Venogram extremity supervision & interpretation unilateral 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

$3,320.00

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.

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

$4,150.00

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.

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The hospital's undiscounted list price — almost no one pays this.

$46.88 with UPMC_Medicaid vs $8,774.10 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.

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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.

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Negotiated rate vs. cash
UPMC_Medicaid All_Plans $46.88 ↓ -99%
Highmark_Wholecare_Gateway_Medicaid All_Plans $46.88 ↓ -99%
PA_Health_&_Wellness_Medicaid All_Plans $46.88 ↓ -99%
Health_Partners_Medicaid All_Other_Plans $46.88 ↓ -99%
Geisinger_Medicaid All_Plans $46.88 ↓ -99%
Amerihealth_Caritas_Medicaid All_Plans $53.25 ↓ -98%
Blue_Cross Capital_Blue_Performance_PPO $76.07 ↓ -98%
Aetna_Better_Health_Kids All_Plans $127.50 ↓ -96%
Blue_Cross Capital_Cares_4_kids $348.99 ↓ -89%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $398.85 ↓ -88%
Blue_Cross All_Other_Plans $498.56 ↓ -85%
Blue_Cross_BlueJourney_Medicare All_Plans $1,534.52 ↓ -54%
Highmark_Medicare All_Plans $1,549.87 ↓ -53%
Aetna_Advantra_Medicare All_Plans $1,580.56 ↓ -52%
Aetna_Medicare All_Plans $1,580.56 ↓ -52%
United_Medicare ISNP_DSNP_Plans $1,611.25 ↓ -51%
Devoted_Medicare All_Plans $1,611.25 ↓ -51%
Geisinger_Gold_Medicare All_Plans $1,611.25 ↓ -51%
Highmark_Wholecare_Gateway_Medicare All_Plans $1,618.15 ↓ -51%
UPMC_Medicare UPMC_for_Life_Complete_Care $1,618.92 ↓ -51%
Amerihealth_Medicare All_Plans $1,618.92 ↓ -51%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $1,618.92 ↓ -51%
Jefferson_Health_Medicare_Advantage All_Plans $1,657.28 ↓ -50%
PA_Health_&_Wellness_Medicare All_Plans $1,657.28 ↓ -50%
Highmark Higmark_Healthy_Kids $2,378.51 ↓ -28%
Cigna All_Plans $2,444.77 ↓ -26%
WellSpan_Capital_Blue_Cross All_Plans $2,490.00 ↓ -25%
UPMC Employees_And_Dependents $2,490.00 ↓ -25%
UPMC UPMC_For_Kids $2,490.00 ↓ -25%
Geisinger All_Plans $2,490.00 ↓ -25%
Health_Partners_Medicaid Kidz_Partners $2,531.96 ↓ -24%
United_Medicaid Community_Plan_For_Kids $2,685.41 ↓ -19%
PHC All_Plans $3,320.00 ↑ +0%
Aetna All_Plans $3,369.80 ↑ +2%
First_Health_Network All_Plans $3,705.95 ↑ +12%
Highmark Choice_Blue_PPO $4,641.46 ↑ +40%
Highmark Blue_Cross_High_Performance_Network $4,641.46 ↑ +40%
Highmark Performance_Blue $4,641.46 ↑ +40%
Highmark All_Other_Plans $5,592.25 ↑ +68%
United_Healthcare All_Plans $8,774.10 ↑ +164%

Visitor-reported prices

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Venogram extremity supervision & interpretation unilateral at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $1,059.00 $22.50 – $1,412.00
UPMC Carlisle Carlisle $1,344.60 $29.48 – $2,377.68
UPMC Cole Coudersport $314.40 $39.38 – $419.20
UPMC Community Osteopathic Harrisburg $1,344.60 $29.48 – $1,904.85
UPMC East Monroeville $777.00 $41.25 – $1,555.07
UPMC Hamot Erie $1,338.60 $41.25 – $1,846.02
UPMC Northwest Seneca $989.40 $41.25 – $1,555.07
UPMC Hanover Hanover $1,344.60 $29.48 – $2,374.40

All Pennsylvania hospitals for this procedure →