Treatment of fibula fracture 27780 at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$690.40
Cash price 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.
$863.00
Gross charge 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.
$144.38 with UPMC_Medicaid vs $1,616.00 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 →
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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 ?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 ?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 |
|---|---|---|---|
| UPMC_Medicaid | All_Plans | $144.38 | ↓ -79% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $144.38 | ↓ -79% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $236.96 | ↓ -66% |
| Health_Partners_Medicaid | All_Other_Plans | $236.96 | ↓ -66% |
| Highmark_Medicare | All_Plans | $239.33 | ↓ -65% |
| Aetna_Medicare | All_Plans | $244.07 | ↓ -65% |
| Aetna_Advantra_Medicare | All_Plans | $244.07 | ↓ -65% |
| Geisinger_Gold_Medicare | All_Plans | $248.81 | ↓ -64% |
| Devoted_Medicare | All_Plans | $248.81 | ↓ -64% |
| United_Medicare | ISNP_DSNP_Plans | $248.81 | ↓ -64% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $249.87 | ↓ -64% |
| Amerihealth_Medicare | All_Plans | $249.99 | ↓ -64% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $249.99 | ↓ -64% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $249.99 | ↓ -64% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $255.92 | ↓ -63% |
| PA_Health_&_Wellness_Medicare | All_Plans | $255.92 | ↓ -63% |
| Highmark | Higmark_Healthy_Kids | $367.29 | ↓ -47% |
| Health_Partners_Medicaid | Kidz_Partners | $390.98 | ↓ -43% |
| United_Medicaid | Community_Plan_For_Kids | $414.68 | ↓ -40% |
| WellSpan_Capital_Blue_Cross | All_Plans | $517.80 | ↓ -25% |
| UPMC | Employees_And_Dependents | $517.80 | ↓ -25% |
| UPMC | UPMC_For_Kids | $517.80 | ↓ -25% |
| Geisinger | All_Plans | $517.80 | ↓ -25% |
| Cigna | All_Plans | $550.77 | ↓ -20% |
| PHC | All_Plans | $690.40 | ↑ +0% |
| Aetna | All_Plans | $700.76 | ↑ +2% |
| Highmark | Performance_Blue | $716.73 | ↑ +4% |
| Highmark | Choice_Blue_PPO | $716.73 | ↑ +4% |
| Highmark | Blue_Cross_High_Performance_Network | $716.73 | ↑ +4% |
| First_Health_Network | All_Plans | $770.66 | ↑ +12% |
| United_Healthcare | All_Plans | $809.49 | ↑ +17% |
| Highmark | All_Other_Plans | $863.55 | ↑ +25% |
| Blue_Cross | Capital_Cares_4_kids | $1,131.20 | ↑ +64% |
| Blue_Cross | Capital_Blue_Performance_PPO | $1,209.00 | ↑ +75% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $1,292.80 | ↑ +87% |
| Blue_Cross | All_Other_Plans | $1,616.00 | ↑ +134% |
Visitor-reported prices
Comments
Treatment of fibula fracture 27780 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,537.20 | $82.51 – $2,305.80 |
| UPMC Carlisle | Carlisle | $769.80 | $126.21 – $1,090.55 |
| UPMC Cole | Coudersport | $1,266.00 | $66.25 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $769.80 | $233.61 – $1,732.75 |
| UPMC Hanover | Hanover | $769.80 | $226.87 – $1,732.75 |
| UPMC Lititz | Lititz | $769.80 | $228.10 – $1,732.75 |
| UPMC Memorial | York | $769.80 | $239.91 – $1,732.75 |
| UPMC Muncy | Muncy | $825.60 | $511.98 – $993.28 |