X-ray surgical specimen at WellSpan Good Samaritan Hospital
252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500
$987.20
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.
$1,234.00
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.
$10.79 with Blue_Cross vs $3,022.37 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 | $10.79 | ↓ -99% |
| UPMC_Medicaid | All_Plans | $23.39 | ↓ -98% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $23.39 | ↓ -98% |
| Health_Partners_Medicaid | All_Other_Plans | $23.39 | ↓ -98% |
| Geisinger_Medicaid | All_Plans | $23.39 | ↓ -98% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $23.39 | ↓ -98% |
| Amerihealth_Caritas_Medicaid | All_Plans | $26.57 | ↓ -97% |
| Blue_Cross | Capital_Cares_4_kids | $49.50 | ↓ -95% |
| Blue_Cross | Capital_Blue_Cross_Healthy_Benefits_PPO | $56.57 | ↓ -94% |
| Aetna_Better_Health_Kids | All_Plans | $63.61 | ↓ -94% |
| Blue_Cross | All_Other_Plans | $70.72 | ↓ -93% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $541.62 | ↓ -45% |
| Highmark_Medicare | All_Plans | $547.04 | ↓ -45% |
| Aetna_Medicare | All_Plans | $557.87 | ↓ -43% |
| Aetna_Advantra_Medicare | All_Plans | $557.87 | ↓ -43% |
| Devoted_Medicare | All_Plans | $568.70 | ↓ -42% |
| Geisinger_Gold_Medicare | All_Plans | $568.70 | ↓ -42% |
| United_Medicare | ISNP_DSNP_Plans | $568.70 | ↓ -42% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $571.14 | ↓ -42% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $571.41 | ↓ -42% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $571.41 | ↓ -42% |
| Amerihealth_Medicare | All_Plans | $571.41 | ↓ -42% |
| PA_Health_&_Wellness_Medicare | All_Plans | $584.95 | ↓ -41% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $584.95 | ↓ -41% |
| Cigna | All_Plans | $726.95 | ↓ -26% |
| WellSpan_Capital_Blue_Cross | All_Plans | $740.40 | ↓ -25% |
| UPMC | Employees_And_Dependents | $740.40 | ↓ -25% |
| UPMC | UPMC_For_Kids | $740.40 | ↓ -25% |
| Geisinger | All_Plans | $740.40 | ↓ -25% |
| Highmark | Higmark_Healthy_Kids | $839.51 | ↓ -15% |
| Health_Partners_Medicaid | Kidz_Partners | $893.67 | ↓ -9% |
| United_Medicaid | Community_Plan_For_Kids | $947.84 | ↓ -4% |
| PHC | All_Plans | $987.20 | ↑ +0% |
| Aetna | All_Plans | $1,002.01 | ↑ +2% |
| First_Health_Network | All_Plans | $1,101.96 | ↑ +12% |
| Highmark | Choice_Blue_PPO | $1,638.24 | ↑ +66% |
| Highmark | Blue_Cross_High_Performance_Network | $1,638.24 | ↑ +66% |
| Highmark | Performance_Blue | $1,638.24 | ↑ +66% |
| Highmark | All_Other_Plans | $1,973.83 | ↑ +100% |
| United_Healthcare | All_Plans | $3,022.37 | ↑ +206% |
Visitor-reported prices
Comments
X-ray surgical specimen at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $190.20 | $10.62 – $253.60 |
| UPMC Bedford | Everett | $540.60 | $19.65 – $810.90 |
| UPMC Carlisle | Carlisle | $1,129.80 | $13.91 – $1,600.55 |
| UPMC Cole | Coudersport | $80.40 | $19.65 – $107.20 |
| UPMC Community Osteopathic | Harrisburg | $1,129.80 | $13.91 – $1,600.55 |
| UPMC East | Monroeville | $4,123.80 | $20.58 – $5,498.40 |
| UPMC Hamot | Erie | $562.20 | $20.58 – $714.96 |
| UPMC Northwest | Seneca | $536.40 | $20.58 – $548.88 |