Prcrd drg 6+yr without anomly at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$2,207.20
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.
$2,759.00
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.
$228.24 with Health_Partners_Medicaid vs $15,600.00 with Aetna — 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 | $228.24 | ↓ -90% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $239.65 | ↓ -89% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $239.65 | ↓ -89% |
| United_Medicare | ISNP_DSNP_Plans | $239.65 | ↓ -89% |
| Devoted_Medicare | All_Plans | $239.65 | ↓ -89% |
| Geisinger_Gold_Medicare | All_Plans | $239.65 | ↓ -89% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $240.68 | ↓ -89% |
| Amerihealth_Medicare | All_Plans | $240.79 | ↓ -89% |
| PA_Health_&_Wellness_Medicare | All_Plans | $246.50 | ↓ -89% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $246.50 | ↓ -89% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $251.34 | ↓ -89% |
| Health_Partners_Medicaid | Kidz_Partners | $376.60 | ↓ -83% |
| United_Medicaid | Community_Plan_For_Kids | $399.42 | ↓ -82% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $485.58 | ↓ -78% |
| Aetna_Better_Health_Kids | All_Plans | $683.64 | ↓ -69% |
| Blue_Cross | Capital_Cares_4_kids | $1,243.37 | ↓ -44% |
| Cigna | All_Plans | $1,679.68 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $1,765.76 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $1,776.24 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $1,776.24 | ↓ -20% |
| Tower Health | All_Plans | $1,793.35 | ↓ -19% |
| UPMC | Employees_And_Dependents | $1,793.35 | ↓ -19% |
| UPMC | UPMC_For_Kids | $1,793.35 | ↓ -19% |
| Geisinger | All_Plans | $1,793.35 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $1,793.35 | ↓ -19% |
| PHC | All_Plans | $1,931.30 | ↓ -13% |
| First_Health_Network | All_Plans | $2,347.91 | ↑ +6% |
| United_Healthcare | All_Plans | $2,601.74 | ↑ +18% |
| Aetna | All_Plans | $15,600.00 | ↑ +607% |
Visitor-reported prices
Comments
Prcrd drg 6+yr without anomly at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,462.60 | $140.69 – $4,616.80 |
| UPMC Carlisle | Carlisle | $2,473.20 | $263.40 – $3,503.70 |
| UPMC Community Osteopathic | Harrisburg | $2,473.20 | $263.40 – $3,503.70 |
| UPMC East | Monroeville | $3,082.80 | $142.03 – $4,110.40 |
| UPMC Hamot | Erie | $3,152.40 | $140.69 – $603.43 |
| UPMC Northwest | Seneca | $3,943.80 | $303.07 – $365.15 |
| UPMC Hanover | Hanover | $2,473.20 | $263.40 – $317.17 |
| UPMC Horizon-Greenville | Greenville | $2,751.00 | $273.71 – $303.07 |