Composite drsg <= 16 sq in at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$37.60
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.
$47.00
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.
$3.76 with Highmark_Wholecare_Gateway_Medicaid vs $44.32 with United_Healthcare — 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 | $3.76 | ↓ -90% |
| Health_Partners_Medicaid | All_Other_Plans | $4.71 | ↓ -87% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $8.27 | ↓ -78% |
| Aetna_Better_Health_Kids | All_Plans | $10.23 | ↓ -73% |
| Blue_Cross | Capital_Cares_4_kids | $21.18 | ↓ -44% |
| Cigna | All_Plans | $28.61 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $30.08 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $30.26 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $30.26 | ↓ -20% |
| Tower Health | All_Plans | $30.55 | ↓ -19% |
| UPMC | Employees_And_Dependents | $30.55 | ↓ -19% |
| UPMC | UPMC_For_Kids | $30.55 | ↓ -19% |
| Geisinger | All_Plans | $30.55 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $30.55 | ↓ -19% |
| PHC | All_Plans | $32.90 | ↓ -13% |
| Aetna | All_Plans | $36.38 | ↓ -3% |
| First_Health_Network | All_Plans | $40.00 | ↑ +6% |
| United_Healthcare | All_Plans | $44.32 | ↑ +18% |
Visitor-reported prices
Comments
Composite drsg <= 16 sq in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3.00 | $2.50 – $18.76 |
| UPMC East | Monroeville | $3.60 | $1.25 – $18.76 |
| UPMC Hamot | Erie | $3.00 | $5.93 – $7.72 |
| UPMC Northwest | Seneca | $3.00 | $7.72 – $22.70 |
| UPMC Magee | Pittsburgh | $3.60 | $3.17 – $18.76 |
| UPMC Mercy | Pittsburgh | $3.60 | $5.93 – $14.81 |
| UPMC Passavant-McCandless | Pittsburgh | $3.60 | $5.99 – $27.22 |
| UPMC Presbyterian | Pittsburgh | $4.80 | $3.61 – $30.33 |