Urethrocystography void s&i 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

$600.00

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.

$750.00

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.

$53.13 with UPMC_Medicaid vs $1,342.45 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
UPMC_Medicaid All_Plans $53.13 ↓ -91%
Highmark_Wholecare_Gateway_Medicaid All_Plans $53.13 ↓ -91%
PA_Health_&_Wellness_Medicaid All_Plans $53.13 ↓ -91%
Health_Partners_Medicaid All_Other_Plans $53.13 ↓ -91%
Geisinger_Medicaid All_Plans $53.13 ↓ -91%
Amerihealth_Caritas_Medicaid All_Plans $60.35 ↓ -90%
Blue_Cross Capital_Blue_Performance_PPO $67.95 ↓ -89%
Aetna_Better_Health_Kids All_Plans $144.50 ↓ -76%
Blue_Cross_BlueJourney_Medicare All_Plans $238.78 ↓ -60%
Highmark_Medicare All_Plans $241.17 ↓ -60%
Aetna_Advantra_Medicare All_Plans $245.94 ↓ -59%
Aetna_Medicare All_Plans $245.94 ↓ -59%
Devoted_Medicare All_Plans $250.72 ↓ -58%
Geisinger_Gold_Medicare All_Plans $250.72 ↓ -58%
United_Medicare ISNP_DSNP_Plans $250.72 ↓ -58%
Highmark_Wholecare_Gateway_Medicare All_Plans $251.79 ↓ -58%
Amerihealth_Medicare All_Plans $251.91 ↓ -58%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $251.91 ↓ -58%
UPMC_Medicare UPMC_for_Life_Complete_Care $251.91 ↓ -58%
Jefferson_Health_Medicare_Advantage All_Plans $257.88 ↓ -57%
PA_Health_&_Wellness_Medicare All_Plans $257.88 ↓ -57%
Blue_Cross Capital_Cares_4_kids $311.74 ↓ -48%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $356.28 ↓ -41%
Highmark Higmark_Healthy_Kids $370.11 ↓ -38%
Health_Partners_Medicaid Kidz_Partners $393.99 ↓ -34%
United_Medicaid Community_Plan_For_Kids $417.87 ↓ -30%
Cigna All_Plans $441.83 ↓ -26%
Blue_Cross All_Other_Plans $445.34 ↓ -26%
WellSpan_Capital_Blue_Cross All_Plans $450.00 ↓ -25%
UPMC Employees_And_Dependents $450.00 ↓ -25%
UPMC UPMC_For_Kids $450.00 ↓ -25%
Geisinger All_Plans $450.00 ↓ -25%
PHC All_Plans $600.00 ↑ +0%
Aetna All_Plans $609.00 ↑ +2%
First_Health_Network All_Plans $669.75 ↑ +12%
Highmark Performance_Blue $722.24 ↑ +20%
Highmark Choice_Blue_PPO $722.24 ↑ +20%
Highmark Blue_Cross_High_Performance_Network $722.24 ↑ +20%
Highmark All_Other_Plans $870.19 ↑ +45%
United_Healthcare All_Plans $1,342.45 ↑ +124%

Visitor-reported prices

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Urethrocystography void s&i at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $272.40 $27.50 – $363.20
UPMC Bedford Everett $288.60 $44.62 – $432.90
UPMC Carlisle Carlisle $547.80 $36.02 – $776.05
UPMC Cole Coudersport $250.20 $44.62 – $333.60
UPMC Community Osteopathic Harrisburg $547.80 $36.02 – $419.90
UPMC Hamot Erie $245.40 $46.75 – $345.98
UPMC Northwest Seneca $306.60 $46.75 – $241.97
UPMC Hanover Hanover $547.80 $36.02 – $369.47

All Pennsylvania hospitals for this procedure →