Debride/subq tissue/ea add 20sq cm 11045 at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$370.40
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.
$463.00
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.
$18.06 with Highmark_Wholecare_Gateway_Medicaid vs $436.61 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 | $18.06 | ↓ -95% |
| Aetna_Better_Health_Kids | All_Plans | $49.13 | ↓ -87% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $81.49 | ↓ -78% |
| Blue_Cross | Capital_Cares_4_kids | $208.66 | ↓ -44% |
| Cigna | All_Plans | $281.87 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $296.32 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $298.08 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $298.08 | ↓ -20% |
| Tower Health | All_Plans | $300.95 | ↓ -19% |
| UPMC | Employees_And_Dependents | $300.95 | ↓ -19% |
| UPMC | UPMC_For_Kids | $300.95 | ↓ -19% |
| Geisinger | All_Plans | $300.95 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $300.95 | ↓ -19% |
| PHC | All_Plans | $324.10 | ↓ -13% |
| Aetna | All_Plans | $358.36 | ↓ -3% |
| First_Health_Network | All_Plans | $394.01 | ↑ +6% |
| United_Healthcare | All_Plans | $436.61 | ↑ +18% |
Visitor-reported prices
Comments
Debride/subq tissue/ea add 20sq cm 11045 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $704.40 | $46.42 – $939.20 |
| UPMC Bedford | Everett | $1,456.20 | $46.42 – $2,184.30 |
| UPMC Carlisle | Carlisle | $822.00 | $18.93 – $9,539.00 |
| UPMC Cole | Coudersport | $316.20 | $7.48 – $1,041.88 |
| UPMC East | Monroeville | $315.60 | $46.42 – $420.80 |
| UPMC Hamot | Erie | $1,602.60 | $46.42 – $618.09 |
| UPMC Northwest | Seneca | $1,588.80 | $46.42 – $235.18 |
| UPMC Hanover | Hanover | $822.00 | $18.93 – $497.84 |