Unsched dialysis esrd pt hos 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

$872.00

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.

Full explanation →

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

$1,090.00

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.

$49.14 with Aetna_Better_Health_Kids vs $2,518.94 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
Aetna_Better_Health_Kids All_Plans $49.14 ↓ -94%
Blue_Cross Capital_Cares_4_kids $111.63 ↓ -87%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $127.57 ↓ -85%
Blue_Cross All_Other_Plans $159.46 ↓ -82%
WellSpan_Capital_Blue_Cross All_Plans $163.80 ↓ -81%
UPMC Employees_And_Dependents $163.80 ↓ -81%
UPMC UPMC_For_Kids $163.80 ↓ -81%
Geisinger All_Plans $163.80 ↓ -81%
Cigna All_Plans $174.23 ↓ -80%
PHC All_Plans $218.40 ↓ -75%
Aetna All_Plans $221.68 ↓ -75%
First_Health_Network All_Plans $243.79 ↓ -72%
United_Healthcare All_Plans $256.07 ↓ -71%
Blue_Cross_BlueJourney_Medicare All_Plans $691.20 ↓ -21%
Highmark_Medicare All_Plans $698.11 ↓ -20%
Aetna_Medicare All_Plans $711.94 ↓ -18%
Aetna_Advantra_Medicare All_Plans $711.94 ↓ -18%
Geisinger_Gold_Medicare All_Plans $725.76 ↓ -17%
Devoted_Medicare All_Plans $725.76 ↓ -17%
United_Medicare ISNP_DSNP_Plans $725.76 ↓ -17%
Highmark_Wholecare_Gateway_Medicare All_Plans $728.87 ↓ -16%
Amerihealth_Medicare All_Plans $729.22 ↓ -16%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $729.22 ↓ -16%
UPMC_Medicare UPMC_for_Life_Complete_Care $729.22 ↓ -16%
Jefferson_Health_Medicare_Advantage All_Plans $746.50 ↓ -14%
PA_Health_&_Wellness_Medicare All_Plans $746.50 ↓ -14%
Highmark Higmark_Healthy_Kids $1,071.36 ↑ +23%
Health_Partners_Medicaid Kidz_Partners $1,140.48 ↑ +31%
United_Medicaid Community_Plan_For_Kids $1,209.60 ↑ +39%
Highmark Blue_Cross_High_Performance_Network $2,090.67 ↑ +140%
Highmark Choice_Blue_PPO $2,090.67 ↑ +140%
Highmark Performance_Blue $2,090.67 ↑ +140%
Highmark All_Other_Plans $2,518.94 ↑ +189%

Visitor-reported prices

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Unsched dialysis esrd pt hos at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $1,635.00 $120.82 – $2,180.00
UPMC Carlisle Carlisle $2,160.60 $368.15 – $3,060.85
UPMC Community Osteopathic Harrisburg $2,160.60 $503.85 – $3,060.85
UPMC East Monroeville $415.80 $121.97 – $720.47
UPMC Hamot Erie $6,177.60 $120.82 – $831.51
UPMC Northwest Seneca $1,776.60 $313.58 – $720.47
UPMC Hanover Hanover $2,160.60 $503.85 – $1,644.55
UPMC Horizon-Greenville Greenville $721.80 $307.92 – $720.47

All Pennsylvania hospitals for this procedure →