Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$18,232.80
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.
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What you pay up front if you don't use insurance.
$22,791.00
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.
$578.84 with Health_Partners_Medicaid vs $46,349.60 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 |
|---|---|---|---|
| Health_Partners_Medicaid | All_Other_Plans | $578.84 | ↓ -97% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $578.84 | ↓ -97% |
| UPMC_Medicaid | All_Plans | $578.84 | ↓ -97% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $578.84 | ↓ -97% |
| Geisinger_Medicaid | All_Plans | $578.84 | ↓ -97% |
| Amerihealth_Caritas_Medicaid | All_Plans | $657.56 | ↓ -96% |
| Aetna_Better_Health_Kids | All_Plans | $1,574.44 | ↓ -91% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $4,011.22 | ↓ -78% |
| Highmark_Medicare | All_Plans | $10,208.49 | ↓ -44% |
| Blue_Cross | Capital_Cares_4_kids | $10,270.99 | ↓ -44% |
| Aetna_Advantra_Medicare | All_Plans | $10,410.64 | ↓ -43% |
| Aetna_Medicare | All_Plans | $10,410.64 | ↓ -43% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $10,612.79 | ↓ -42% |
| Geisinger_Gold_Medicare | All_Plans | $10,612.79 | ↓ -42% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $10,612.79 | ↓ -42% |
| United_Medicare | ISNP_DSNP_Plans | $10,612.79 | ↓ -42% |
| Devoted_Medicare | All_Plans | $10,612.79 | ↓ -42% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $10,658.27 | ↓ -42% |
| Amerihealth_Medicare | All_Plans | $10,663.33 | ↓ -42% |
| PA_Health_&_Wellness_Medicare | All_Plans | $10,916.01 | ↓ -40% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $10,916.01 | ↓ -40% |
| Cigna | All_Plans | $13,875.16 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $14,586.24 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $14,672.85 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $14,672.85 | ↓ -20% |
| Tower Health | All_Plans | $14,814.15 | ↓ -19% |
| UPMC | Employees_And_Dependents | $14,814.15 | ↓ -19% |
| UPMC | UPMC_For_Kids | $14,814.15 | ↓ -19% |
| Geisinger | All_Plans | $14,814.15 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $14,814.15 | ↓ -19% |
| Highmark | Higmark_Healthy_Kids | $15,691.77 | ↓ -14% |
| PHC | All_Plans | $15,953.70 | ↓ -13% |
| Health_Partners_Medicaid | Kidz_Partners | $16,677.24 | ↓ -9% |
| Aetna | All_Plans | $17,510.00 | ↓ -4% |
| United_Medicaid | Community_Plan_For_Kids | $17,687.99 | ↓ -3% |
| First_Health_Network | All_Plans | $19,262.00 | ↑ +6% |
| United_Healthcare | All_Plans | $21,491.91 | ↑ +18% |
| Highmark | My_Priority_Blue_Flex | $37,080.08 | ↑ +103% |
| Highmark | My_Direct_Blue | $37,080.08 | ↑ +103% |
| Highmark | Blue_Cross_High_Performance_Network | $38,469.85 | ↑ +111% |
| Highmark | Choice_Blue_PPO | $38,469.85 | ↑ +111% |
| Highmark | Performance_Blue | $38,469.85 | ↑ +111% |
| Highmark | All_Other_Plans | $46,349.60 | ↑ +154% |
Visitor-reported prices
Comments
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $12,450.60 | $463.07 – $16,600.80 |
| UPMC Carlisle | Carlisle | $25,401.60 | $588.10 – $35,985.60 |
| UPMC Cole | Coudersport | $1,003.20 | $463.48 – $1,954.88 |
| UPMC Community Osteopathic | Harrisburg | $25,401.60 | $588.10 – $35,985.60 |
| UPMC East | Monroeville | $3,822.60 | $509.38 – $10,476.31 |
| UPMC Hamot | Erie | $12,843.00 | $509.38 – $14,511.47 |
| UPMC Hanover | Hanover | $25,401.60 | $588.10 – $15,996.05 |
| UPMC Jameson | New Castle | $18,378.00 | $509.38 – $13,469.54 |