Endo, single, pulmonary at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$543.20
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.
$679.00
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.
$119.50 with Blue_Cross_BlueJourney_Medicare vs $712.41 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 | $119.50 | ↓ -78% |
| Health_Partners_Medicaid | All_Other_Plans | $194.19 | ↓ -64% |
| Highmark_Medicare | All_Plans | $196.13 | ↓ -64% |
| Aetna_Advantra_Medicare | All_Plans | $200.02 | ↓ -63% |
| Aetna_Medicare | All_Plans | $200.02 | ↓ -63% |
| Geisinger_Gold_Medicare | All_Plans | $203.90 | ↓ -62% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $203.90 | ↓ -62% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $203.90 | ↓ -62% |
| United_Medicare | ISNP_DSNP_Plans | $203.90 | ↓ -62% |
| Devoted_Medicare | All_Plans | $203.90 | ↓ -62% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $204.77 | ↓ -62% |
| Amerihealth_Medicare | All_Plans | $204.87 | ↓ -62% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $209.73 | ↓ -61% |
| PA_Health_&_Wellness_Medicare | All_Plans | $209.73 | ↓ -61% |
| Blue_Cross | Capital_Cares_4_kids | $306.00 | ↓ -44% |
| Health_Partners_Medicaid | Kidz_Partners | $320.41 | ↓ -41% |
| United_Medicaid | Community_Plan_For_Kids | $339.83 | ↓ -37% |
| Cigna | All_Plans | $413.38 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $434.56 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $437.14 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $437.14 | ↓ -20% |
| Tower Health | All_Plans | $441.35 | ↓ -19% |
| UPMC | Employees_And_Dependents | $441.35 | ↓ -19% |
| UPMC | UPMC_For_Kids | $441.35 | ↓ -19% |
| Geisinger | All_Plans | $441.35 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $441.35 | ↓ -19% |
| PHC | All_Plans | $475.30 | ↓ -13% |
| Aetna | All_Plans | $525.55 | ↓ -3% |
| First_Health_Network | All_Plans | $577.83 | ↑ +6% |
| United_Healthcare | All_Plans | $640.30 | ↑ +18% |
| Highmark | My_Priority_Blue_Flex | $712.41 | ↑ +31% |
| Highmark | My_Direct_Blue | $712.41 | ↑ +31% |
Visitor-reported prices
Comments
Endo, single, pulmonary at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $620.40 | $141.66 – $878.90 |
| UPMC Community Osteopathic | Harrisburg | $620.40 | $206.80 – $878.90 |
| WellSpan Chambersburg Hospital | Chambersburg | $789.36 | $301.44 – $391.87 |
| Uniontown Hospital | Uniontown | $2,412.50 | not published |
| WellSpan Gettysburg Hospital | Gettysburg | $2,626.42 | $663.17 – $1,160.55 |