MRI breast c-+ w/cad uni at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$680.00
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.
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What you pay up front if you don't use insurance.
$2,600.00
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.
$275.67 with UPMC_Medicaid vs $1,820.00 with PHC — 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 | $275.67 | ↓ -59% |
| Highmark_Medicare | All_Plans | $348.37 | ↓ -49% |
| Aetna_Advantra_Medicare | All_Plans | $355.27 | ↓ -48% |
| Aetna_Medicare | All_Plans | $355.27 | ↓ -48% |
| Devoted_Medicare | All_Plans | $362.17 | ↓ -47% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $362.17 | ↓ -47% |
| United_Medicare | ISNP_DSNP_Plans | $362.17 | ↓ -47% |
| Geisinger_Gold_Medicare | All_Plans | $362.17 | ↓ -47% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $362.17 | ↓ -47% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $363.72 | ↓ -47% |
| Amerihealth_Medicare | All_Plans | $363.89 | ↓ -46% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $372.51 | ↓ -45% |
| PA_Health_&_Wellness_Medicare | All_Plans | $372.51 | ↓ -45% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $381.45 | ↓ -44% |
| Geisinger_Medicaid | All_Plans | $381.45 | ↓ -44% |
| Health_Partners_Medicaid | All_Other_Plans | $381.45 | ↓ -44% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $381.45 | ↓ -44% |
| Amerihealth_Caritas_Medicaid | All_Plans | $433.33 | ↓ -36% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $457.60 | ↓ -33% |
| Highmark | Higmark_Healthy_Kids | $535.49 | ↓ -21% |
| Health_Partners_Medicaid | Kidz_Partners | $569.12 | ↓ -16% |
| United_Medicaid | Community_Plan_For_Kids | $603.61 | ↓ -11% |
| Blue_Cross | Capital_Blue_Performance_PPO | $718.00 | ↑ +6% |
| WellSpan_Capital_Blue_Cross | All_Plans | $737.00 | ↑ +8% |
| Aetna_Better_Health_Kids | All_Plans | $1,037.54 | ↑ +53% |
| Blue_Cross | Capital_Cares_4_kids | $1,171.72 | ↑ +72% |
| Highmark | My_Priority_Blue_Flex | $1,265.37 | ↑ +86% |
| Highmark | My_Direct_Blue | $1,265.37 | ↑ +86% |
| Highmark | Blue_Cross_High_Performance_Network | $1,312.80 | ↑ +93% |
| Highmark | Choice_Blue_PPO | $1,312.80 | ↑ +93% |
| Highmark | Performance_Blue | $1,312.80 | ↑ +93% |
| United_Healthcare | All_Plans | $1,395.12 | ↑ +105% |
| Cigna | All_Plans | $1,404.00 | ↑ +106% |
| Aetna | All_Plans | $1,477.00 | ↑ +117% |
| Highmark | All_Other_Plans | $1,581.70 | ↑ +133% |
| First_Health_Network | All_Plans | $1,624.00 | ↑ +139% |
| Blue_Cross | All_Other_Plans | $1,673.88 | ↑ +146% |
| Geisinger | All_Plans | $1,690.00 | ↑ +149% |
| UPMC | UPMC_For_Kids | $1,690.00 | ↑ +149% |
| Tower Health | All_Plans | $1,690.00 | ↑ +149% |
| UPMC | Employees_And_Dependents | $1,690.00 | ↑ +149% |
| Independence_Blue_Cross | All_Plans | $1,690.00 | ↑ +149% |
| PHC | All_Plans | $1,820.00 | ↑ +168% |
Visitor-reported prices
Comments
MRI breast c-+ w/cad uni at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,966.80 | $320.42 – $2,622.40 |
| WellSpan Good Samaritan Hospital | Lebanon | $680.00 | $352.78 – $1,395.12 |
| WellSpan Gettysburg Hospital | Gettysburg | $680.00 | $275.67 – $1,395.12 |