St evaluation motion fluoroscopic swallow function cine/video 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

$430.40

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.

$538.00

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.

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The hospital's undiscounted list price — almost no one pays this.

$34.78 with Blue_Cross vs $504.64 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.

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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 Capital_Blue_Performance_PPO $34.78 ↓ -92%
Health_Partners_Medicaid All_Other_Plans $52.90 ↓ -88%
UPMC_Medicaid All_Plans $52.90 ↓ -88%
Highmark_Wholecare_Gateway_Medicaid All_Plans $52.90 ↓ -88%
Geisinger_Medicaid All_Plans $52.90 ↓ -88%
PA_Health_&_Wellness_Medicaid All_Plans $52.90 ↓ -88%
Amerihealth_Caritas_Medicaid All_Plans $60.09 ↓ -86%
Blue_Cross_BlueJourney_Medicare All_Plans $85.62 ↓ -80%
Highmark_Medicare All_Plans $86.48 ↓ -80%
Aetna_Medicare All_Plans $88.19 ↓ -80%
Aetna_Advantra_Medicare All_Plans $88.19 ↓ -80%
Devoted_Medicare All_Plans $89.90 ↓ -79%
United_Medicare ISNP_DSNP_Plans $89.90 ↓ -79%
Geisinger_Gold_Medicare All_Plans $89.90 ↓ -79%
Highmark_Wholecare_Gateway_Medicare All_Plans $90.29 ↓ -79%
Amerihealth_Medicare All_Plans $90.33 ↓ -79%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $90.33 ↓ -79%
UPMC_Medicare UPMC_for_Life_Complete_Care $90.33 ↓ -79%
PA_Health_&_Wellness_Medicare All_Plans $92.47 ↓ -79%
Jefferson_Health_Medicare_Advantage All_Plans $92.47 ↓ -79%
Highmark Higmark_Healthy_Kids $132.71 ↓ -69%
Health_Partners_Medicaid Kidz_Partners $141.27 ↓ -67%
Aetna_Better_Health_Kids All_Plans $143.89 ↓ -67%
United_Medicaid Community_Plan_For_Kids $149.84 ↓ -65%
Blue_Cross Capital_Cares_4_kids $219.99 ↓ -49%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $251.41 ↓ -42%
Highmark Performance_Blue $258.97 ↓ -40%
Highmark Choice_Blue_PPO $258.97 ↓ -40%
Highmark Blue_Cross_High_Performance_Network $258.97 ↓ -40%
Highmark All_Other_Plans $312.02 ↓ -28%
Blue_Cross All_Other_Plans $314.25 ↓ -27%
WellSpan_Capital_Blue_Cross All_Plans $322.80 ↓ -25%
UPMC Employees_And_Dependents $322.80 ↓ -25%
UPMC UPMC_For_Kids $322.80 ↓ -25%
Geisinger All_Plans $322.80 ↓ -25%
Cigna All_Plans $343.35 ↓ -20%
PHC All_Plans $430.40 ↑ +0%
Aetna All_Plans $436.86 ↑ +2%
First_Health_Network All_Plans $480.43 ↑ +12%
United_Healthcare All_Plans $504.64 ↑ +17%

Visitor-reported prices

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St evaluation motion fluoroscopic swallow function cine/video at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $373.80 $42.32 – $498.40
UPMC Bedford Everett $558.60 $44.44 – $837.90
UPMC Carlisle Carlisle $263.40 $53.75 – $591.00
UPMC Cole Coudersport $418.80 $44.44 – $558.40
UPMC Community Osteopathic Harrisburg $263.40 $53.75 – $1,395.12
UPMC East Monroeville $486.60 $46.55 – $648.80
UPMC Hamot Erie $489.00 $46.55 – $223.13
UPMC Northwest Seneca $455.40 $46.55 – $579.11

All Pennsylvania hospitals for this procedure →