Endoscopic injection/implant at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$4,883.20
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.
$6,104.00
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.
$232.11 with UPMC_Medicaid vs $15,275.06 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 |
|---|---|---|---|
| UPMC_Medicaid | All_Plans | $232.11 | ↓ -95% |
| Health_Partners_Medicaid | All_Other_Plans | $232.11 | ↓ -95% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $232.11 | ↓ -95% |
| Geisinger_Medicaid | All_Plans | $232.11 | ↓ -95% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $232.11 | ↓ -95% |
| Amerihealth_Caritas_Medicaid | All_Plans | $263.68 | ↓ -95% |
| Aetna_Better_Health_Kids | All_Plans | $631.35 | ↓ -87% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $1,074.30 | ↓ -78% |
| Blue_Cross | Capital_Cares_4_kids | $2,750.83 | ↓ -44% |
| Health_Partners_Medicaid | Kidz_Partners | $3,331.02 | ↓ -32% |
| Highmark_Medicare | All_Plans | $3,364.33 | ↓ -31% |
| Aetna_Medicare | All_Plans | $3,430.95 | ↓ -30% |
| Aetna_Advantra_Medicare | All_Plans | $3,430.95 | ↓ -30% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $3,497.57 | ↓ -28% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $3,497.57 | ↓ -28% |
| United_Medicare | ISNP_DSNP_Plans | $3,497.57 | ↓ -28% |
| Devoted_Medicare | All_Plans | $3,497.57 | ↓ -28% |
| Geisinger_Gold_Medicare | All_Plans | $3,497.57 | ↓ -28% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $3,512.56 | ↓ -28% |
| Amerihealth_Medicare | All_Plans | $3,514.23 | ↓ -28% |
| Cigna | All_Plans | $3,595.87 | ↓ -26% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $3,597.50 | ↓ -26% |
| PA_Health_&_Wellness_Medicare | All_Plans | $3,597.50 | ↓ -26% |
| WellSpan_Capital_Blue_Cross | All_Plans | $3,906.56 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $3,929.76 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $3,929.76 | ↓ -20% |
| Tower Health | All_Plans | $3,967.60 | ↓ -19% |
| UPMC | Employees_And_Dependents | $3,967.60 | ↓ -19% |
| UPMC | UPMC_For_Kids | $3,967.60 | ↓ -19% |
| Geisinger | All_Plans | $3,967.60 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $3,967.60 | ↓ -19% |
| PHC | All_Plans | $4,272.80 | ↓ -13% |
| Aetna | All_Plans | $4,724.50 | ↓ -3% |
| Highmark | Higmark_Healthy_Kids | $5,163.08 | ↑ +6% |
| First_Health_Network | All_Plans | $5,194.50 | ↑ +6% |
| United_Healthcare | All_Plans | $5,756.07 | ↑ +18% |
| United_Medicaid | Community_Plan_For_Kids | $5,829.29 | ↑ +19% |
| Highmark | My_Priority_Blue_Flex | $12,220.18 | ↑ +150% |
| Highmark | My_Direct_Blue | $12,220.18 | ↑ +150% |
| Highmark | Blue_Cross_High_Performance_Network | $12,678.20 | ↑ +160% |
| Highmark | Performance_Blue | $12,678.20 | ↑ +160% |
| Highmark | Choice_Blue_PPO | $12,678.20 | ↑ +160% |
| Highmark | All_Other_Plans | $15,275.06 | ↑ +213% |
Visitor-reported prices
Comments
Endoscopic injection/implant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $360.60 | $166.60 – $771.51 |
| UPMC Magee | Pittsburgh | $10,579.80 | $204.26 – $3,551.23 |
| UPMC Wellsboro | Wellsboro | $12,844.00 | $204.26 – $993.28 |
| UPMC Altoona | Altoona | not published | $185.69 – $3,551.23 |
| UPMC Carlisle | Carlisle | not published | $235.83 – $5,278.96 |
| UPMC Community Osteopathic | Harrisburg | not published | $250.68 – $7,348.95 |
| UPMC East | Monroeville | not published | $204.26 – $3,617.00 |
| UPMC Hamot | Erie | not published | $204.26 – $4,782.42 |