Repair pm/icd lead sgl at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$4,884.80
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.
$6,106.00
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.
$455.53 with Health_Partners_Medicaid vs $16,118.00 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 |
|---|---|---|---|
| Health_Partners_Medicaid | All_Other_Plans | $455.53 | ↓ -91% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $455.53 | ↓ -91% |
| UPMC_Medicaid | All_Plans | $455.53 | ↓ -91% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $455.53 | ↓ -91% |
| Geisinger_Medicaid | All_Plans | $455.53 | ↓ -91% |
| Amerihealth_Caritas_Medicaid | All_Plans | $517.48 | ↓ -89% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $1,074.66 | ↓ -78% |
| Aetna_Better_Health_Kids | All_Plans | $1,239.03 | ↓ -75% |
| Blue_Cross | Capital_Cares_4_kids | $2,751.73 | ↓ -44% |
| Highmark_Medicare | All_Plans | $3,549.99 | ↓ -27% |
| Aetna_Medicare | All_Plans | $3,620.29 | ↓ -26% |
| Aetna_Advantra_Medicare | All_Plans | $3,620.29 | ↓ -26% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $3,690.58 | ↓ -24% |
| United_Medicare | ISNP_DSNP_Plans | $3,690.58 | ↓ -24% |
| Geisinger_Gold_Medicare | All_Plans | $3,690.58 | ↓ -24% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $3,690.58 | ↓ -24% |
| Devoted_Medicare | All_Plans | $3,690.58 | ↓ -24% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $3,706.40 | ↓ -24% |
| Amerihealth_Medicare | All_Plans | $3,708.16 | ↓ -24% |
| Cigna | All_Plans | $3,717.33 | ↓ -24% |
| PA_Health_&_Wellness_Medicare | All_Plans | $3,796.03 | ↓ -22% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $3,796.03 | ↓ -22% |
| WellSpan_Capital_Blue_Cross | All_Plans | $3,907.84 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $3,931.04 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $3,931.04 | ↓ -20% |
| Tower Health | All_Plans | $3,968.90 | ↓ -19% |
| UPMC | Employees_And_Dependents | $3,968.90 | ↓ -19% |
| UPMC | UPMC_For_Kids | $3,968.90 | ↓ -19% |
| Geisinger | All_Plans | $3,968.90 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $3,968.90 | ↓ -19% |
| PHC | All_Plans | $4,274.20 | ↓ -13% |
| Highmark | Higmark_Healthy_Kids | $5,456.79 | ↑ +12% |
| United_Healthcare | All_Plans | $5,757.96 | ↑ +18% |
| Health_Partners_Medicaid | Kidz_Partners | $5,799.49 | ↑ +19% |
| United_Medicaid | Community_Plan_For_Kids | $6,150.97 | ↑ +26% |
| Aetna | All_Plans | $12,504.00 | ↑ +156% |
| Highmark | My_Direct_Blue | $12,894.54 | ↑ +164% |
| Highmark | My_Priority_Blue_Flex | $12,894.54 | ↑ +164% |
| Highmark | Choice_Blue_PPO | $13,377.83 | ↑ +174% |
| Highmark | Performance_Blue | $13,377.83 | ↑ +174% |
| Highmark | Blue_Cross_High_Performance_Network | $13,377.83 | ↑ +174% |
| First_Health_Network | All_Plans | $13,754.00 | ↑ +182% |
| Highmark | All_Other_Plans | $16,118.00 | ↑ +230% |
Visitor-reported prices
Comments
Repair pm/icd lead sgl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,523.40 | $462.81 – $6,408.15 |
| UPMC Community Osteopathic | Harrisburg | $4,523.40 | $462.81 – $6,408.15 |
| UPMC Hamot | Erie | $3,993.00 | $400.86 – $4,324.74 |
| UPMC Hanover | Hanover | $4,523.40 | $462.81 – $5,562.59 |
| UPMC Lititz | Lititz | $4,523.40 | $462.81 – $5,592.64 |
| UPMC Memorial | York | $4,523.40 | $462.81 – $5,583.55 |
| UPMC Presbyterian | Pittsburgh | $4,941.60 | $400.86 – $3,816.60 |
| UPMC Somerset | Somerset | $4,523.40 | $400.86 – $3,469.64 |