Injection(s) trigger point(s) single/multiple >= 3 muscle(s) at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$548.80
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.
?
What you pay up front if you don't use insurance.
$686.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$43.09 with UPMC_Medicaid vs $1,307.34 with Highmark — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $43.09 | ↓ -92% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $43.09 | ↓ -92% |
| Health_Partners_Medicaid | All_Other_Plans | $43.09 | ↓ -92% |
| Geisinger_Medicaid | All_Plans | $43.09 | ↓ -92% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $43.09 | ↓ -92% |
| Amerihealth_Caritas_Medicaid | All_Plans | $48.95 | ↓ -91% |
| Aetna_Better_Health_Kids | All_Plans | $117.20 | ↓ -79% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $120.74 | ↓ -78% |
| Health_Partners_Medicaid | Kidz_Partners | $285.09 | ↓ -48% |
| Highmark_Medicare | All_Plans | $287.94 | ↓ -48% |
| Aetna_Advantra_Medicare | All_Plans | $293.64 | ↓ -46% |
| Aetna_Medicare | All_Plans | $293.64 | ↓ -46% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $299.34 | ↓ -45% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $299.34 | ↓ -45% |
| United_Medicare | ISNP_DSNP_Plans | $299.34 | ↓ -45% |
| Devoted_Medicare | All_Plans | $299.34 | ↓ -45% |
| Geisinger_Gold_Medicare | All_Plans | $299.34 | ↓ -45% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $300.63 | ↓ -45% |
| Amerihealth_Medicare | All_Plans | $300.77 | ↓ -45% |
| PA_Health_&_Wellness_Medicare | All_Plans | $307.90 | ↓ -44% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $307.90 | ↓ -44% |
| Blue_Cross | Capital_Cares_4_kids | $309.15 | ↓ -44% |
| Cigna | All_Plans | $417.64 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $439.04 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $441.65 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $441.65 | ↓ -20% |
| Highmark | Higmark_Healthy_Kids | $441.89 | ↓ -19% |
| Tower Health | All_Plans | $445.90 | ↓ -19% |
| UPMC | Employees_And_Dependents | $445.90 | ↓ -19% |
| UPMC | UPMC_For_Kids | $445.90 | ↓ -19% |
| Geisinger | All_Plans | $445.90 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $445.90 | ↓ -19% |
| PHC | All_Plans | $480.20 | ↓ -13% |
| United_Medicaid | Community_Plan_For_Kids | $498.91 | ↓ -9% |
| Aetna | All_Plans | $530.96 | ↓ -3% |
| First_Health_Network | All_Plans | $583.79 | ↑ +6% |
| United_Healthcare | All_Plans | $646.90 | ↑ +18% |
| Highmark | My_Direct_Blue | $1,045.88 | ↑ +91% |
| Highmark | My_Priority_Blue_Flex | $1,045.88 | ↑ +91% |
| Highmark | Performance_Blue | $1,085.08 | ↑ +98% |
| Highmark | Choice_Blue_PPO | $1,085.08 | ↑ +98% |
| Highmark | Blue_Cross_High_Performance_Network | $1,085.08 | ↑ +98% |
| Highmark | All_Other_Plans | $1,307.34 | ↑ +138% |
Visitor-reported prices
Comments
Injection(s) trigger point(s) single/multiple >= 3 muscle(s) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $470.40 | $34.47 – $627.20 |
| UPMC Carlisle | Carlisle | $766.20 | $43.78 – $1,085.45 |
| UPMC Cole | Coudersport | $79.20 | $11.64 – $116.19 |
| UPMC Community Osteopathic | Harrisburg | $766.20 | $43.78 – $1,085.45 |
| UPMC East | Monroeville | $603.00 | $37.92 – $804.00 |
| UPMC Northwest | Seneca | $647.40 | $37.92 – $295.50 |
| UPMC Hanover | Hanover | $766.20 | $43.78 – $451.20 |
| UPMC Horizon-Greenville | Greenville | $725.40 | $37.92 – $303.94 |