Sleeve fing rolyan med 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

$316.80

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.

Full explanation →

What you pay up front if you don't use insurance.

$396.00

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.

$67.93 with Highmark_Wholecare_Gateway_Medicaid vs $832.07 with Highmark — 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 $67.93 ↓ -79%
Blue_Cross Capital_Cares_4_kids $161.92 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $185.05 ↓ -42%
Blue_Cross_BlueJourney_Medicare All_Plans $228.32 ↓ -28%
Health_Partners_Medicaid All_Other_Plans $228.32 ↓ -28%
Highmark_Medicare All_Plans $230.60 ↓ -27%
Blue_Cross All_Other_Plans $231.30 ↓ -27%
Aetna_Advantra_Medicare All_Plans $235.17 ↓ -26%
Aetna_Medicare All_Plans $235.17 ↓ -26%
UPMC Employees_And_Dependents $237.60 ↓ -25%
UPMC UPMC_For_Kids $237.60 ↓ -25%
WellSpan_Capital_Blue_Cross All_Plans $237.60 ↓ -25%
Geisinger All_Plans $237.60 ↓ -25%
Devoted_Medicare All_Plans $239.74 ↓ -24%
Geisinger_Gold_Medicare All_Plans $239.74 ↓ -24%
United_Medicare ISNP_DSNP_Plans $239.74 ↓ -24%
Highmark_Wholecare_Gateway_Medicare All_Plans $240.76 ↓ -24%
Amerihealth_Medicare All_Plans $240.88 ↓ -24%
UPMC_Medicare UPMC_for_Life_Complete_Care $240.88 ↓ -24%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $240.88 ↓ -24%
Jefferson_Health_Medicare_Advantage All_Plans $246.59 ↓ -22%
PA_Health_&_Wellness_Medicare All_Plans $246.59 ↓ -22%
Cigna All_Plans $252.73 ↓ -20%
PHC All_Plans $316.80 ↑ +0%
Aetna All_Plans $321.55 ↑ +1%
First_Health_Network All_Plans $353.63 ↑ +12%
Highmark Higmark_Healthy_Kids $353.90 ↑ +12%
United_Healthcare All_Plans $371.45 ↑ +17%
Health_Partners_Medicaid Kidz_Partners $376.73 ↑ +19%
United_Medicaid Community_Plan_For_Kids $399.56 ↑ +26%
Highmark Blue_Cross_High_Performance_Network $690.60 ↑ +118%
Highmark Choice_Blue_PPO $690.60 ↑ +118%
Highmark Performance_Blue $690.60 ↑ +118%
Highmark All_Other_Plans $832.07 ↑ +163%

Visitor-reported prices

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Sleeve fing rolyan med at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Cole Coudersport $127.20 $40.28 – $169.60
WellSpan Chambersburg Hospital Chambersburg $316.00 $67.93 – $1,015.64
WellSpan Ephrata Community Hospital Ephrata $309.60 $67.93 – $399.56
WellSpan Surgery & Rehabilitation Hospital York PA 17403 $316.00 $184.76 – $399.56
WellSpan Waynesboro Hospital Waynesboro $316.00 $67.93 – $776.29
WellSpan Gettysburg Hospital Gettysburg $316.00 $67.93 – $399.56

All Pennsylvania hospitals for this procedure →