Pr incision & drainage abscess vulva/perineal at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$1,056.00
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.
$1,320.00
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.
$117.26 with PA_Health_&_Wellness_Medicaid vs $9,629.00 with First_Health_Network — 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 |
|---|---|---|---|
| PA_Health_&_Wellness_Medicaid | All_Plans | $117.26 | ↓ -89% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $117.26 | ↓ -89% |
| Health_Partners_Medicaid | All_Other_Plans | $117.26 | ↓ -89% |
| UPMC_Medicaid | All_Plans | $117.26 | ↓ -89% |
| Geisinger_Medicaid | All_Plans | $117.26 | ↓ -89% |
| Amerihealth_Caritas_Medicaid | All_Plans | $133.21 | ↓ -87% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $232.32 | ↓ -78% |
| Highmark_Medicare | All_Plans | $296.73 | ↓ -72% |
| Aetna_Medicare | All_Plans | $302.60 | ↓ -71% |
| Aetna_Advantra_Medicare | All_Plans | $302.60 | ↓ -71% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $308.48 | ↓ -71% |
| Devoted_Medicare | All_Plans | $308.48 | ↓ -71% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $308.48 | ↓ -71% |
| United_Medicare | ISNP_DSNP_Plans | $308.48 | ↓ -71% |
| Geisinger_Gold_Medicare | All_Plans | $308.48 | ↓ -71% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $309.80 | ↓ -71% |
| Amerihealth_Medicare | All_Plans | $309.95 | ↓ -71% |
| PA_Health_&_Wellness_Medicare | All_Plans | $317.29 | ↓ -70% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $317.29 | ↓ -70% |
| Aetna_Better_Health_Kids | All_Plans | $318.95 | ↓ -70% |
| Highmark | Higmark_Healthy_Kids | $456.11 | ↓ -57% |
| Health_Partners_Medicaid | Kidz_Partners | $484.75 | ↓ -54% |
| United_Medicaid | Community_Plan_For_Kids | $514.13 | ↓ -51% |
| Blue_Cross | Capital_Cares_4_kids | $594.87 | ↓ -44% |
| Cigna | All_Plans | $803.62 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $844.80 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $849.82 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $849.82 | ↓ -20% |
| Tower Health | All_Plans | $858.00 | ↓ -19% |
| UPMC | Employees_And_Dependents | $858.00 | ↓ -19% |
| UPMC | UPMC_For_Kids | $858.00 | ↓ -19% |
| Geisinger | All_Plans | $858.00 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $858.00 | ↓ -19% |
| PHC | All_Plans | $924.00 | ↓ -13% |
| Highmark | My_Direct_Blue | $1,077.80 | ↑ +2% |
| Highmark | My_Priority_Blue_Flex | $1,077.80 | ↑ +2% |
| Highmark | Choice_Blue_PPO | $1,118.19 | ↑ +6% |
| Highmark | Performance_Blue | $1,118.19 | ↑ +6% |
| Highmark | Blue_Cross_High_Performance_Network | $1,118.19 | ↑ +6% |
| United_Healthcare | All_Plans | $1,244.76 | ↑ +18% |
| Highmark | All_Other_Plans | $1,347.23 | ↑ +28% |
| Aetna | All_Plans | $8,754.00 | ↑ +729% |
| First_Health_Network | All_Plans | $9,629.00 | ↑ +812% |
Visitor-reported prices
Comments
Pr incision & drainage abscess vulva/perineal at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $93.81 – $4,246.40 |
| UPMC Bedford | Everett | $4,303.80 | $98.50 – $6,455.70 |
| UPMC Carlisle | Carlisle | $831.60 | $119.14 – $1,178.10 |
| UPMC Cole | Coudersport | $1,693.20 | $91.75 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $831.60 | $119.14 – $2,316.05 |
| UPMC East | Monroeville | $3,055.20 | $103.19 – $4,073.60 |
| UPMC Hamot | Erie | $3,124.20 | $103.19 – $729.80 |
| UPMC Northwest | Seneca | $2,183.40 | $103.19 – $304.51 |