Abd/low ext cath 1st at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$1,803.20
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.
$2,254.00
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.
$168.13 with Highmark_Wholecare_Gateway_Medicaid vs $2,125.52 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 |
|---|---|---|---|
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $168.13 | ↓ -91% |
| UPMC_Medicaid | All_Plans | $168.13 | ↓ -91% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $168.13 | ↓ -91% |
| Health_Partners_Medicaid | All_Other_Plans | $168.13 | ↓ -91% |
| Geisinger_Medicaid | All_Plans | $168.13 | ↓ -91% |
| Amerihealth_Caritas_Medicaid | All_Plans | $190.99 | ↓ -89% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $396.70 | ↓ -78% |
| Aetna_Better_Health_Kids | All_Plans | $457.30 | ↓ -75% |
| Blue_Cross | Capital_Cares_4_kids | $1,015.79 | ↓ -44% |
| Cigna | All_Plans | $1,372.24 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,442.56 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $1,451.13 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $1,451.13 | ↓ -20% |
| UPMC | UPMC_For_Kids | $1,465.10 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $1,465.10 | ↓ -19% |
| Geisinger | All_Plans | $1,465.10 | ↓ -19% |
| Tower Health | All_Plans | $1,465.10 | ↓ -19% |
| UPMC | Employees_And_Dependents | $1,465.10 | ↓ -19% |
| PHC | All_Plans | $1,577.80 | ↓ -13% |
| Aetna | All_Plans | $1,744.60 | ↓ -3% |
| First_Health_Network | All_Plans | $1,918.15 | ↑ +6% |
| United_Healthcare | All_Plans | $2,125.52 | ↑ +18% |
Visitor-reported prices
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Abd/low ext cath 1st at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,824.00 | $717.91 – $2,656.30 |
| UPMC Carlisle | Carlisle | $4,321.20 | $751.30 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $4,321.20 | $760.24 – $6,121.70 |
| UPMC East | Monroeville | $3,504.60 | $763.10 – $4,672.80 |
| UPMC Hamot | Erie | $3,583.20 | $763.10 – $3,297.90 |
| UPMC Northwest | Seneca | $5,015.40 | $726.45 – $2,172.24 |
| UPMC Hanover | Hanover | $4,321.20 | $760.24 – $2,656.30 |
| UPMC Jameson | New Castle | $949.20 | $249.85 – $2,656.30 |