Cdna analysis for variants at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$605.60
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.
$757.00
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.
$92.60 with Amerihealth_Caritas_Medicaid vs $849.27 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 |
|---|---|---|---|
| Amerihealth_Caritas_Medicaid | All_Plans | $92.60 | ↓ -85% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $133.23 | ↓ -78% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $138.90 | ↓ -77% |
| Health_Partners_Medicaid | All_Other_Plans | $185.20 | ↓ -69% |
| Highmark_Medicare | All_Plans | $187.05 | ↓ -69% |
| Aetna_Advantra_Medicare | All_Plans | $190.76 | ↓ -69% |
| Aetna_Medicare | All_Plans | $190.76 | ↓ -69% |
| United_Medicare | ISNP_DSNP_Plans | $194.46 | ↓ -68% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $194.46 | ↓ -68% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $194.46 | ↓ -68% |
| Geisinger_Gold_Medicare | All_Plans | $194.46 | ↓ -68% |
| Devoted_Medicare | All_Plans | $194.46 | ↓ -68% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $195.29 | ↓ -68% |
| Amerihealth_Medicare | All_Plans | $195.39 | ↓ -68% |
| PA_Health_&_Wellness_Medicare | All_Plans | $200.02 | ↓ -67% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $200.02 | ↓ -67% |
| Highmark | Higmark_Healthy_Kids | $287.52 | ↓ -53% |
| Health_Partners_Medicaid | Kidz_Partners | $305.58 | ↓ -50% |
| United_Medicaid | Community_Plan_For_Kids | $324.10 | ↓ -46% |
| Blue_Cross | Capital_Cares_4_kids | $341.15 | ↓ -44% |
| Cigna | All_Plans | $483.12 | ↓ -20% |
| WellSpan_Capital_Blue_Cross | All_Plans | $484.48 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $487.36 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $487.36 | ↓ -20% |
| Tower Health | All_Plans | $492.05 | ↓ -19% |
| UPMC | Employees_And_Dependents | $492.05 | ↓ -19% |
| UPMC | UPMC_For_Kids | $492.05 | ↓ -19% |
| Geisinger | All_Plans | $492.05 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $492.05 | ↓ -19% |
| PHC | All_Plans | $529.90 | ↓ -13% |
| United_Healthcare | All_Plans | $555.60 | ↓ -8% |
| Highmark | My_Priority_Blue_Flex | $679.42 | ↑ +12% |
| Highmark | My_Direct_Blue | $679.42 | ↑ +12% |
| Highmark | Performance_Blue | $704.89 | ↑ +16% |
| Highmark | Choice_Blue_PPO | $704.89 | ↑ +16% |
| Highmark | Blue_Cross_High_Performance_Network | $704.89 | ↑ +16% |
| Aetna | All_Plans | $764.88 | ↑ +26% |
| First_Health_Network | All_Plans | $840.81 | ↑ +39% |
| Highmark | All_Other_Plans | $849.27 | ↑ +40% |
Visitor-reported prices
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Cdna analysis for variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,277.60 | $183.04 – $736.00 |
| UPMC Bedford | Everett | $2,343.60 | $66.82 – $1,841.40 |
| UPMC Carlisle | Carlisle | $1,070.40 | $101.86 – $1,516.40 |
| UPMC Cole | Coudersport | $1,117.20 | $53.00 – $1,489.60 |
| UPMC Community Osteopathic | Harrisburg | $1,070.40 | $147.99 – $1,516.40 |
| UPMC East | Monroeville | $1,916.40 | $183.04 – $814.40 |
| UPMC Hamot | Erie | $4,339.20 | $183.04 – $458.53 |
| UPMC Hanover | Hanover | $1,070.40 | $147.99 – $978.04 |