Wellspan Good Samaritan Hospital
Wellspan Health
Hospital Overview
Facility Details
CCN
390066
NPI
1407928500
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Other
Beds
159
Contact Information
Address
Fourth And Walnut Streets
Lebanon, PA 17042
Phone
(717) 270-7500
Insurance Accepted
💡
Important Notice
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.
Price Transparency Contract Information
💡 The data below comes from CMS-mandated price transparency data. Learn more.
💡 Tip: Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.
| Payer | Category | Code Type & Group | Contract Type | Rate Compared to State Average |
|---|---|---|---|---|
Aetna | Facility | RC Pharmacy - Extension of 025X Range: 0630 - 0639 | Percentage of Bill Charged | |
Aetna | Inpatient | MS-DRG Pre-MDC Range: 001 - 019 | Negotiated | Low |
Aetna | Inpatient | MS-DRG Human Immunodeficiency Virus Infections Range: 969 - 977 | Negotiated | Low |
Aetna | Inpatient | MS-DRG Diseases & Disorders of the Ear, Nose, Mouth & Throat Range: 135 - 159 | Negotiated | Low |
Aetna | Outpatient | CPT Surgery Range: 10004 - 69990 | Percentage of Bill Charged | |
Aetna | Facility | RC Other Room and Board Range: 0160 - 0169 | Percentage of Bill Charged | |
Aetna | Outpatient | HCPCS Drugs Administered Other than Oral Method Range: J0120 - J8999 | Percentage of Bill Charged | |
Aetna | Facility | RC Laboratory Range: 0300 - 0309 | Percentage of Bill Charged | |
Aetna | Outpatient | HCPCS Chemotherapy Drugs Range: J9000 - J9999 | Negotiated | Average |
Aetna | Outpatient | HCPCS Temporary National Codes (Non-Medicare) Range: S0012 - S9999 | Percentage of Bill Charged |
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