Diagnostic Mammogram (both breasts) at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$208.00
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.
$564.00
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.
$99.26 with Blue_Cross_BlueJourney_Medicare vs $632.62 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 |
|---|---|---|---|
| Blue_Cross_BlueJourney_Medicare | All_Plans | $99.26 | ↓ -52% |
| Highmark_Medicare | All_Plans | $101.45 | ↓ -51% |
| Aetna_Advantra_Medicare | All_Plans | $103.46 | ↓ -50% |
| Aetna_Medicare | All_Plans | $103.46 | ↓ -50% |
| Devoted_Medicare | All_Plans | $105.47 | ↓ -49% |
| United_Medicare | ISNP_DSNP_Plans | $105.47 | ↓ -49% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $105.47 | ↓ -49% |
| Geisinger_Gold_Medicare | All_Plans | $105.47 | ↓ -49% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $105.47 | ↓ -49% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $105.92 | ↓ -49% |
| Amerihealth_Medicare | All_Plans | $105.97 | ↓ -49% |
| PA_Health_&_Wellness_Medicare | All_Plans | $108.49 | ↓ -48% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $108.49 | ↓ -48% |
| UPMC_Medicaid | All_Plans | $113.53 | ↓ -45% |
| WellSpan_Capital_Blue_Cross | All_Plans | $140.00 | ↓ -33% |
| Highmark | Higmark_Healthy_Kids | $155.95 | ↓ -25% |
| Health_Partners_Medicaid | All_Other_Plans | $162.31 | ↓ -22% |
| Geisinger_Medicaid | All_Plans | $162.31 | ↓ -22% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $162.31 | ↓ -22% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $162.31 | ↓ -22% |
| Health_Partners_Medicaid | Kidz_Partners | $165.74 | ↓ -20% |
| United_Medicaid | Community_Plan_For_Kids | $175.79 | ↓ -15% |
| Amerihealth_Caritas_Medicaid | All_Plans | $184.39 | ↓ -11% |
| Blue_Cross | Capital_Blue_Performance_PPO | $194.00 | ↓ -7% |
| Blue_Cross | Capital_Cares_4_kids | $254.17 | ↑ +22% |
| Cigna | All_Plans | $304.56 | ↑ +46% |
| Blue_Cross | All_Other_Plans | $363.10 | ↑ +75% |
| Tower Health | All_Plans | $366.60 | ↑ +76% |
| UPMC | Employees_And_Dependents | $366.60 | ↑ +76% |
| UPMC | UPMC_For_Kids | $366.60 | ↑ +76% |
| Geisinger | All_Plans | $366.60 | ↑ +76% |
| Independence_Blue_Cross | All_Plans | $366.60 | ↑ +76% |
| Highmark | My_Priority_Blue_Flex | $368.51 | ↑ +77% |
| Highmark | My_Direct_Blue | $368.51 | ↑ +77% |
| Highmark | Choice_Blue_PPO | $382.32 | ↑ +84% |
| Highmark | Performance_Blue | $382.32 | ↑ +84% |
| Highmark | Blue_Cross_High_Performance_Network | $382.32 | ↑ +84% |
| PHC | All_Plans | $394.80 | ↑ +90% |
| Aetna | All_Plans | $436.54 | ↑ +110% |
| Aetna_Better_Health_Kids | All_Plans | $441.49 | ↑ +112% |
| Highmark | All_Other_Plans | $460.63 | ↑ +121% |
| First_Health_Network | All_Plans | $479.96 | ↑ +131% |
| United_Healthcare | All_Plans | $632.62 | ↑ +204% |
Visitor-reported prices
Comments
Diagnostic Mammogram (both breasts) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $583.20 | $73.61 – $777.60 |
| UPMC Bedford | Everett | $609.00 | $136.34 – $913.50 |
| UPMC Carlisle | Carlisle | $310.20 | $70.83 – $611.06 |
| UPMC Cole | Coudersport | $458.40 | $136.34 – $611.20 |
| UPMC Community Osteopathic | Harrisburg | $310.20 | $103.40 – $675.02 |
| UPMC Hamot | Erie | $612.00 | $73.61 – $221.29 |
| UPMC Northwest | Seneca | $591.60 | $142.84 – $221.29 |
| UPMC Hanover | Hanover | $310.20 | $118.99 – $611.06 |