Tx closed hip disl traumatic without anes 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

$1,441.60

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.

$1,802.00

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.

$236.96 with Blue_Cross_BlueJourney_Medicare vs $1,690.28 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
Blue_Cross_BlueJourney_Medicare All_Plans $236.96 ↓ -84%
Highmark_Medicare All_Plans $239.33 ↓ -83%
Aetna_Medicare All_Plans $244.07 ↓ -83%
Aetna_Advantra_Medicare All_Plans $244.07 ↓ -83%
Geisinger_Gold_Medicare All_Plans $248.81 ↓ -83%
United_Medicare ISNP_DSNP_Plans $248.81 ↓ -83%
Devoted_Medicare All_Plans $248.81 ↓ -83%
Highmark_Wholecare_Gateway_Medicare All_Plans $249.87 ↓ -83%
Amerihealth_Medicare All_Plans $249.99 ↓ -83%
UPMC_Medicare UPMC_for_Life_Complete_Care $249.99 ↓ -83%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $249.99 ↓ -83%
Highmark_Wholecare_Gateway_Medicaid All_Plans $255.81 ↓ -82%
PA_Health_&_Wellness_Medicaid All_Plans $255.81 ↓ -82%
UPMC_Medicaid All_Plans $255.81 ↓ -82%
Geisinger_Medicaid All_Plans $255.81 ↓ -82%
Health_Partners_Medicaid All_Other_Plans $255.81 ↓ -82%
PA_Health_&_Wellness_Medicare All_Plans $255.92 ↓ -82%
Jefferson_Health_Medicare_Advantage All_Plans $255.92 ↓ -82%
Amerihealth_Caritas_Medicaid All_Plans $290.60 ↓ -80%
Highmark Higmark_Healthy_Kids $367.29 ↓ -75%
Health_Partners_Medicaid Kidz_Partners $390.98 ↓ -73%
United_Medicaid Community_Plan_For_Kids $414.68 ↓ -71%
Aetna_Better_Health_Kids All_Plans $695.81 ↓ -52%
Highmark Blue_Cross_High_Performance_Network $716.73 ↓ -50%
Highmark Choice_Blue_PPO $716.73 ↓ -50%
Highmark Performance_Blue $716.73 ↓ -50%
Highmark All_Other_Plans $863.55 ↓ -40%
WellSpan_Capital_Blue_Cross All_Plans $1,081.20 ↓ -25%
UPMC Employees_And_Dependents $1,081.20 ↓ -25%
UPMC UPMC_For_Kids $1,081.20 ↓ -25%
Geisinger All_Plans $1,081.20 ↓ -25%
Blue_Cross Capital_Cares_4_kids $1,131.20 ↓ -22%
Cigna All_Plans $1,150.04 ↓ -20%
Blue_Cross Capital_Blue_Performance_PPO $1,209.00 ↓ -16%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,292.80 ↓ -10%
PHC All_Plans $1,441.60 ↑ +0%
Aetna All_Plans $1,463.22 ↑ +1%
First_Health_Network All_Plans $1,609.19 ↑ +12%
Blue_Cross All_Other_Plans $1,616.00 ↑ +12%
United_Healthcare All_Plans $1,690.28 ↑ +17%

Visitor-reported prices

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Tx closed hip disl traumatic without anes at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $2,275.20 $204.65 – $3,033.60
UPMC Bedford Everett $3,584.40 $82.51 – $5,376.60
UPMC Carlisle Carlisle $1,249.20 $227.18 – $1,769.70
UPMC Cole Coudersport $1,266.00 $214.88 – $1,215.20
UPMC Community Osteopathic Harrisburg $1,249.20 $233.61 – $1,769.70
UPMC East Monroeville $2,281.20 $225.12 – $3,041.60
UPMC Hamot Erie $2,313.60 $225.12 – $1,120.46
UPMC Northwest Seneca $3,032.40 $207.41 – $939.53

All Pennsylvania hospitals for this procedure →