Vaccine influenza inactivated adjuvant im at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$643.00
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.
$803.75
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.
$12.50 with UPMC_Medicaid vs $652.65 with Aetna — 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 | $12.50 | ↓ -98% |
| Blue_Cross | Capital_Cares_4_kids | $72.33 | ↓ -89% |
| Geisinger_Medicaid | All_Plans | $98.16 | ↓ -85% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $98.16 | ↓ -85% |
| Amerihealth_Caritas_Medicaid | All_Plans | $98.16 | ↓ -85% |
| Health_Partners_Medicaid | All_Other_Plans | $98.16 | ↓ -85% |
| Blue_Cross | Capital_Blue_Performance_PPO | $103.33 | ↓ -84% |
| Blue_Cross | All_Other_Plans | $103.33 | ↓ -84% |
| Highmark_Medicare | All_Plans | $178.60 | ↓ -72% |
| Aetna_Advantra_Medicare | All_Plans | $182.13 | ↓ -72% |
| Aetna_Medicare | All_Plans | $182.13 | ↓ -72% |
| Devoted_Medicare | All_Plans | $185.67 | ↓ -71% |
| United_Medicare | ISNP_DSNP_Plans | $185.67 | ↓ -71% |
| Geisinger_Gold_Medicare | All_Plans | $185.67 | ↓ -71% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $186.47 | ↓ -71% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $186.56 | ↓ -71% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $186.56 | ↓ -71% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $190.98 | ↓ -70% |
| PA_Health_&_Wellness_Medicare | All_Plans | $190.98 | ↓ -70% |
| Health_Partners_Medicaid | Kidz_Partners | $241.13 | ↓ -62% |
| United_Healthcare | All_Plans | $267.17 | ↓ -58% |
| Highmark | Higmark_Healthy_Kids | $274.09 | ↓ -57% |
| Cigna | All_Plans | $287.56 | ↓ -55% |
| United_Medicaid | Community_Plan_For_Kids | $309.45 | ↓ -52% |
| First_Health_Network | All_Plans | $328.25 | ↓ -49% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $375.59 | ↓ -42% |
| WellSpan_Capital_Blue_Cross | All_Plans | $482.25 | ↓ -25% |
| UPMC | Employees_And_Dependents | $482.25 | ↓ -25% |
| UPMC | UPMC_For_Kids | $482.25 | ↓ -25% |
| Geisinger | All_Plans | $482.25 | ↓ -25% |
| Highmark | Performance_Blue | $534.86 | ↓ -17% |
| Highmark | Choice_Blue_PPO | $534.86 | ↓ -17% |
| Highmark | Blue_Cross_High_Performance_Network | $534.86 | ↓ -17% |
| PHC | All_Plans | $643.00 | ↑ +0% |
| Highmark | All_Other_Plans | $644.42 | ↑ +0% |
| Aetna | All_Plans | $652.65 | ↑ +2% |
Visitor-reported prices
Comments
Vaccine influenza inactivated adjuvant im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| WellSpan Chambersburg Hospital | Chambersburg | $167.20 | $12.50 – $532.95 |
| WellSpan Ephrata Community Hospital | Ephrata | $506.20 | $12.50 – $328.25 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | $531.80 | $12.50 – $287.56 |
| Uniontown Hospital | Uniontown | $73.00 | $11.00 – $115.56 |
| WellSpan Waynesboro Hospital | Waynesboro | $167.20 | $72.33 – $596.90 |
| WellSpan Gettysburg Hospital | Gettysburg | $531.80 | $12.50 – $298.41 |