Advance care planning each additional 30 min 99498 at WellSpan Ephrata Community Hospital

169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 17, 2026

$232.00

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$290.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$50.00 with PA_Health_&_Wellness_Medicaid vs $273.47 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 →

Payer
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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
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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
PA_Health_&_Wellness_Medicaid All_Plans $50.00 ↓ -78%
UPMC_Medicaid All_Plans $50.00 ↓ -78%
Geisinger_Medicaid All_Plans $50.00 ↓ -78%
Health_Partners_Medicaid All_Other_Plans $50.00 ↓ -78%
Highmark_Wholecare_Gateway_Medicaid All_Plans $50.00 ↓ -78%
Blue_Cross_BlueJourney_Medicare All_Plans $51.04 ↓ -78%
Amerihealth_Caritas_Medicaid All_Plans $56.80 ↓ -76%
Aetna_Better_Health_Kids All_Plans $136.00 ↓ -41%
Cigna All_Plans $185.08 ↓ -20%
WellSpan_Capital_Blue_Cross All_Plans $185.60 ↓ -20%
Tower Health All_Plans $188.50 ↓ -19%
UPMC UPMC_For_Kids $188.50 ↓ -19%
Geisinger All_Plans $188.50 ↓ -19%
Independence_Blue_Cross All_Plans $188.50 ↓ -19%
UPMC Employees_And_Dependents $188.50 ↓ -19%
PHC All_Plans $203.00 ↓ -13%
United_Healthcare All_Plans $273.47 ↑ +18%

Visitor-reported prices

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Advance care planning each additional 30 min 99498 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Magee Pittsburgh $464.40 $55.62 – $63.09
UPMC Presbyterian Pittsburgh $572.40 $52.34 – $55.62

All Pennsylvania hospitals for this procedure →