Mayo adalimumab (humira) therapeutic drug level at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$148.00
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.
$185.00
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.
$28.93 with Highmark_Wholecare_Gateway_Medicaid vs $176.87 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 |
|---|---|---|---|
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $28.93 | ↓ -80% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $32.56 | ↓ -78% |
| Health_Partners_Medicaid | All_Other_Plans | $38.57 | ↓ -74% |
| Highmark_Medicare | All_Plans | $38.96 | ↓ -74% |
| Aetna_Medicare | All_Plans | $39.73 | ↓ -73% |
| Aetna_Advantra_Medicare | All_Plans | $39.73 | ↓ -73% |
| Geisinger_Gold_Medicare | All_Plans | $40.50 | ↓ -73% |
| Devoted_Medicare | All_Plans | $40.50 | ↓ -73% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $40.50 | ↓ -73% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $40.50 | ↓ -73% |
| United_Medicare | ISNP_DSNP_Plans | $40.50 | ↓ -73% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $40.67 | ↓ -73% |
| Amerihealth_Medicare | All_Plans | $40.69 | ↓ -73% |
| PA_Health_&_Wellness_Medicare | All_Plans | $41.66 | ↓ -72% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $41.66 | ↓ -72% |
| Highmark | Higmark_Healthy_Kids | $59.88 | ↓ -60% |
| Health_Partners_Medicaid | Kidz_Partners | $63.64 | ↓ -57% |
| United_Medicaid | Community_Plan_For_Kids | $67.50 | ↓ -54% |
| PHC | All_Plans | $74.00 | ↓ -50% |
| Blue_Cross | Capital_Cares_4_kids | $83.37 | ↓ -44% |
| United_Healthcare | All_Plans | $115.71 | ↓ -22% |
| Cigna | All_Plans | $118.07 | ↓ -20% |
| WellSpan_Capital_Blue_Cross | All_Plans | $118.40 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $119.10 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $119.10 | ↓ -20% |
| Tower Health | All_Plans | $120.25 | ↓ -19% |
| UPMC | Employees_And_Dependents | $120.25 | ↓ -19% |
| UPMC | UPMC_For_Kids | $120.25 | ↓ -19% |
| Geisinger | All_Plans | $120.25 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $120.25 | ↓ -19% |
| Highmark | My_Priority_Blue_Flex | $141.50 | ↓ -4% |
| Highmark | My_Direct_Blue | $141.50 | ↓ -4% |
| Highmark | Blue_Cross_High_Performance_Network | $146.80 | ↓ -1% |
| Highmark | Performance_Blue | $146.80 | ↓ -1% |
| Highmark | Choice_Blue_PPO | $146.80 | ↓ -1% |
| Aetna | All_Plans | $159.29 | ↑ +8% |
| First_Health_Network | All_Plans | $175.11 | ↑ +18% |
| Highmark | All_Other_Plans | $176.87 | ↑ +20% |
Visitor-reported prices
Comments
Mayo adalimumab (humira) therapeutic drug level at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $189.00 | $21.60 – $252.00 |
| UPMC Bedford | Everett | $144.60 | $13.92 – $216.90 |
| UPMC Carlisle | Carlisle | $85.80 | $19.59 – $121.55 |
| UPMC Community Osteopathic | Harrisburg | $85.80 | $28.60 – $217.06 |
| UPMC East | Monroeville | $171.00 | $18.48 – $44.80 |
| UPMC Hamot | Erie | $155.40 | $21.60 – $41.66 |
| UPMC Northwest | Seneca | $141.00 | $34.98 – $41.66 |
| UPMC Hanover | Hanover | $85.80 | $22.37 – $217.06 |