -41%
Blue_Cross Capital_Blue_Performance_PPO $181.06 ↓ -39%
United_Medicaid Community_Plan_For_Kids $183.82 ↓ -38%
Amerihealth_Caritas_Medicaid All_Plans $184.60 ↓ -37%
WellSpan_Capital_Blue_Cross All_Plans $252.00 ↓ -15%
Highmark Performance_Blue $317.71 ↑ +8%
Highmark Blue_Cross_High_Performance_Network $317.71 ↑ +8%
Highmark Choice_Blue_PPO $317.71 ↑ +8%
Highmark All_Other_Plans $382.80 ↑ +30%
Aetna_Better_Health_Kids All_Plans $442.00 ↑ +50%
United_Healthcare All_Plans $602.31 ↑ +104%
Blue_Cross Capital_Cares_4_kids $830.67 ↑ +182%
Cigna All_Plans $837.84 ↑ +184%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $949.33 ↑ +222%
Aetna All_Plans $957.00 ↑ +224%
UPMC Employees_And_Dependents $966.00 ↑ +227%
Geisinger All_Plans $966.00 ↑ +227%
UPMC UPMC_For_Kids $966.00 ↑ +227%
First_Health_Network All_Plans $1,052.00 ↑ +257%
Blue_Cross All_Other_Plans $1,186.67 ↑ +302%
PHC All_Plans $1,288.00 ↑ +337%

Visitor-reported prices

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Sinus CT scan (without contrast) at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $1,017.00 $77.50 – $1,356.00
UPMC Bedford Everett $741.00 $36.58 – $1,111.50
UPMC Carlisle Carlisle $796.80 $100.71 – $1,128.80
UPMC Cole Coudersport $1,144.80 $136.50 – $1,526.40
UPMC Community Osteopathic Harrisburg $796.80 $101.53 – $1,128.80
UPMC East Monroeville $1,863.00 $101.65 – $2,484.00
UPMC Hamot Erie $1,464.60 $98.61 – $590.02
UPMC Northwest Seneca $1,226.40 $91.94 – $556.42

All Pennsylvania hospitals for this procedure →