CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Wellspan Good Samaritan Hospital

Billing Code: 70553 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$1,068
about 3.0× the $356 Medicare rate · typically $934–$1,186
modeled estimate · not a bill or quote
What this hospital charges insurers
$1,067
About the fair price
about $1 under the fair price · 3.0× Medicare
Medicare pays $356 Fair price $1,068 This hospital $1,067 Cash price $702 Hospital's list price $2,390

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $211 Priciest $1,067

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a MRI, brain (with and without contrast) is about $1,068 (about 3.0× the $356 Medicare rate). Wellspan Good Samaritan Hospital charges insurers about $1,067, or about $702 in cash — about the fair price. Located in Lebanon, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $2,107 591%
Blue Cross Blue Shieldmajor $503 - $3,300 141%
Aetnamajor $363 - $1,477 102%
Cignamajor $1,244 349%
Geisinger $1,434 402%
UPMC Health Plan $1,434 402%
Government programs also on file: Medicare, Medicaid.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 252 South 4Th Street, Lebanon, PA 17042
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals