Repair rpr lip full thickness vermilion only at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$1,176.00
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.
$1,470.00
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.
$258.72 with Blue_Cross_BlueJourney_Medicare vs $2,255.38 with Highmark — 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 |
|---|---|---|---|
| Blue_Cross_BlueJourney_Medicare | All_Plans | $258.72 | ↓ -78% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $311.16 | ↓ -74% |
| Health_Partners_Medicaid | All_Other_Plans | $311.16 | ↓ -74% |
| UPMC_Medicaid | All_Plans | $311.16 | ↓ -74% |
| Geisinger_Medicaid | All_Plans | $311.16 | ↓ -74% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $311.16 | ↓ -74% |
| Amerihealth_Caritas_Medicaid | All_Plans | $353.48 | ↓ -70% |
| Highmark_Medicare | All_Plans | $496.75 | ↓ -58% |
| Aetna_Medicare | All_Plans | $506.58 | ↓ -57% |
| Aetna_Advantra_Medicare | All_Plans | $506.58 | ↓ -57% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $516.42 | ↓ -56% |
| Devoted_Medicare | All_Plans | $516.42 | ↓ -56% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $516.42 | ↓ -56% |
| United_Medicare | ISNP_DSNP_Plans | $516.42 | ↓ -56% |
| Geisinger_Gold_Medicare | All_Plans | $516.42 | ↓ -56% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $518.63 | ↓ -56% |
| Amerihealth_Medicare | All_Plans | $518.88 | ↓ -56% |
| PA_Health_&_Wellness_Medicare | All_Plans | $531.18 | ↓ -55% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $531.18 | ↓ -55% |
| Blue_Cross | Capital_Cares_4_kids | $662.47 | ↓ -44% |
| Highmark | Higmark_Healthy_Kids | $763.57 | ↓ -35% |
| Health_Partners_Medicaid | Kidz_Partners | $811.52 | ↓ -31% |
| Aetna_Better_Health_Kids | All_Plans | $846.36 | ↓ -28% |
| United_Medicaid | Community_Plan_For_Kids | $860.70 | ↓ -27% |
| Cigna | All_Plans | $894.94 | ↓ -24% |
| WellSpan_Capital_Blue_Cross | All_Plans | $940.80 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $946.39 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $946.39 | ↓ -20% |
| Tower Health | All_Plans | $955.50 | ↓ -19% |
| UPMC | Employees_And_Dependents | $955.50 | ↓ -19% |
| UPMC | UPMC_For_Kids | $955.50 | ↓ -19% |
| Geisinger | All_Plans | $955.50 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $955.50 | ↓ -19% |
| PHC | All_Plans | $1,029.00 | ↓ -13% |
| Aetna | All_Plans | $1,137.78 | ↓ -3% |
| First_Health_Network | All_Plans | $1,250.97 | ↑ +6% |
| United_Healthcare | All_Plans | $1,386.21 | ↑ +18% |
| Highmark | My_Direct_Blue | $1,804.33 | ↑ +53% |
| Highmark | My_Priority_Blue_Flex | $1,804.33 | ↑ +53% |
| Highmark | Blue_Cross_High_Performance_Network | $1,871.95 | ↑ +59% |
| Highmark | Choice_Blue_PPO | $1,871.95 | ↑ +59% |
| Highmark | Performance_Blue | $1,871.95 | ↑ +59% |
| Highmark | All_Other_Plans | $2,255.38 | ↑ +92% |
Visitor-reported prices
Comments
Repair rpr lip full thickness vermilion only at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $993.00 | $226.74 – $1,406.75 |
| UPMC Community Osteopathic | Harrisburg | $993.00 | $316.14 – $2,637.49 |
| UPMC Hamot | Erie | $3,558.60 | $273.82 – $1,188.02 |
| UPMC Hanover | Hanover | $993.00 | $316.14 – $1,443.91 |
| UPMC Jameson | New Castle | $1,159.80 | $273.82 – $1,379.73 |
| UPMC Lititz | Lititz | $993.00 | $316.14 – $1,016.56 |
| UPMC Memorial | York | $993.00 | $316.14 – $1,443.91 |
| UPMC Mercy | Pittsburgh | $2,097.00 | $273.82 – $857.21 |