Dialysis one evaluation at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$960.00
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.
$1,200.00
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.
$43.75 with Highmark_Wholecare_Gateway_Medicaid vs $1,885.91 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 |
|---|---|---|---|
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $43.75 | ↓ -95% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $102.26 | ↓ -89% |
| Aetna_Better_Health_Kids | All_Plans | $119.00 | ↓ -88% |
| Blue_Cross | Capital_Cares_4_kids | $261.83 | ↓ -73% |
| Cigna | All_Plans | $353.71 | ↓ -63% |
| WellSpan_Capital_Blue_Cross | All_Plans | $371.84 | ↓ -61% |
| Blue_Cross | All_Other_Plans | $374.05 | ↓ -61% |
| Blue_Cross | Capital_Blue_Performance_PPO | $374.05 | ↓ -61% |
| Tower Health | All_Plans | $377.65 | ↓ -61% |
| UPMC | Employees_And_Dependents | $377.65 | ↓ -61% |
| UPMC | UPMC_For_Kids | $377.65 | ↓ -61% |
| Geisinger | All_Plans | $377.65 | ↓ -61% |
| Independence_Blue_Cross | All_Plans | $377.65 | ↓ -61% |
| PHC | All_Plans | $406.70 | ↓ -58% |
| Health_Partners_Medicaid | All_Other_Plans | $411.26 | ↓ -57% |
| Highmark_Medicare | All_Plans | $415.37 | ↓ -57% |
| Aetna_Medicare | All_Plans | $423.60 | ↓ -56% |
| Aetna_Advantra_Medicare | All_Plans | $423.60 | ↓ -56% |
| Geisinger_Gold_Medicare | All_Plans | $431.82 | ↓ -55% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $431.82 | ↓ -55% |
| Devoted_Medicare | All_Plans | $431.82 | ↓ -55% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $431.82 | ↓ -55% |
| United_Medicare | ISNP_DSNP_Plans | $431.82 | ↓ -55% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $433.67 | ↓ -55% |
| Amerihealth_Medicare | All_Plans | $433.88 | ↓ -55% |
| PA_Health_&_Wellness_Medicare | All_Plans | $444.16 | ↓ -54% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $444.16 | ↓ -54% |
| Aetna | All_Plans | $449.69 | ↓ -53% |
| First_Health_Network | All_Plans | $494.43 | ↓ -48% |
| United_Healthcare | All_Plans | $547.88 | ↓ -43% |
| Highmark | Higmark_Healthy_Kids | $638.48 | ↓ -33% |
| Health_Partners_Medicaid | Kidz_Partners | $678.58 | ↓ -29% |
| United_Medicaid | Community_Plan_For_Kids | $719.71 | ↓ -25% |
| Highmark | My_Direct_Blue | $1,508.75 | ↑ +57% |
| Highmark | My_Priority_Blue_Flex | $1,508.75 | ↑ +57% |
| Highmark | Blue_Cross_High_Performance_Network | $1,565.30 | ↑ +63% |
| Highmark | Choice_Blue_PPO | $1,565.30 | ↑ +63% |
| Highmark | Performance_Blue | $1,565.30 | ↑ +63% |
| Highmark | All_Other_Plans | $1,885.91 | ↑ +96% |
Visitor-reported prices
Comments
Dialysis one evaluation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $750.00 | $212.24 – $1,000.00 |
| UPMC Carlisle | Carlisle | $970.80 | $45.85 – $1,375.30 |
| UPMC Community Osteopathic | Harrisburg | $970.80 | $45.85 – $1,375.30 |
| UPMC Hanover | Hanover | $970.80 | $45.85 – $1,128.12 |
| UPMC Horizon-Greenville | Greenville | $2,317.80 | $214.93 – $761.80 |
| UPMC Jameson | New Castle | $2,373.00 | $40.25 – $507.46 |
| UPMC Lititz | Lititz | $970.80 | $45.85 – $1,128.12 |
| UPMC Magee | Pittsburgh | $1,371.60 | $226.76 – $446.57 |