Insert cath pleura without image at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$3,650.40
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.
$4,563.00
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.
$121.63 with UPMC_Medicaid vs $9,629.00 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 | $121.63 | ↓ -97% |
| Health_Partners_Medicaid | All_Other_Plans | $121.63 | ↓ -97% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $121.63 | ↓ -97% |
| Geisinger_Medicaid | All_Plans | $121.63 | ↓ -97% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $121.63 | ↓ -97% |
| Amerihealth_Caritas_Medicaid | All_Plans | $138.17 | ↓ -96% |
| Aetna_Better_Health_Kids | All_Plans | $330.82 | ↓ -91% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $803.09 | ↓ -78% |
| Highmark_Medicare | All_Plans | $1,850.43 | ↓ -49% |
| Aetna_Advantra_Medicare | All_Plans | $1,887.07 | ↓ -48% |
| Aetna_Medicare | All_Plans | $1,887.07 | ↓ -48% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $1,923.72 | ↓ -47% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $1,923.72 | ↓ -47% |
| United_Medicare | ISNP_DSNP_Plans | $1,923.72 | ↓ -47% |
| Devoted_Medicare | All_Plans | $1,923.72 | ↓ -47% |
| Geisinger_Gold_Medicare | All_Plans | $1,923.72 | ↓ -47% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $1,931.96 | ↓ -47% |
| Amerihealth_Medicare | All_Plans | $1,932.88 | ↓ -47% |
| PA_Health_&_Wellness_Medicare | All_Plans | $1,978.68 | ↓ -46% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $1,978.68 | ↓ -46% |
| Blue_Cross | Capital_Cares_4_kids | $2,056.36 | ↓ -44% |
| Cigna | All_Plans | $2,777.95 | ↓ -24% |
| Highmark | Higmark_Healthy_Kids | $2,844.35 | ↓ -22% |
| WellSpan_Capital_Blue_Cross | All_Plans | $2,920.32 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $2,937.66 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $2,937.66 | ↓ -20% |
| Tower Health | All_Plans | $2,965.95 | ↓ -19% |
| UPMC | Employees_And_Dependents | $2,965.95 | ↓ -19% |
| UPMC | UPMC_For_Kids | $2,965.95 | ↓ -19% |
| Geisinger | All_Plans | $2,965.95 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $2,965.95 | ↓ -19% |
| Health_Partners_Medicaid | Kidz_Partners | $3,022.98 | ↓ -17% |
| PHC | All_Plans | $3,194.10 | ↓ -13% |
| United_Medicaid | Community_Plan_For_Kids | $3,206.19 | ↓ -12% |
| United_Healthcare | All_Plans | $4,302.91 | ↑ +18% |
| Highmark | My_Priority_Blue_Flex | $6,721.28 | ↑ +84% |
| Highmark | My_Direct_Blue | $6,721.28 | ↑ +84% |
| Highmark | Blue_Cross_High_Performance_Network | $6,973.19 | ↑ +91% |
| Highmark | Performance_Blue | $6,973.19 | ↑ +91% |
| Highmark | Choice_Blue_PPO | $6,973.19 | ↑ +91% |
| Highmark | All_Other_Plans | $8,401.51 | ↑ +130% |
| Aetna | All_Plans | $8,754.00 | ↑ +140% |
| First_Health_Network | All_Plans | $9,629.00 | ↑ +164% |
Visitor-reported prices
Comments
Insert cath pleura without image at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $843.60 | $472.66 – $1,953.23 |
| UPMC Cole | Coudersport | $218.40 | $44.35 – $791.18 |
| UPMC East | Monroeville | $832.80 | $458.04 – $1,953.23 |
| UPMC Hamot | Erie | $931.20 | $472.66 – $2,630.42 |
| UPMC Northwest | Seneca | $2,829.00 | $791.18 – $1,953.23 |
| UPMC Horizon-Greenville | Greenville | $2,109.00 | $791.18 – $1,953.23 |
| UPMC Jameson | New Castle | $2,335.80 | $481.00 – $2,441.54 |
| UPMC Magee | Pittsburgh | $2,370.00 | $477.16 – $1,989.40 |