Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im 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

$144.60

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.

$180.75

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.

$12.50 with PA_Health_&_Wellness_Medicaid vs $146.77 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 →

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
PA_Health_&_Wellness_Medicaid All_Plans $12.50 ↓ -91%
Highmark_Wholecare_Gateway_Medicaid All_Plans $12.50 ↓ -91%
Health_Partners_Medicaid All_Other_Plans $12.50 ↓ -91%
Geisinger_Medicaid All_Plans $12.50 ↓ -91%
UPMC_Medicaid All_Plans $14.78 ↓ -90%
Blue_Cross Capital_Cares_4_kids $17.11 ↓ -88%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $19.55 ↓ -86%
Amerihealth_Caritas_Medicaid All_Plans $23.22 ↓ -84%
Blue_Cross All_Other_Plans $24.44 ↓ -83%
Blue_Cross Capital_Blue_Performance_PPO $24.44 ↓ -83%
Aetna_Better_Health_Kids All_Plans $34.00 ↓ -76%
Highmark_Medicare All_Plans $40.17 ↓ -72%
Aetna_Medicare All_Plans $40.96 ↓ -72%
Aetna_Advantra_Medicare All_Plans $40.96 ↓ -72%
Devoted_Medicare All_Plans $41.76 ↓ -71%
United_Medicare ISNP_DSNP_Plans $41.76 ↓ -71%
Geisinger_Gold_Medicare All_Plans $41.76 ↓ -71%
Highmark_Wholecare_Gateway_Medicare All_Plans $41.94 ↓ -71%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $41.96 ↓ -71%
UPMC_Medicare UPMC_for_Life_Complete_Care $41.96 ↓ -71%
Jefferson_Health_Medicare_Advantage All_Plans $42.95 ↓ -70%
PA_Health_&_Wellness_Medicare All_Plans $42.95 ↓ -70%
Health_Partners_Medicaid Kidz_Partners $54.23 ↓ -62%
Highmark Higmark_Healthy_Kids $61.64 ↓ -57%
United_Medicaid Community_Plan_For_Kids $69.60 ↓ -52%
United_Healthcare All_Plans $71.52 ↓ -51%
Cigna All_Plans $77.35 ↓ -47%
First_Health_Network All_Plans $77.63 ↓ -46%
WellSpan_Capital_Blue_Cross All_Plans $108.45 ↓ -25%
UPMC Employees_And_Dependents $108.45 ↓ -25%
UPMC UPMC_For_Kids $108.45 ↓ -25%
Geisinger All_Plans $108.45 ↓ -25%
Highmark Performance_Blue $120.29 ↓ -17%
Highmark Choice_Blue_PPO $120.29 ↓ -17%
Highmark Blue_Cross_High_Performance_Network $120.29 ↓ -17%
PHC All_Plans $144.60 ↑ +0%
Highmark All_Other_Plans $144.93 ↑ +0%
Aetna All_Plans $146.77 ↑ +2%

Visitor-reported prices

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Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Cole Coudersport $29.40 $5.54 – $16.00
UPMC Magee Pittsburgh $13.20 $11.00 – $29.69
WellSpan Chambersburg Hospital Chambersburg $37.60 $12.50 – $119.85
WellSpan Ephrata Community Hospital Ephrata $114.00 $12.50 – $77.63
WellSpan Surgery & Rehabilitation Hospital York PA 17403 $119.60 $12.50 – $77.35
Uniontown Hospital Uniontown $19.50 $11.00 – $26.00
WellSpan Waynesboro Hospital Waynesboro $37.60 $10.55 – $134.23
WellSpan Gettysburg Hospital Gettysburg $119.60 $12.50 – $77.35

All Pennsylvania hospitals for this procedure →