X-ray sacroiliac joints >= 3 views 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

$432.00

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.

$540.00

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.

$23.24 with Blue_Cross vs $602.31 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 →

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 $23.24 ↓ -95%
UPMC_Medicaid All_Plans $31.63 ↓ -93%
PA_Health_&_Wellness_Medicaid All_Plans $31.63 ↓ -93%
Highmark_Wholecare_Gateway_Medicaid All_Plans $31.63 ↓ -93%
Geisinger_Medicaid All_Plans $31.63 ↓ -93%
Health_Partners_Medicaid All_Other_Plans $31.63 ↓ -93%
Amerihealth_Caritas_Medicaid All_Plans $35.93 ↓ -92%
Aetna_Better_Health_Kids All_Plans $86.02 ↓ -80%
Blue_Cross_BlueJourney_Medicare All_Plans $105.04 ↓ -76%
Highmark_Medicare All_Plans $106.09 ↓ -75%
Blue_Cross Capital_Cares_4_kids $106.62 ↓ -75%
Aetna_Advantra_Medicare All_Plans $108.19 ↓ -75%
Aetna_Medicare All_Plans $108.19 ↓ -75%
WellSpan_Capital_Blue_Cross All_Plans $109.00 ↓ -75%
Devoted_Medicare All_Plans $110.29 ↓ -74%
Geisinger_Gold_Medicare All_Plans $110.29 ↓ -74%
United_Medicare ISNP_DSNP_Plans $110.29 ↓ -74%
Highmark_Wholecare_Gateway_Medicare All_Plans $110.76 ↓ -74%
Amerihealth_Medicare All_Plans $110.82 ↓ -74%
UPMC_Medicare UPMC_for_Life_Complete_Care $110.82 ↓ -74%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $110.82 ↓ -74%
PA_Health_&_Wellness_Medicare All_Plans $113.44 ↓ -74%
Jefferson_Health_Medicare_Advantage All_Plans $113.44 ↓ -74%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $121.85 ↓ -72%
Blue_Cross All_Other_Plans $152.31 ↓ -65%
Highmark Higmark_Healthy_Kids $162.81 ↓ -62%
Health_Partners_Medicaid Kidz_Partners $173.32 ↓ -60%
United_Medicaid Community_Plan_For_Kids $183.82 ↓ -57%
Highmark Choice_Blue_PPO $317.71 ↓ -26%
Highmark Blue_Cross_High_Performance_Network $317.71 ↓ -26%
Highmark Performance_Blue $317.71 ↓ -26%
Cigna All_Plans $318.11 ↓ -26%
UPMC UPMC_For_Kids $324.00 ↓ -25%
UPMC Employees_And_Dependents $324.00 ↓ -25%
Geisinger All_Plans $324.00 ↓ -25%
Highmark All_Other_Plans $382.80 ↓ -11%
PHC All_Plans $432.00 ↑ +0%
Aetna All_Plans $438.48 ↑ +2%
First_Health_Network All_Plans $482.22 ↑ +12%
United_Healthcare All_Plans $602.31 ↑ +39%

Visitor-reported prices

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X-ray sacroiliac joints >= 3 views at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $222.60 $16.50 – $296.80
UPMC Bedford Everett $108.00 $26.57 – $162.00
UPMC Carlisle Carlisle $262.80 $21.61 – $372.30
UPMC Cole Coudersport $192.60 $26.57 – $256.80
UPMC Community Osteopathic Harrisburg $262.80 $21.61 – $372.30
UPMC East Monroeville $436.20 $27.83 – $581.60
UPMC Hamot Erie $375.00 $21.89 – $166.40
UPMC Northwest Seneca $154.80 $27.83 – $106.45

All Pennsylvania hospitals for this procedure →