Wellspan Health · Lebanon, PA
39
In-network payers
237
Disclosed rate categories
159
Beds
4
Care quality
Wellspan Good Samaritan Hospital is a 159-bed voluntary non-profit - other hospital in Lebanon, PA, affiliated with Wellspan Health. Below you'll find publicly disclosed negotiated rates and facility details, including 39 in-network payers and 237 disclosed rate categories.
CCN (Medicare provider number)
390066
NPI
1407928500
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Other
Beds
159
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Wellspan Good Samaritan Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$9,186 - $15,900
from 4 insurers · median $12,239
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 788
$12,025 - $28,500
from 4 insurers · median $17,304
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Gynecology
CPT 58558
$946 - $9,600
from 2 insurers · median $5,273
25 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 216
$172,044 - $246,895
from 3 insurers · median $212,029
Hospital reports cardiac thoracic surgery services to CMS
CT imaging
CPT 74177
$810 - $2,107
from 4 insurers · median $1,262
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$256 - $4,032
from 4 insurers · median $2,201
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$602 - $957
from 3 insurers · median $838
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$19,329
negotiated rate
70 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Childbirth · Inpatient
MS-DRG 807
$9,186 - $15,900
from 4 insurers · median $12,239
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Digestive procedures
CPT 49650
$20,855
negotiated rate
70 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Gynecology
CPT 58571
$33,150
negotiated rate
21 Medicare claims in Level 2 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 460
$48,237 - $84,206
from 2 insurers · median $66,221
Hospital reports orthopedic surgery services to CMS
CT imaging
CPT 74176
$425 - $1,342
from 4 insurers · median $1,083
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$490 - $3,586
from 2 insurers · median $2,038
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$957 - $1,554
from 4 insurers · median $1,193
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$170 - $522
from 3 insurers · median $222
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$654 - $2,389
from 4 insurers · median $1,675
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$332 - $2,620
from 2 insurers · median $1,476
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$508 - $7,779
from 4 insurers · median $2,794
Common here, based on CMS Medicare volume
Digestive procedures
CPT 47563
$17,064
negotiated rate
70 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
X-ray and bone density
CPT 71046
$40 - $498
from 4 insurers · median $168
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 473
$32,733 - $53,350
from 3 insurers · median $33,202
Hospital reports orthopedic surgery services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$29,249 - $41,444
from 3 insurers · median $29,358
Hospital reports orthopedic surgery services to CMS
Ultrasound
CPT 76705
$115 - $812
from 4 insurers · median $511
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 17 | 566% | 14 | 0 |
| Insurer B* | 13 | 466% | 7 | 2 |
| Insurer C* | 21 | 293% | 3 | 9 |
| Insurer D* | 20 | 107% | 3 | 14 |
How we chose these services: 5 appear in this hospital's own Medicare claims, 12 are common here based on CMS Medicare volume, and 7 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Wellspan Good Samaritan Hospital.
Fourth And Walnut Streets, Lebanon, PA 17042
(717) 270-7500
The nearest hospitals of similar type and size. Their rates are compared with Wellspan Good Samaritan Hospital for the same insurers and services above.
Upmc Lititz
▲ Rates typically 15% higher than Wellspan Good Samaritan Hospital (20 services)
St. Joseph Medical Center
▲ Rates typically 17% higher than Wellspan Good Samaritan Hospital (20 services)
Lehigh Valley Hospital - Schuylkill
▲ Rates typically 6% higher than Wellspan Good Samaritan Hospital (21 services)
Holy Spirit Hospital
Rates about the same as Wellspan Good Samaritan Hospital (21 services)
Lehigh Valley Hospital - Schuylkill E. Norwegian Street
▲ Rates typically 6% higher than Wellspan Good Samaritan Hospital (21 services)
Upmc Memorial
▼ Rates typically 17% lower than Wellspan Good Samaritan Hospital (21 services)
Wellspan Surgery & Rehabilitation Hospital
Wellspan Gettysburg Hospital
Wellspan Ephrata Community Hospital
Wellspan York Hospital
About Wellspan Good Samaritan Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Wellspan Good Samaritan Hospital range from $654 to $2,389 across 4 insurers. UnitedHealthcare's rate is $2,107. The median at nearby comparable hospitals is $1,310. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Wellspan Good Samaritan Hospital range from $810 to $2,107 across 4 insurers. Cigna's rate is $1,567. The median at nearby comparable hospitals is $1,417. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Wellspan Good Samaritan Hospital range from $490 to $3,586 across 2 insurers. Blue Cross Blue Shield's rate is $3,586. The median at nearby comparable hospitals is $3,372. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Wellspan Good Samaritan Hospital range from $9,186 to $15,900 across 4 insurers. UnitedHealthcare's rate is $14,843. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Wellspan Good Samaritan Hospital range from $170 to $522 across 3 insurers. Cigna's rate is $222. The median at nearby comparable hospitals is $316. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Wellspan Good Samaritan Hospital range from $29,249 to $41,444 across 3 insurers. Aetna's rate is $29,249. The median at nearby comparable hospitals is $34,930. What a patient pays depends on their plan's deductible, coinsurance and network status.
Wellspan Good Samaritan Hospital has 159 beds. Facility type: Short Term Acute Care Hospital.
Wellspan Good Samaritan Hospital is located at Fourth And Walnut Streets, Lebanon, PA 17042. Its main phone number is (717) 270-7500.
Wellspan Good Samaritan Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 390066.
The National Provider Identifier (NPI) on file for Wellspan Good Samaritan Hospital is 1407928500.
Wellspan Good Samaritan Hospital is affiliated with Wellspan Health.
Wellspan Good Samaritan Hospital lists 39 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
237 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers