Diagnostic radio unlisted proc at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$552.80
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.
$691.00
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.
$66.04 with Highmark_Wholecare_Gateway_Medicaid vs $588.04 with First_Health_Network — 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 | $66.04 | ↓ -88% |
| Health_Partners_Medicaid | All_Other_Plans | $85.04 | ↓ -85% |
| Highmark_Medicare | All_Plans | $85.89 | ↓ -84% |
| Aetna_Medicare | All_Plans | $87.59 | ↓ -84% |
| Aetna_Advantra_Medicare | All_Plans | $87.59 | ↓ -84% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $89.29 | ↓ -84% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $89.29 | ↓ -84% |
| Geisinger_Gold_Medicare | All_Plans | $89.29 | ↓ -84% |
| Devoted_Medicare | All_Plans | $89.29 | ↓ -84% |
| United_Medicare | ISNP_DSNP_Plans | $89.29 | ↓ -84% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $89.67 | ↓ -84% |
| Amerihealth_Medicare | All_Plans | $89.72 | ↓ -84% |
| PA_Health_&_Wellness_Medicare | All_Plans | $91.84 | ↓ -83% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $91.84 | ↓ -83% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $121.62 | ↓ -78% |
| Highmark | Higmark_Healthy_Kids | $132.02 | ↓ -76% |
| Health_Partners_Medicaid | Kidz_Partners | $140.32 | ↓ -75% |
| United_Medicaid | Community_Plan_For_Kids | $148.82 | ↓ -73% |
| Blue_Cross | Capital_Cares_4_kids | $311.41 | ↓ -44% |
| Highmark | My_Direct_Blue | $311.98 | ↓ -44% |
| Highmark | My_Priority_Blue_Flex | $311.98 | ↓ -44% |
| Highmark | Performance_Blue | $323.67 | ↓ -41% |
| Highmark | Choice_Blue_PPO | $323.67 | ↓ -41% |
| Highmark | Blue_Cross_High_Performance_Network | $323.67 | ↓ -41% |
| Highmark | All_Other_Plans | $389.97 | ↓ -29% |
| Cigna | All_Plans | $407.07 | ↓ -26% |
| WellSpan_Capital_Blue_Cross | All_Plans | $442.24 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $444.87 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $444.87 | ↓ -20% |
| Tower Health | All_Plans | $449.15 | ↓ -19% |
| UPMC | Employees_And_Dependents | $449.15 | ↓ -19% |
| UPMC | UPMC_For_Kids | $449.15 | ↓ -19% |
| Geisinger | All_Plans | $449.15 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $449.15 | ↓ -19% |
| PHC | All_Plans | $483.70 | ↓ -13% |
| United_Healthcare | All_Plans | $497.84 | ↓ -10% |
| Aetna | All_Plans | $534.83 | ↓ -3% |
| First_Health_Network | All_Plans | $588.04 | ↑ +6% |
Visitor-reported prices
Comments
Diagnostic radio unlisted proc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $255.00 | $64.74 – $340.00 |
| UPMC Carlisle | Carlisle | $170.40 | $38.91 – $241.40 |
| UPMC Community Osteopathic | Harrisburg | $170.40 | $56.80 – $241.40 |
| UPMC Hanover | Hanover | $170.40 | $64.74 – $134.58 |
| UPMC Kane | Kane | $264.00 | $47.67 – $47.67 |
| UPMC Lititz | Lititz | $170.40 | $64.74 – $135.31 |
| UPMC Magee | Pittsburgh | $2,070.60 | $18.84 – $92.34 |
| UPMC Memorial | York | $170.40 | $64.74 – $279.67 |