_afb org id by sequencing rflx ast-sendout at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$480.00
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.
?
What you pay up front if you don't use insurance.
$600.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$105.60 with Blue_Cross_BlueJourney_Medicare vs $529.01 with Highmark — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Blue_Cross_BlueJourney_Medicare | All_Plans | $105.60 | ↓ -78% |
| Highmark_Medicare | All_Plans | $116.51 | ↓ -76% |
| Aetna_Medicare | All_Plans | $118.82 | ↓ -75% |
| Aetna_Advantra_Medicare | All_Plans | $118.82 | ↓ -75% |
| Geisinger_Gold_Medicare | All_Plans | $121.13 | ↓ -75% |
| United_Medicare | ISNP_DSNP_Plans | $121.13 | ↓ -75% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $121.13 | ↓ -75% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $121.13 | ↓ -75% |
| Devoted_Medicare | All_Plans | $121.13 | ↓ -75% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $121.65 | ↓ -75% |
| Amerihealth_Medicare | All_Plans | $121.70 | ↓ -75% |
| PA_Health_&_Wellness_Medicare | All_Plans | $124.59 | ↓ -74% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $124.59 | ↓ -74% |
| Amerihealth_Caritas_Medicaid | All_Plans | $132.18 | ↓ -72% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $165.23 | ↓ -66% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $165.23 | ↓ -66% |
| UPMC_Medicaid | All_Plans | $165.23 | ↓ -66% |
| Geisinger_Medicaid | All_Plans | $165.23 | ↓ -66% |
| Health_Partners_Medicaid | All_Other_Plans | $165.23 | ↓ -66% |
| Highmark | Higmark_Healthy_Kids | $179.10 | ↓ -63% |
| Health_Partners_Medicaid | Kidz_Partners | $190.34 | ↓ -60% |
| United_Medicaid | Community_Plan_For_Kids | $201.88 | ↓ -58% |
| PHC | All_Plans | $240.00 | ↓ -50% |
| Blue_Cross | Capital_Cares_4_kids | $270.40 | ↓ -44% |
| United_Healthcare | All_Plans | $346.08 | ↓ -28% |
| Cigna | All_Plans | $382.92 | ↓ -20% |
| WellSpan_Capital_Blue_Cross | All_Plans | $384.00 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $386.28 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $386.28 | ↓ -20% |
| Independence_Blue_Cross | All_Plans | $390.00 | ↓ -19% |
| Tower Health | All_Plans | $390.00 | ↓ -19% |
| Geisinger | All_Plans | $390.00 | ↓ -19% |
| UPMC | UPMC_For_Kids | $390.00 | ↓ -19% |
| UPMC | Employees_And_Dependents | $390.00 | ↓ -19% |
| Highmark | My_Priority_Blue_Flex | $423.21 | ↓ -12% |
| Highmark | My_Direct_Blue | $423.21 | ↓ -12% |
| Highmark | Blue_Cross_High_Performance_Network | $439.07 | ↓ -9% |
| Highmark | Choice_Blue_PPO | $439.07 | ↓ -9% |
| Highmark | Performance_Blue | $439.07 | ↓ -9% |
| Aetna_Better_Health_Kids | All_Plans | $449.41 | ↓ -6% |
| Aetna | All_Plans | $476.44 | ↓ -1% |
| First_Health_Network | All_Plans | $523.73 | ↑ +9% |
| Highmark | All_Other_Plans | $529.01 | ↑ +10% |
Visitor-reported prices
Comments
_afb org id by sequencing rflx ast-sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,507.80 | $114.02 – $2,010.40 |
| UPMC Bedford | Everett | $1,939.20 | $41.62 – $2,908.80 |
| UPMC Carlisle | Carlisle | $642.60 | $9.29 – $910.35 |
| UPMC Community Osteopathic | Harrisburg | $642.60 | $114.21 – $910.35 |
| UPMC East | Monroeville | $1,253.40 | $50.88 – $1,671.20 |
| UPMC Northwest | Seneca | $1,823.40 | $51.36 – $152.01 |
| UPMC Hanover | Hanover | $642.60 | $9.29 – $184.58 |
| UPMC Horizon-Greenville | Greenville | $1,105.80 | $51.52 – $216.47 |