Ins/rpl ldless pm right vent w img & eval at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$5,923.20
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.
$7,404.00
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.
$1,303.10 with Blue_Cross_BlueJourney_Medicare vs $84,463.69 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 | $1,303.10 | ↓ -78% |
| Blue_Cross | Capital_Cares_4_kids | $3,336.69 | ↓ -44% |
| Cigna | All_Plans | $4,507.56 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $4,738.56 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $4,766.70 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $4,766.70 | ↓ -20% |
| UPMC | Employees_And_Dependents | $4,812.60 | ↓ -19% |
| Geisinger | All_Plans | $4,812.60 | ↓ -19% |
| Tower Health | All_Plans | $4,812.60 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $4,812.60 | ↓ -19% |
| UPMC | UPMC_For_Kids | $4,812.60 | ↓ -19% |
| PHC | All_Plans | $5,182.80 | ↓ -13% |
| United_Healthcare | All_Plans | $6,981.97 | ↑ +18% |
| Aetna | All_Plans | $12,504.00 | ↑ +111% |
| First_Health_Network | All_Plans | $13,754.00 | ↑ +132% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $14,303.37 | ↑ +141% |
| Highmark_Medicare | All_Plans | $18,603.12 | ↑ +214% |
| Aetna_Advantra_Medicare | All_Plans | $18,971.50 | ↑ +220% |
| Aetna_Medicare | All_Plans | $18,971.50 | ↑ +220% |
| Health_Partners_Medicaid | All_Other_Plans | $19,071.16 | ↑ +222% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $19,339.88 | ↑ +227% |
| Geisinger_Gold_Medicare | All_Plans | $19,339.88 | ↑ +227% |
| United_Medicare | ISNP_DSNP_Plans | $19,339.88 | ↑ +227% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $19,339.88 | ↑ +227% |
| Devoted_Medicare | All_Plans | $19,339.88 | ↑ +227% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $19,422.76 | ↑ +228% |
| Amerihealth_Medicare | All_Plans | $19,431.97 | ↑ +228% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $19,892.44 | ↑ +236% |
| PA_Health_&_Wellness_Medicare | All_Plans | $19,892.44 | ↑ +236% |
| Highmark | Higmark_Healthy_Kids | $28,595.39 | ↑ +383% |
| Health_Partners_Medicaid | Kidz_Partners | $30,391.23 | ↑ +413% |
| United_Medicaid | Community_Plan_For_Kids | $32,233.13 | ↑ +444% |
| Highmark | My_Priority_Blue_Flex | $67,571.69 | ↑ +1041% |
| Highmark | My_Direct_Blue | $67,571.69 | ↑ +1041% |
| Highmark | Performance_Blue | $70,104.29 | ↑ +1084% |
| Highmark | Choice_Blue_PPO | $70,104.29 | ↑ +1084% |
| Highmark | Blue_Cross_High_Performance_Network | $70,104.29 | ↑ +1084% |
| Highmark | All_Other_Plans | $84,463.69 | ↑ +1326% |
Visitor-reported prices
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Ins/rpl ldless pm right vent w img & eval at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $15,600.00 | $307.59 – $20,800.00 |
| UPMC Carlisle | Carlisle | $24,161.40 | $638.52 – $34,228.65 |
| UPMC Community Osteopathic | Harrisburg | $24,161.40 | $638.52 – $34,228.65 |
| UPMC Hamot | Erie | $17,683.80 | $307.59 – $26,444.52 |
| UPMC Hanover | Hanover | $24,161.40 | $638.52 – $29,149.89 |
| UPMC Lititz | Lititz | $24,161.40 | $638.52 – $29,307.34 |
| UPMC Magee | Pittsburgh | $1,543.20 | $310.52 – $20,000.27 |
| UPMC Memorial | York | $24,161.40 | $250.70 – $29,259.74 |