Cllr miami j sm at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$248.80
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.
$311.00
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.
$16.24 with Blue_Cross_BlueJourney_Medicare vs $1,419.18 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 | $16.24 | ↓ -93% |
| Blue_Cross | Capital_Cares_4_kids | $41.60 | ↓ -83% |
| Cigna | All_Plans | $56.19 | ↓ -77% |
| WellSpan_Capital_Blue_Cross | All_Plans | $59.07 | ↓ -76% |
| Blue_Cross | Capital_Blue_Performance_PPO | $59.42 | ↓ -76% |
| Blue_Cross | All_Other_Plans | $59.42 | ↓ -76% |
| Tower Health | All_Plans | $60.00 | ↓ -76% |
| UPMC | Employees_And_Dependents | $60.00 | ↓ -76% |
| UPMC | UPMC_For_Kids | $60.00 | ↓ -76% |
| Geisinger | All_Plans | $60.00 | ↓ -76% |
| Independence_Blue_Cross | All_Plans | $60.00 | ↓ -76% |
| PHC | All_Plans | $64.61 | ↓ -74% |
| Aetna | All_Plans | $71.44 | ↓ -71% |
| First_Health_Network | All_Plans | $78.55 | ↓ -68% |
| United_Healthcare | All_Plans | $87.04 | ↓ -65% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $177.98 | ↓ -28% |
| Health_Partners_Medicaid | All_Other_Plans | $309.48 | ↑ +24% |
| Highmark_Medicare | All_Plans | $312.57 | ↑ +26% |
| Aetna_Advantra_Medicare | All_Plans | $318.76 | ↑ +28% |
| Aetna_Medicare | All_Plans | $318.76 | ↑ +28% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $324.95 | ↑ +31% |
| United_Medicare | ISNP_DSNP_Plans | $324.95 | ↑ +31% |
| Devoted_Medicare | All_Plans | $324.95 | ↑ +31% |
| Geisinger_Gold_Medicare | All_Plans | $324.95 | ↑ +31% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $324.95 | ↑ +31% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $326.35 | ↑ +31% |
| Amerihealth_Medicare | All_Plans | $326.50 | ↑ +31% |
| PA_Health_&_Wellness_Medicare | All_Plans | $334.24 | ↑ +34% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $334.24 | ↑ +34% |
| Highmark | Higmark_Healthy_Kids | $480.47 | ↑ +93% |
| Aetna_Better_Health_Kids | All_Plans | $484.09 | ↑ +95% |
| Health_Partners_Medicaid | Kidz_Partners | $510.64 | ↑ +105% |
| United_Medicaid | Community_Plan_For_Kids | $541.59 | ↑ +118% |
| Highmark | My_Priority_Blue_Flex | $1,135.36 | ↑ +356% |
| Highmark | My_Direct_Blue | $1,135.36 | ↑ +356% |
| Highmark | Blue_Cross_High_Performance_Network | $1,177.91 | ↑ +373% |
| Highmark | Choice_Blue_PPO | $1,177.91 | ↑ +373% |
| Highmark | Performance_Blue | $1,177.91 | ↑ +373% |
| Highmark | All_Other_Plans | $1,419.18 | ↑ +470% |
Visitor-reported prices
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Cllr miami j sm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | $188.66 | $309.48 – $541.59 |