Bx breast add lesion mr imag at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$892.80
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.
$1,116.00
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.
$89.58 with Highmark_Wholecare_Gateway_Medicaid vs $6,190.00 with First_Health_Network — 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 | $89.58 | ↓ -90% |
| UPMC_Medicaid | All_Plans | $89.58 | ↓ -90% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $89.58 | ↓ -90% |
| Health_Partners_Medicaid | All_Other_Plans | $89.58 | ↓ -90% |
| Geisinger_Medicaid | All_Plans | $89.58 | ↓ -90% |
| Amerihealth_Caritas_Medicaid | All_Plans | $101.76 | ↓ -89% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $196.42 | ↓ -78% |
| Aetna_Better_Health_Kids | All_Plans | $243.64 | ↓ -73% |
| Blue_Cross | Capital_Cares_4_kids | $502.94 | ↓ -44% |
| Cigna | All_Plans | $679.42 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $714.24 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $718.48 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $718.48 | ↓ -20% |
| UPMC | UPMC_For_Kids | $725.40 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $725.40 | ↓ -19% |
| Geisinger | All_Plans | $725.40 | ↓ -19% |
| UPMC | Employees_And_Dependents | $725.40 | ↓ -19% |
| Tower Health | All_Plans | $725.40 | ↓ -19% |
| PHC | All_Plans | $781.20 | ↓ -13% |
| United_Healthcare | All_Plans | $1,052.39 | ↑ +18% |
| Aetna | All_Plans | $5,627.00 | ↑ +530% |
| First_Health_Network | All_Plans | $6,190.00 | ↑ +593% |
Visitor-reported prices
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Bx breast add lesion mr imag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,042.80 | $91.01 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $1,042.80 | $93.87 – $2,307.90 |
| UPMC Hamot | Erie | $3,243.60 | $78.83 – $1,064.82 |
| UPMC Hanover | Hanover | $1,042.80 | $91.01 – $1,114.34 |
| UPMC Kane | Kane | $1,858.80 | $78.83 – $2,491.15 |
| UPMC Lititz | Lititz | $1,042.80 | $78.08 – $1,114.34 |
| UPMC Magee | Pittsburgh | $5,692.20 | $78.83 – $1,064.82 |
| UPMC Memorial | York | $1,042.80 | $78.08 – $1,114.34 |