Insert/repl sq defib w/eltrd at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$72,809.60
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.
$91,012.00
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.
$2,854.98 with Aetna_Better_Health_Kids vs $141,996.52 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 |
|---|---|---|---|
| Aetna_Better_Health_Kids | All_Plans | $2,854.98 | ↓ -96% |
| Aetna | All_Plans | $10,638.00 | ↓ -85% |
| First_Health_Network | All_Plans | $11,702.00 | ↓ -84% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $16,018.11 | ↓ -78% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $24,046.19 | ↓ -67% |
| Highmark_Medicare | All_Plans | $31,274.72 | ↓ -57% |
| Aetna_Advantra_Medicare | All_Plans | $31,894.02 | ↓ -56% |
| Aetna_Medicare | All_Plans | $31,894.02 | ↓ -56% |
| Health_Partners_Medicaid | All_Other_Plans | $32,061.58 | ↓ -56% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $32,513.32 | ↓ -55% |
| Geisinger_Gold_Medicare | All_Plans | $32,513.32 | ↓ -55% |
| United_Medicare | ISNP_DSNP_Plans | $32,513.32 | ↓ -55% |
| Devoted_Medicare | All_Plans | $32,513.32 | ↓ -55% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $32,513.32 | ↓ -55% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $32,652.67 | ↓ -55% |
| Amerihealth_Medicare | All_Plans | $32,668.15 | ↓ -55% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $33,442.28 | ↓ -54% |
| PA_Health_&_Wellness_Medicare | All_Plans | $33,442.28 | ↓ -54% |
| Blue_Cross | Capital_Cares_4_kids | $41,015.47 | ↓ -44% |
| Highmark | Higmark_Healthy_Kids | $48,073.27 | ↓ -34% |
| Health_Partners_Medicaid | Kidz_Partners | $51,092.37 | ↓ -30% |
| United_Medicaid | Community_Plan_For_Kids | $54,188.87 | ↓ -26% |
| Cigna | All_Plans | $55,408.11 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $58,247.68 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $58,593.53 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $58,593.53 | ↓ -20% |
| Tower Health | All_Plans | $59,157.80 | ↓ -19% |
| Geisinger | All_Plans | $59,157.80 | ↓ -19% |
| UPMC | UPMC_For_Kids | $59,157.80 | ↓ -19% |
| UPMC | Employees_And_Dependents | $59,157.80 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $59,157.80 | ↓ -19% |
| PHC | All_Plans | $63,708.40 | ↓ -13% |
| United_Healthcare | All_Plans | $85,824.32 | ↑ +18% |
| Highmark | My_Priority_Blue_Flex | $113,598.46 | ↑ +56% |
| Highmark | My_Direct_Blue | $113,598.46 | ↑ +56% |
| Highmark | Choice_Blue_PPO | $117,856.15 | ↑ +62% |
| Highmark | Performance_Blue | $117,856.15 | ↑ +62% |
| Highmark | Blue_Cross_High_Performance_Network | $117,856.15 | ↑ +62% |
| Highmark | All_Other_Plans | $141,996.52 | ↑ +95% |
Visitor-reported prices
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Insert/repl sq defib w/eltrd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $40,435.80 | $401.56 – $53,914.40 |
| UPMC Carlisle | Carlisle | $48,933.60 | $922.97 – $69,322.60 |
| UPMC Community Osteopathic | Harrisburg | $48,933.60 | $922.97 – $69,322.60 |
| UPMC East | Monroeville | $31,258.80 | $405.38 – $41,678.40 |
| UPMC Hamot | Erie | $34,910.40 | $401.56 – $44,457.34 |
| UPMC Hanover | Hanover | $48,933.60 | $922.97 – $49,005.49 |
| UPMC Lititz | Lititz | $48,933.60 | $922.97 – $49,270.19 |
| UPMC Magee | Pittsburgh | $2,995.20 | $405.38 – $33,623.56 |