ER Visit (level 3) at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$1,638.40
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.
$2,048.00
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.
$98.75 with Geisinger_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 |
|---|---|---|---|
| Geisinger_Medicaid | All_Plans | $98.75 | ↓ -94% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $98.75 | ↓ -94% |
| UPMC_Medicaid | All_Plans | $98.75 | ↓ -94% |
| Health_Partners_Medicaid | All_Other_Plans | $98.75 | ↓ -94% |
| Amerihealth_Caritas_Medicaid | All_Plans | $200.00 | ↓ -88% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $255.03 | ↓ -84% |
| Aetna_Better_Health_Kids | All_Plans | $268.60 | ↓ -84% |
| Highmark_Medicare | All_Plans | $270.09 | ↓ -84% |
| Aetna_Medicare | All_Plans | $275.44 | ↓ -83% |
| Aetna_Advantra_Medicare | All_Plans | $275.44 | ↓ -83% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $280.79 | ↓ -83% |
| United_Medicare | ISNP_DSNP_Plans | $280.79 | ↓ -83% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $280.79 | ↓ -83% |
| Devoted_Medicare | All_Plans | $280.79 | ↓ -83% |
| Geisinger_Gold_Medicare | All_Plans | $280.79 | ↓ -83% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $281.99 | ↓ -83% |
| Amerihealth_Medicare | All_Plans | $282.13 | ↓ -83% |
| PA_Health_&_Wellness_Medicare | All_Plans | $288.81 | ↓ -82% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $288.81 | ↓ -82% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $360.45 | ↓ -78% |
| Highmark | Higmark_Healthy_Kids | $392.76 | ↓ -76% |
| Health_Partners_Medicaid | Kidz_Partners | $441.24 | ↓ -73% |
| United_Medicaid | Community_Plan_For_Kids | $467.99 | ↓ -71% |
| Blue_Cross | Capital_Cares_4_kids | $922.95 | ↓ -44% |
| Highmark | My_Direct_Blue | $932.52 | ↓ -43% |
| Highmark | My_Priority_Blue_Flex | $932.52 | ↓ -43% |
| Highmark | Choice_Blue_PPO | $962.87 | ↓ -41% |
| Highmark | Performance_Blue | $962.87 | ↓ -41% |
| Highmark | Blue_Cross_High_Performance_Network | $962.87 | ↓ -41% |
| Highmark | All_Other_Plans | $1,160.07 | ↓ -29% |
| Cigna | All_Plans | $1,307.03 | ↓ -20% |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,310.72 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $1,318.50 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $1,318.50 | ↓ -20% |
| Tower Health | All_Plans | $1,331.20 | ↓ -19% |
| Geisinger | All_Plans | $1,331.20 | ↓ -19% |
| UPMC | UPMC_For_Kids | $1,331.20 | ↓ -19% |
| UPMC | Employees_And_Dependents | $1,331.20 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $1,331.20 | ↓ -19% |
| PHC | All_Plans | $1,433.60 | ↓ -13% |
| United_Healthcare | All_Plans | $1,837.00 | ↑ +12% |
| Aetna | All_Plans | $2,074.00 | ↑ +27% |
| First_Health_Network | All_Plans | $2,281.00 | ↑ +39% |
Visitor-reported prices
Comments
ER Visit (level 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $709.20 | $79.00 – $945.60 |
| UPMC Bedford | Everett | $429.60 | $59.48 – $644.40 |
| UPMC Carlisle | Carlisle | $887.40 | $45.50 – $1,257.15 |
| UPMC Cole | Coudersport | $274.20 | $39.46 – $272.94 |
| UPMC Community Osteopathic | Harrisburg | $887.40 | $45.50 – $1,257.15 |
| UPMC East | Monroeville | $880.20 | $62.31 – $1,173.60 |
| UPMC Hamot | Erie | $793.20 | $62.31 – $329.04 |
| UPMC Northwest | Seneca | $336.60 | $62.31 – $285.07 |