Prq trluml revsc ch occ ant at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$34,973.60
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.
$43,717.00
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.
$674.98 with Highmark_Wholecare_Gateway_Medicaid vs $50,225.89 with Highmark — 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_Wholecare_Gateway_Medicaid | All_Plans | $674.98 | ↓ -98% |
| Aetna_Better_Health_Kids | All_Plans | $1,835.93 | ↓ -95% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $7,694.19 | ↓ -78% |
| Highmark_Medicare | All_Plans | $11,062.25 | ↓ -68% |
| Aetna_Advantra_Medicare | All_Plans | $11,281.30 | ↓ -68% |
| Aetna_Medicare | All_Plans | $11,281.30 | ↓ -68% |
| Health_Partners_Medicaid | All_Other_Plans | $11,340.57 | ↓ -68% |
| Devoted_Medicare | All_Plans | $11,500.36 | ↓ -67% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $11,500.36 | ↓ -67% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $11,500.36 | ↓ -67% |
| United_Medicare | ISNP_DSNP_Plans | $11,500.36 | ↓ -67% |
| Geisinger_Gold_Medicare | All_Plans | $11,500.36 | ↓ -67% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $11,549.64 | ↓ -67% |
| Amerihealth_Medicare | All_Plans | $11,555.12 | ↓ -67% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $11,828.94 | ↓ -66% |
| PA_Health_&_Wellness_Medicare | All_Plans | $11,828.94 | ↓ -66% |
| Highmark | Higmark_Healthy_Kids | $17,004.10 | ↓ -51% |
| Health_Partners_Medicaid | Kidz_Partners | $18,071.99 | ↓ -48% |
| United_Medicaid | Community_Plan_For_Kids | $19,167.26 | ↓ -45% |
| Blue_Cross | Capital_Cares_4_kids | $19,701.50 | ↓ -44% |
| Cigna | All_Plans | $26,614.91 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $27,978.88 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $28,145.00 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $28,145.00 | ↓ -20% |
| Tower Health | All_Plans | $28,416.05 | ↓ -19% |
| UPMC | Employees_And_Dependents | $28,416.05 | ↓ -19% |
| UPMC | UPMC_For_Kids | $28,416.05 | ↓ -19% |
| Geisinger | All_Plans | $28,416.05 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $28,416.05 | ↓ -19% |
| Aetna | All_Plans | $29,397.00 | ↓ -16% |
| PHC | All_Plans | $30,601.90 | ↓ -13% |
| First_Health_Network | All_Plans | $32,336.00 | ↓ -8% |
| Highmark | My_Priority_Blue_Flex | $40,181.15 | ↑ +15% |
| Highmark | My_Direct_Blue | $40,181.15 | ↑ +15% |
| United_Healthcare | All_Plans | $41,225.13 | ↑ +18% |
| Highmark | Choice_Blue_PPO | $41,687.15 | ↑ +19% |
| Highmark | Performance_Blue | $41,687.15 | ↑ +19% |
| Highmark | Blue_Cross_High_Performance_Network | $41,687.15 | ↑ +19% |
| Highmark | All_Other_Plans | $50,225.89 | ↑ +44% |
Visitor-reported prices
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Prq trluml revsc ch occ ant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $10,183.20 | $575.52 – $13,576.80 |
| UPMC Carlisle | Carlisle | $15,411.00 | $1,008.17 – $21,832.25 |
| UPMC Community Osteopathic | Harrisburg | $15,411.00 | $1,008.17 – $21,832.25 |
| UPMC East | Monroeville | $24,012.00 | $581.00 – $32,016.00 |
| UPMC Hanover | Hanover | $15,411.00 | $1,008.17 – $17,333.84 |
| UPMC Lititz | Lititz | $15,411.00 | $1,008.17 – $17,427.46 |
| UPMC McKeesport | Mckeesport | $23,637.00 | $581.00 – $963.36 |
| UPMC Memorial | York | $15,411.00 | $469.07 – $17,399.15 |