Pet image w/ct lmtd at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$6,880.00
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.
$8,600.00
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.
$1,422.80 with Highmark_Medicare vs $8,570.95 with United_Healthcare — 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 |
|---|---|---|---|
| Highmark_Medicare | All_Plans | $1,422.80 | ↓ -79% |
| Aetna_Advantra_Medicare | All_Plans | $1,450.97 | ↓ -79% |
| Aetna_Medicare | All_Plans | $1,450.97 | ↓ -79% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $1,479.15 | ↓ -79% |
| Geisinger_Gold_Medicare | All_Plans | $1,479.15 | ↓ -79% |
| United_Medicare | ISNP_DSNP_Plans | $1,479.15 | ↓ -79% |
| Devoted_Medicare | All_Plans | $1,479.15 | ↓ -79% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $1,479.15 | ↓ -79% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $1,485.48 | ↓ -78% |
| Amerihealth_Medicare | All_Plans | $1,486.19 | ↓ -78% |
| UPMC_Medicaid | All_Plans | $1,509.07 | ↓ -78% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $1,513.60 | ↓ -78% |
| PA_Health_&_Wellness_Medicare | All_Plans | $1,521.41 | ↓ -78% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $1,521.41 | ↓ -78% |
| Health_Partners_Medicaid | All_Other_Plans | $1,622.19 | ↓ -76% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $1,622.19 | ↓ -76% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $1,622.19 | ↓ -76% |
| Geisinger_Medicaid | All_Plans | $1,622.19 | ↓ -76% |
| Amerihealth_Caritas_Medicaid | All_Plans | $1,842.81 | ↓ -73% |
| Highmark | Higmark_Healthy_Kids | $2,187.02 | ↓ -68% |
| Health_Partners_Medicaid | Kidz_Partners | $2,324.37 | ↓ -66% |
| United_Medicaid | Community_Plan_For_Kids | $2,465.24 | ↓ -64% |
| Blue_Cross | Capital_Cares_4_kids | $3,875.68 | ↓ -44% |
| Aetna_Better_Health_Kids | All_Plans | $4,412.35 | ↓ -36% |
| Cigna | All_Plans | $4,644.00 | ↓ -33% |
| Highmark | My_Direct_Blue | $5,167.99 | ↓ -25% |
| Highmark | My_Priority_Blue_Flex | $5,167.99 | ↓ -25% |
| Highmark | Blue_Cross_High_Performance_Network | $5,361.69 | ↓ -22% |
| Highmark | Choice_Blue_PPO | $5,361.69 | ↓ -22% |
| Highmark | Performance_Blue | $5,361.69 | ↓ -22% |
| WellSpan_Capital_Blue_Cross | All_Plans | $5,504.00 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $5,536.68 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $5,536.68 | ↓ -20% |
| Tower Health | All_Plans | $5,590.00 | ↓ -19% |
| UPMC | Employees_And_Dependents | $5,590.00 | ↓ -19% |
| UPMC | UPMC_For_Kids | $5,590.00 | ↓ -19% |
| Geisinger | All_Plans | $5,590.00 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $5,590.00 | ↓ -19% |
| PHC | All_Plans | $6,020.00 | ↓ -13% |
| Highmark | All_Other_Plans | $6,459.92 | ↓ -6% |
| Aetna | All_Plans | $6,656.40 | ↓ -3% |
| First_Health_Network | All_Plans | $7,318.60 | ↑ +6% |
| United_Healthcare | All_Plans | $8,570.95 | ↑ +25% |
Visitor-reported prices
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Pet image w/ct lmtd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,341.60 | $1,207.25 – $5,788.80 |
| UPMC Carlisle | Carlisle | $5,639.40 | $800.00 – $7,989.15 |
| UPMC Cole | Coudersport | $6,335.40 | $1,362.64 – $8,447.20 |
| UPMC Community Osteopathic | Harrisburg | $5,639.40 | $1,581.50 – $11,375.98 |
| UPMC Hanover | Hanover | $5,639.40 | $800.00 – $7,584.17 |
| UPMC Kane | Kane | $4,769.40 | $1,427.53 – $5,997.30 |
| UPMC Lititz | Lititz | $5,639.40 | $800.00 – $7,584.17 |
| UPMC Magee | Pittsburgh | $9,591.60 | $1,301.45 – $2,612.09 |