Bx breast pq tomo guide at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$2,424.80
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.
$3,031.00
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.
$533.46 with Blue_Cross_BlueJourney_Medicare vs $16,959.39 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 | $533.46 | ↓ -78% |
| Blue_Cross | Capital_Cares_4_kids | $1,365.95 | ↓ -44% |
| Cigna | All_Plans | $1,845.27 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,939.84 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $1,951.36 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $1,951.36 | ↓ -20% |
| UPMC | UPMC_For_Kids | $1,970.15 | ↓ -19% |
| Geisinger | All_Plans | $1,970.15 | ↓ -19% |
| Tower Health | All_Plans | $1,970.15 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $1,970.15 | ↓ -19% |
| UPMC | Employees_And_Dependents | $1,970.15 | ↓ -19% |
| PHC | All_Plans | $2,121.70 | ↓ -13% |
| United_Healthcare | All_Plans | $2,858.23 | ↑ +18% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $2,871.96 | ↑ +18% |
| Health_Partners_Medicaid | All_Other_Plans | $3,698.32 | ↑ +53% |
| Highmark_Medicare | All_Plans | $3,735.30 | ↑ +54% |
| Aetna_Medicare | All_Plans | $3,809.27 | ↑ +57% |
| Aetna_Advantra_Medicare | All_Plans | $3,809.27 | ↑ +57% |
| Devoted_Medicare | All_Plans | $3,883.24 | ↑ +60% |
| Geisinger_Gold_Medicare | All_Plans | $3,883.24 | ↑ +60% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $3,883.24 | ↑ +60% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $3,883.24 | ↑ +60% |
| United_Medicare | ISNP_DSNP_Plans | $3,883.24 | ↑ +60% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $3,899.88 | ↑ +61% |
| Amerihealth_Medicare | All_Plans | $3,901.73 | ↑ +61% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $3,994.19 | ↑ +65% |
| PA_Health_&_Wellness_Medicare | All_Plans | $3,994.19 | ↑ +65% |
| Aetna | All_Plans | $5,627.00 | ↑ +132% |
| Highmark | Higmark_Healthy_Kids | $5,741.64 | ↑ +137% |
| Health_Partners_Medicaid | Kidz_Partners | $6,102.23 | ↑ +152% |
| First_Health_Network | All_Plans | $6,190.00 | ↑ +155% |
| United_Medicaid | Community_Plan_For_Kids | $6,472.06 | ↑ +167% |
| Highmark | My_Priority_Blue_Flex | $13,567.66 | ↑ +460% |
| Highmark | My_Direct_Blue | $13,567.66 | ↑ +460% |
| Highmark | Performance_Blue | $14,076.18 | ↑ +481% |
| Highmark | Blue_Cross_High_Performance_Network | $14,076.18 | ↑ +481% |
| Highmark | Choice_Blue_PPO | $14,076.18 | ↑ +481% |
| Highmark | All_Other_Plans | $16,959.39 | ↑ +599% |
Visitor-reported prices
Comments
Bx breast pq tomo guide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $7,249.80 | $47.21 – $10,270.55 |
| UPMC Community Osteopathic | Harrisburg | $7,249.80 | $47.21 – $10,270.55 |
| UPMC Hanover | Hanover | $7,249.80 | $47.21 – $5,852.98 |
| UPMC Lititz | Lititz | $7,249.80 | $47.21 – $5,884.59 |
| UPMC Memorial | York | $7,249.80 | $15.15 – $5,875.04 |
| UPMC Somerset | Somerset | $7,249.80 | $18.40 – $3,942.46 |
| WellSpan Evangelical Community Hospital | Lewisburg | $9,758.40 | $86.34 – $86.34 |
| WellSpan Good Samaritan Hospital | Lebanon | $2,471.20 | $157.32 – $6,066.00 |