Bundled special stain group 2 at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$141.60
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.
$177.00
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.
$31.15 with Blue_Cross_BlueJourney_Medicare vs $570.87 with Highmark — 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 |
|---|---|---|---|
| Blue_Cross_BlueJourney_Medicare | All_Plans | $31.15 | ↓ -78% |
| Amerihealth_Caritas_Medicaid | All_Plans | $51.01 | ↓ -64% |
| UPMC_Medicaid | All_Plans | $51.50 | ↓ -64% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $63.76 | ↓ -55% |
| Geisinger_Medicaid | All_Plans | $63.76 | ↓ -55% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $63.76 | ↓ -55% |
| Health_Partners_Medicaid | All_Other_Plans | $63.76 | ↓ -55% |
| Blue_Cross | Capital_Cares_4_kids | $79.77 | ↓ -44% |
| Cigna | All_Plans | $112.96 | ↓ -20% |
| WellSpan_Capital_Blue_Cross | All_Plans | $113.28 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $113.95 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $113.95 | ↓ -20% |
| Independence_Blue_Cross | All_Plans | $115.05 | ↓ -19% |
| UPMC | UPMC_For_Kids | $115.05 | ↓ -19% |
| UPMC | Employees_And_Dependents | $115.05 | ↓ -19% |
| Geisinger | All_Plans | $115.05 | ↓ -19% |
| Tower Health | All_Plans | $115.05 | ↓ -19% |
| PHC | All_Plans | $123.90 | ↓ -13% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $124.49 | ↓ -12% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $124.49 | ↓ -12% |
| United_Medicaid | Community_Plan_For_Kids | $124.49 | ↓ -12% |
| Highmark_Medicare | All_Plans | $125.73 | ↓ -11% |
| Aetna_Medicare | All_Plans | $128.22 | ↓ -9% |
| Aetna_Advantra_Medicare | All_Plans | $128.22 | ↓ -9% |
| Geisinger_Gold_Medicare | All_Plans | $130.71 | ↓ -8% |
| Devoted_Medicare | All_Plans | $130.71 | ↓ -8% |
| United_Medicare | ISNP_DSNP_Plans | $130.71 | ↓ -8% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $131.27 | ↓ -7% |
| Amerihealth_Medicare | All_Plans | $131.34 | ↓ -7% |
| PA_Health_&_Wellness_Medicare | All_Plans | $134.45 | ↓ -5% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $134.45 | ↓ -5% |
| Aetna_Better_Health_Kids | All_Plans | $173.43 | ↑ +22% |
| United_Healthcare | All_Plans | $174.84 | ↑ +23% |
| Highmark | Higmark_Healthy_Kids | $193.27 | ↑ +36% |
| Health_Partners_Medicaid | Kidz_Partners | $205.41 | ↑ +45% |
| Aetna | All_Plans | $320.78 | ↑ +127% |
| First_Health_Network | All_Plans | $352.62 | ↑ +149% |
| Highmark | My_Priority_Blue_Flex | $456.70 | ↑ +223% |
| Highmark | My_Direct_Blue | $456.70 | ↑ +223% |
| Highmark | Performance_Blue | $473.82 | ↑ +235% |
| Highmark | Choice_Blue_PPO | $473.82 | ↑ +235% |
| Highmark | Blue_Cross_High_Performance_Network | $473.82 | ↑ +235% |
| Highmark | All_Other_Plans | $570.87 | ↑ +303% |
Visitor-reported prices
Comments
Bundled special stain group 2 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $139.20 | $6.25 – $185.60 |
| UPMC Bedford | Everett | $49.80 | $6.54 – $86.93 |
| UPMC Carlisle | Carlisle | $78.60 | $17.95 – $197.30 |
| UPMC Cole | Coudersport | $180.60 | $23.46 – $240.80 |
| UPMC Community Osteopathic | Harrisburg | $78.60 | $13.60 – $135.68 |
| UPMC East | Monroeville | $48.00 | $6.31 – $129.03 |
| UPMC Hamot | Erie | $147.60 | $6.25 – $153.18 |
| UPMC Northwest | Seneca | $67.20 | $6.51 – $129.03 |