X-ray exam entire spi 6/> vw 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

$820.00

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.

$1,025.00

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.

$56.23 with Blue_Cross vs $915.33 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
Blue_Cross Capital_Blue_Performance_PPO $56.23 ↓ -93%
Health_Partners_Medicaid All_Other_Plans $76.60 ↓ -91%
UPMC_Medicaid All_Plans $76.60 ↓ -91%
PA_Health_&_Wellness_Medicaid All_Plans $76.60 ↓ -91%
Highmark_Wholecare_Gateway_Medicaid All_Plans $76.60 ↓ -91%
Geisinger_Medicaid All_Plans $76.60 ↓ -91%
Amerihealth_Caritas_Medicaid All_Plans $87.02 ↓ -89%
WellSpan_Capital_Blue_Cross All_Plans $96.00 ↓ -88%
Blue_Cross_BlueJourney_Medicare All_Plans $105.04 ↓ -87%
Highmark_Medicare All_Plans $106.09 ↓ -87%
Aetna_Advantra_Medicare All_Plans $108.19 ↓ -87%
Aetna_Medicare All_Plans $108.19 ↓ -87%
Devoted_Medicare All_Plans $110.29 ↓ -87%
Geisinger_Gold_Medicare All_Plans $110.29 ↓ -87%
United_Medicare ISNP_DSNP_Plans $110.29 ↓ -87%
Highmark_Wholecare_Gateway_Medicare All_Plans $110.76 ↓ -86%
Amerihealth_Medicare All_Plans $110.82 ↓ -86%
UPMC_Medicare UPMC_for_Life_Complete_Care $110.82 ↓ -86%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $110.82 ↓ -86%
PA_Health_&_Wellness_Medicare All_Plans $113.44 ↓ -86%
Jefferson_Health_Medicare_Advantage All_Plans $113.44 ↓ -86%
Highmark Higmark_Healthy_Kids $162.81 ↓ -80%
Health_Partners_Medicaid Kidz_Partners $173.32 ↓ -79%
United_Medicaid Community_Plan_For_Kids $183.82 ↓ -78%
Aetna_Better_Health_Kids All_Plans $208.35 ↓ -75%
Blue_Cross Capital_Cares_4_kids $257.97 ↓ -69%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $294.83 ↓ -64%
Highmark Choice_Blue_PPO $317.71 ↓ -61%
Highmark Performance_Blue $317.71 ↓ -61%
Highmark Blue_Cross_High_Performance_Network $317.71 ↓ -61%
Blue_Cross All_Other_Plans $368.53 ↓ -55%
Highmark All_Other_Plans $382.80 ↓ -53%
United_Healthcare All_Plans $602.31 ↓ -27%
Cigna All_Plans $603.83 ↓ -26%
Geisinger All_Plans $615.00 ↓ -25%
UPMC UPMC_For_Kids $615.00 ↓ -25%
UPMC Employees_And_Dependents $615.00 ↓ -25%
PHC All_Plans $820.00 ↑ +0%
Aetna All_Plans $832.30 ↑ +2%
First_Health_Network All_Plans $915.33 ↑ +12%

Visitor-reported prices

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X-ray exam entire spi 6/> vw at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $621.60 $39.30 – $828.80
UPMC Carlisle Carlisle $262.80 $58.92 – $372.30
UPMC Community Osteopathic Harrisburg $262.80 $58.92 – $482.72
UPMC East Monroeville $732.60 $39.67 – $976.80
UPMC Hamot Erie $786.60 $39.30 – $166.40
UPMC Northwest Seneca $241.20 $67.41 – $106.45
UPMC Hanover Hanover $262.80 $58.92 – $162.54
UPMC Jameson New Castle $385.80 $39.99 – $251.90

All Pennsylvania hospitals for this procedure →