ER Visit (level 1, minor) at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$511.20
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.
$639.00
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.
$26.25 with UPMC_Medicaid vs $2,281.00 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 |
|---|---|---|---|
| UPMC_Medicaid | All_Plans | $26.25 | ↓ -95% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $26.25 | ↓ -95% |
| Geisinger_Medicaid | All_Plans | $26.25 | ↓ -95% |
| Health_Partners_Medicaid | All_Other_Plans | $26.25 | ↓ -95% |
| Aetna_Better_Health_Kids | All_Plans | $71.40 | ↓ -86% |
| Highmark_Medicare | All_Plans | $85.89 | ↓ -83% |
| Aetna_Medicare | All_Plans | $87.59 | ↓ -83% |
| Aetna_Advantra_Medicare | All_Plans | $87.59 | ↓ -83% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $89.29 | ↓ -83% |
| United_Medicare | ISNP_DSNP_Plans | $89.29 | ↓ -83% |
| Devoted_Medicare | All_Plans | $89.29 | ↓ -83% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $89.29 | ↓ -83% |
| Geisinger_Gold_Medicare | All_Plans | $89.29 | ↓ -83% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $89.67 | ↓ -82% |
| Amerihealth_Medicare | All_Plans | $89.72 | ↓ -82% |
| PA_Health_&_Wellness_Medicare | All_Plans | $91.84 | ↓ -82% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $91.84 | ↓ -82% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $112.46 | ↓ -78% |
| Highmark | Higmark_Healthy_Kids | $124.90 | ↓ -76% |
| Health_Partners_Medicaid | Kidz_Partners | $140.32 | ↓ -73% |
| United_Medicaid | Community_Plan_For_Kids | $148.82 | ↓ -71% |
| Amerihealth_Caritas_Medicaid | All_Plans | $200.00 | ↓ -61% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $255.03 | ↓ -50% |
| Blue_Cross | Capital_Cares_4_kids | $287.97 | ↓ -44% |
| Highmark | My_Direct_Blue | $296.54 | ↓ -42% |
| Highmark | My_Priority_Blue_Flex | $296.54 | ↓ -42% |
| Highmark | Blue_Cross_High_Performance_Network | $306.20 | ↓ -40% |
| Highmark | Choice_Blue_PPO | $306.20 | ↓ -40% |
| Highmark | Performance_Blue | $306.20 | ↓ -40% |
| Highmark | All_Other_Plans | $368.90 | ↓ -28% |
| Cigna | All_Plans | $407.81 | ↓ -20% |
| WellSpan_Capital_Blue_Cross | All_Plans | $408.96 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $411.39 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $411.39 | ↓ -20% |
| Tower Health | All_Plans | $415.35 | ↓ -19% |
| Geisinger | All_Plans | $415.35 | ↓ -19% |
| UPMC | UPMC_For_Kids | $415.35 | ↓ -19% |
| UPMC | Employees_And_Dependents | $415.35 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $415.35 | ↓ -19% |
| PHC | All_Plans | $447.30 | ↓ -13% |
| United_Healthcare | All_Plans | $1,837.00 | ↑ +259% |
| Aetna | All_Plans | $2,074.00 | ↑ +306% |
| First_Health_Network | All_Plans | $2,281.00 | ↑ +346% |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $374.40 | $21.00 – $499.20 |
| UPMC Bedford | Everett | $215.40 | $30.29 – $323.10 |
| UPMC Carlisle | Carlisle | $391.20 | $21.05 – $554.20 |
| UPMC Cole | Coudersport | $136.20 | $18.26 – $103.74 |
| UPMC Community Osteopathic | Harrisburg | $391.20 | $21.05 – $554.20 |
| UPMC East | Monroeville | $260.40 | $51.60 – $347.20 |
| UPMC Hamot | Erie | $384.60 | $51.60 – $104.63 |
| UPMC Northwest | Seneca | $213.00 | $51.26 – $90.67 |