X-ray mandible ltd <4 views at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$224.00
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.
$280.00
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.
$19.46 with Blue_Cross vs $497.84 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.
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 |
|---|---|---|---|
| Blue_Cross | Capital_Blue_Performance_PPO | $19.46 | ↓ -91% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $31.15 | ↓ -86% |
| Health_Partners_Medicaid | All_Other_Plans | $31.15 | ↓ -86% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $31.15 | ↓ -86% |
| UPMC_Medicaid | All_Plans | $31.15 | ↓ -86% |
| Geisinger_Medicaid | All_Plans | $31.15 | ↓ -86% |
| Amerihealth_Caritas_Medicaid | All_Plans | $35.39 | ↓ -84% |
| Aetna_Better_Health_Kids | All_Plans | $84.73 | ↓ -62% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $86.98 | ↓ -61% |
| Highmark_Medicare | All_Plans | $87.85 | ↓ -61% |
| Blue_Cross | Capital_Cares_4_kids | $89.28 | ↓ -60% |
| Aetna_Advantra_Medicare | All_Plans | $89.59 | ↓ -60% |
| Aetna_Medicare | All_Plans | $89.59 | ↓ -60% |
| Geisinger_Gold_Medicare | All_Plans | $91.33 | ↓ -59% |
| Devoted_Medicare | All_Plans | $91.33 | ↓ -59% |
| United_Medicare | ISNP_DSNP_Plans | $91.33 | ↓ -59% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $91.72 | ↓ -59% |
| Amerihealth_Medicare | All_Plans | $91.76 | ↓ -59% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $91.76 | ↓ -59% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $91.76 | ↓ -59% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $93.94 | ↓ -58% |
| PA_Health_&_Wellness_Medicare | All_Plans | $93.94 | ↓ -58% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $102.03 | ↓ -54% |
| WellSpan_Capital_Blue_Cross | All_Plans | $111.00 | ↓ -50% |
| Blue_Cross | All_Other_Plans | $127.54 | ↓ -43% |
| Highmark | Higmark_Healthy_Kids | $134.82 | ↓ -40% |
| Health_Partners_Medicaid | Kidz_Partners | $143.52 | ↓ -36% |
| United_Medicaid | Community_Plan_For_Kids | $152.22 | ↓ -32% |
| Cigna | All_Plans | $164.95 | ↓ -26% |
| UPMC | Employees_And_Dependents | $168.00 | ↓ -25% |
| UPMC | UPMC_For_Kids | $168.00 | ↓ -25% |
| Geisinger | All_Plans | $168.00 | ↓ -25% |
| PHC | All_Plans | $224.00 | ↑ +0% |
| Aetna | All_Plans | $227.36 | ↑ +2% |
| First_Health_Network | All_Plans | $250.04 | ↑ +12% |
| Highmark | Blue_Cross_High_Performance_Network | $263.09 | ↑ +17% |
| Highmark | Choice_Blue_PPO | $263.09 | ↑ +17% |
| Highmark | Performance_Blue | $263.09 | ↑ +17% |
| Highmark | All_Other_Plans | $316.98 | ↑ +42% |
| United_Healthcare | All_Plans | $497.84 | ↑ +122% |
Visitor-reported prices
Comments
X-ray mandible ltd <4 views at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $202.80 | $16.50 – $270.40 |
| UPMC Carlisle | Carlisle | $188.40 | $21.61 – $266.90 |
| UPMC Community Osteopathic | Harrisburg | $188.40 | $21.61 – $266.90 |
| UPMC East | Monroeville | $436.20 | $27.25 – $581.60 |
| UPMC Hamot | Erie | $253.20 | $21.06 – $118.50 |
| UPMC Northwest | Seneca | $226.80 | $27.41 – $88.15 |
| UPMC Hanover | Hanover | $188.40 | $21.61 – $134.58 |
| UPMC Horizon-Greenville | Greenville | $321.00 | $26.17 – $90.67 |