Dstrj nulyt agt gnclr nrv at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$3,328.80
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.
$4,161.00
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.
$732.34 with Blue_Cross_BlueJourney_Medicare vs $8,648.58 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 |
|---|---|---|---|
| Blue_Cross_BlueJourney_Medicare | All_Plans | $732.34 | ↓ -78% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $1,464.58 | ↓ -56% |
| Blue_Cross | Capital_Cares_4_kids | $1,875.20 | ↓ -44% |
| Health_Partners_Medicaid | All_Other_Plans | $1,885.99 | ↓ -43% |
| Highmark_Medicare | All_Plans | $1,904.85 | ↓ -43% |
| Aetna_Medicare | All_Plans | $1,942.57 | ↓ -42% |
| Aetna_Advantra_Medicare | All_Plans | $1,942.57 | ↓ -42% |
| Devoted_Medicare | All_Plans | $1,980.29 | ↓ -41% |
| Geisinger_Gold_Medicare | All_Plans | $1,980.29 | ↓ -41% |
| United_Medicare | ISNP_DSNP_Plans | $1,980.29 | ↓ -41% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $1,980.29 | ↓ -41% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $1,980.29 | ↓ -41% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $1,988.78 | ↓ -40% |
| Amerihealth_Medicare | All_Plans | $1,989.72 | ↓ -40% |
| PA_Health_&_Wellness_Medicare | All_Plans | $2,036.87 | ↓ -39% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $2,036.87 | ↓ -39% |
| Cigna | All_Plans | $2,533.22 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $2,663.04 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $2,678.85 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $2,678.85 | ↓ -20% |
| Tower Health | All_Plans | $2,704.65 | ↓ -19% |
| UPMC | Employees_And_Dependents | $2,704.65 | ↓ -19% |
| UPMC | UPMC_For_Kids | $2,704.65 | ↓ -19% |
| Geisinger | All_Plans | $2,704.65 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $2,704.65 | ↓ -19% |
| PHC | All_Plans | $2,912.70 | ↓ -13% |
| Highmark | Higmark_Healthy_Kids | $2,928.00 | ↓ -12% |
| Health_Partners_Medicaid | Kidz_Partners | $3,111.88 | ↓ -7% |
| United_Medicaid | Community_Plan_For_Kids | $3,300.48 | ↓ -1% |
| United_Healthcare | All_Plans | $3,923.82 | ↑ +18% |
| Aetna | All_Plans | $5,627.00 | ↑ +69% |
| First_Health_Network | All_Plans | $6,190.00 | ↑ +86% |
| Highmark | My_Direct_Blue | $6,918.94 | ↑ +108% |
| Highmark | My_Priority_Blue_Flex | $6,918.94 | ↑ +108% |
| Highmark | Choice_Blue_PPO | $7,178.27 | ↑ +116% |
| Highmark | Blue_Cross_High_Performance_Network | $7,178.27 | ↑ +116% |
| Highmark | Performance_Blue | $7,178.27 | ↑ +116% |
| Highmark | All_Other_Plans | $8,648.58 | ↑ +160% |
Visitor-reported prices
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Dstrj nulyt agt gnclr nrv at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $5,661.00 | $502.67 – $8,019.75 |
| UPMC Cole | Coudersport | $219.60 | $98.03 – $480.33 |
| UPMC Community Osteopathic | Harrisburg | $5,661.00 | $502.67 – $8,019.75 |
| UPMC East | Monroeville | $3,961.20 | $224.43 – $5,281.60 |
| UPMC Northwest | Seneca | $1,400.40 | $480.33 – $2,010.67 |
| UPMC Hanover | Hanover | $5,661.00 | $502.67 – $2,984.77 |
| UPMC Horizon-Greenville | Greenville | $1,033.80 | $432.50 – $2,010.67 |
| UPMC Jameson | New Castle | $1,033.80 | $226.24 – $2,513.34 |