X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study 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

$1,141.60

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.

$1,427.00

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.

$81.25 with Geisinger_Medicaid vs $1,274.31 with First_Health_Network — 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
Geisinger_Medicaid All_Plans $81.25 ↓ -93%
PA_Health_&_Wellness_Medicaid All_Plans $81.25 ↓ -93%
UPMC_Medicaid All_Plans $81.25 ↓ -93%
Highmark_Wholecare_Gateway_Medicaid All_Plans $81.25 ↓ -93%
Health_Partners_Medicaid All_Other_Plans $81.25 ↓ -93%
Amerihealth_Caritas_Medicaid All_Plans $92.30 ↓ -92%
Blue_Cross Capital_Blue_Performance_PPO $132.84 ↓ -88%
Blue_Cross_BlueJourney_Medicare All_Plans $175.85 ↓ -85%
Highmark_Medicare All_Plans $177.61 ↓ -84%
Aetna_Advantra_Medicare All_Plans $181.13 ↓ -84%
Aetna_Medicare All_Plans $181.13 ↓ -84%
United_Medicare ISNP_DSNP_Plans $184.64 ↓ -84%
Devoted_Medicare All_Plans $184.64 ↓ -84%
Geisinger_Gold_Medicare All_Plans $184.64 ↓ -84%
Highmark_Wholecare_Gateway_Medicare All_Plans $185.43 ↓ -84%
Amerihealth_Medicare All_Plans $185.52 ↓ -84%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $185.52 ↓ -84%
UPMC_Medicare UPMC_for_Life_Complete_Care $185.52 ↓ -84%
PA_Health_&_Wellness_Medicare All_Plans $189.92 ↓ -83%
Jefferson_Health_Medicare_Advantage All_Plans $189.92 ↓ -83%
Aetna_Better_Health_Kids All_Plans $221.00 ↓ -81%
Highmark Higmark_Healthy_Kids $272.57 ↓ -76%
Health_Partners_Medicaid Kidz_Partners $290.15 ↓ -75%
United_Medicaid Community_Plan_For_Kids $307.74 ↓ -73%
Highmark Performance_Blue $531.89 ↓ -53%
Highmark Choice_Blue_PPO $531.89 ↓ -53%
Highmark Blue_Cross_High_Performance_Network $531.89 ↓ -53%
Blue_Cross Capital_Cares_4_kids $609.44 ↓ -47%
Highmark All_Other_Plans $640.85 ↓ -44%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $696.51 ↓ -39%
Cigna All_Plans $840.65 ↓ -26%
WellSpan_Capital_Blue_Cross All_Plans $856.20 ↓ -25%
UPMC Employees_And_Dependents $856.20 ↓ -25%
UPMC UPMC_For_Kids $856.20 ↓ -25%
Geisinger All_Plans $856.20 ↓ -25%
Blue_Cross All_Other_Plans $870.63 ↓ -24%
United_Healthcare All_Plans $1,006.60 ↓ -12%
PHC All_Plans $1,141.60 ↑ +0%
Aetna All_Plans $1,158.72 ↑ +1%
First_Health_Network All_Plans $1,274.31 ↑ +12%

Visitor-reported prices

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X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $843.00 $39.00 – $1,124.00
UPMC Bedford Everett $377.40 $61.23 – $566.10
UPMC Carlisle Carlisle $427.80 $51.09 – $606.05
UPMC Cole Coudersport $518.40 $68.25 – $691.20
UPMC Community Osteopathic Harrisburg $427.80 $51.09 – $606.05
UPMC East Monroeville $1,380.60 $71.50 – $1,840.80
UPMC Hamot Erie $877.80 $71.50 – $346.34
UPMC Northwest Seneca $502.20 $71.50 – $328.72

All Pennsylvania hospitals for this procedure →