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Wellspan Good Samaritan Hospital

Lebanon, PA · 145 beds · 48 procedures priced

Sourced from this hospital's machine-readable file, posted Thu Jun 04 2026 00:00:00 GMT+0000 (Coordinated Universal Time) · data quality 93/100 · source file ↗

Category

Procedure ▲	Negotiated i	Cash i	Gross i
Basic Metabolic Panel	$13$8$79	$20	$46
Bone Marrow Biopsy	$1,729$87$5.8k	$2,307	$2,884
Breast Biopsy (Ultrasound-guided)	$1,817$174$5.9k	$2,721	$3,401
Cardiac Catheterization (Left Heart)	$5,560$3.1k$17k	$13,615	$17,019
Chemotherapy Infusion (First Hour)	$389$141$1.3k	$1,074	$1,343
Chest X-ray (2 Views)	$93$19$498	$322	$403
Complete Abdominal Ultrasound	$149$88$2.0k	$1,754	$2,192
Complete Blood Count (CBC) with Differential	$12$8$72	$15	$74
Comprehensive Metabolic Panel	$16$11$98	$25	$57
Critical Care, First Hour	$1,095$190$7.6k	$2,227	$2,784
CT Abdomen and Pelvis with Contrast	$388$241$2.4k	$438	$3,012
CT Cardiac Calcium Scoring	$92$42$1.1k	$86	$135
CT Chest without Contrast	$177$105$1.3k	$285	$1,610
CT Head without Contrast	$165$105$1.3k	$296	$1,610
DEXA Bone Density Scan	$138$58$602	$237	$627
Diagnostic Mammogram (Both Breasts)	$162$100$744	$208	$564
Echocardiogram (Complete with Doppler)	$894$176$4.4k	$3,438	$4,298
Emergency Room Visit (Level 3)	$360$99$1.8k	$1,226	$1,533
Hemoglobin A1c (Diabetes Test)	$15$9$90	$25	$75
HIV Antibody Test	$15$9$83	$37	$46
Intensity-modulated Radiation Therapy (IMRT) Treatment	$751$60$5.0k	$4,231	$5,289
Lipid Panel (Cholesterol Test)	$20$13$125	$40	$70
Lumbar Puncture (Spinal Tap)	$891$53$3.4k	$1,392	$1,740
MRI Abdomen with and without Contrast	$721$353$3.3k	$706	$2,486
MRI Brain with and without Contrast	$525$353$3.3k	$702	$2,390
MRI Brain with Contrast	$514$353$2.6k	$636	$2,350
MRI Brain without Contrast	$422$239$2.1k	$455	$2,225
MRI Cervical Spine (Neck) without Contrast	$424$239$2.1k	$454	$2,225
MRI Knee without Contrast	$414$239$2.1k	$462	$2,225
MRI Lower Back (Lumbar Spine) without Contrast	$367$239$2.1k	$454	$2,225
MRI Thoracic Spine (Mid-back) without Contrast	$371$239$2.1k	$454	$2,225
Newborn Circumcision	$2,105$99$8.1k	$413	$516
Nuclear Cardiac Stress Test	$1,377$278$7.8k	$6,240	$7,800
Office Visit, Established Patient (Level 3)	$134$39$522	$353	$441
Office Visit, New Patient (Level 3)	$134$46$464	$181	$226
Pacemaker Insertion (Dual Chamber)	$11,165$579$43k	$37,081	$46,351
PET/CT Scan, Whole Body	$2,045$972$8.6k	$6,880	$8,600
Pregnancy Ultrasound (Second or Third Trimester)	$138$89$1.2k	$1,080	$1,350
PSA Prostate Cancer Screening	$30$18$171	$45	$96
Pulmonary Function Test with Bronchodilator	$332$24$1.1k	$842	$1,052
Screening Mammogram	$134$83$615	$225	$427
Skin Biopsy (Tangential)	$258$40$1.6k	$618	$772
Skin Lesion Removal (Benign, up to 0.5 cm)	$1,689$970$6.4k	—	—
Sleep Study (In-lab Polysomnography)	$1,178$433$4.6k	$3,935	$4,919
Spirometry (Breathing Test)	$167$19$563	$324	$405
TSH Thyroid Function Test	$29$17$156	$40	$119
Urinalysis with Microscopy	$5$3$29	$10	$21
Vitamin D Blood Test	$51$30$275	$100	$154

Median facility price per procedure. Negotiated shows the median across payers with the full range. Figures as reported in the hospital's file — not a quote.