Rmvl pm gen w/rplc pm gen sgl lead sys at WellSpan Ephrata Community Hospital
169 Martin Ave, Ephrata, PA · Wellspan · · NPI 1083615587
$13,512.80
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.
$16,891.00
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.
$337.09 with Highmark_Wholecare_Gateway_Medicaid vs $36,653.22 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 | $337.09 | ↓ -98% |
| Aetna_Better_Health_Kids | All_Plans | $916.88 | ↓ -93% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $2,972.82 | ↓ -78% |
| Blue_Cross | Capital_Cares_4_kids | $7,612.10 | ↓ -44% |
| Highmark_Medicare | All_Plans | $8,072.87 | ↓ -40% |
| Aetna_Medicare | All_Plans | $8,232.73 | ↓ -39% |
| Aetna_Advantra_Medicare | All_Plans | $8,232.73 | ↓ -39% |
| Health_Partners_Medicaid | All_Other_Plans | $8,275.98 | ↓ -39% |
| United_Medicare | ISNP_DSNP_Plans | $8,392.59 | ↓ -38% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $8,392.59 | ↓ -38% |
| Geisinger_Gold_Medicare | All_Plans | $8,392.59 | ↓ -38% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $8,392.59 | ↓ -38% |
| Devoted_Medicare | All_Plans | $8,392.59 | ↓ -38% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $8,428.56 | ↓ -38% |
| Amerihealth_Medicare | All_Plans | $8,432.55 | ↓ -38% |
| PA_Health_&_Wellness_Medicare | All_Plans | $8,632.38 | ↓ -36% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $8,632.38 | ↓ -36% |
| Cigna | All_Plans | $10,283.24 | ↓ -24% |
| Aetna | All_Plans | $10,638.00 | ↓ -21% |
| WellSpan_Capital_Blue_Cross | All_Plans | $10,810.24 | ↓ -20% |
| Blue_Cross | All_Other_Plans | $10,874.43 | ↓ -20% |
| Blue_Cross | Capital_Blue_Performance_PPO | $10,874.43 | ↓ -20% |
| Tower Health | All_Plans | $10,979.15 | ↓ -19% |
| Geisinger | All_Plans | $10,979.15 | ↓ -19% |
| UPMC | UPMC_For_Kids | $10,979.15 | ↓ -19% |
| UPMC | Employees_And_Dependents | $10,979.15 | ↓ -19% |
| Independence_Blue_Cross | All_Plans | $10,979.15 | ↓ -19% |
| First_Health_Network | All_Plans | $11,702.00 | ↓ -13% |
| PHC | All_Plans | $11,823.70 | ↓ -13% |
| Highmark | Higmark_Healthy_Kids | $12,409.04 | ↓ -8% |
| Health_Partners_Medicaid | Kidz_Partners | $13,188.35 | ↓ -2% |
| United_Medicaid | Community_Plan_For_Kids | $13,987.65 | ↑ +4% |
| United_Healthcare | All_Plans | $15,928.21 | ↑ +18% |
| Highmark | My_Priority_Blue_Flex | $29,322.90 | ↑ +117% |
| Highmark | My_Direct_Blue | $29,322.90 | ↑ +117% |
| Highmark | Choice_Blue_PPO | $30,421.93 | ↑ +125% |
| Highmark | Performance_Blue | $30,421.93 | ↑ +125% |
| Highmark | Blue_Cross_High_Performance_Network | $30,421.93 | ↑ +125% |
| Highmark | All_Other_Plans | $36,653.22 | ↑ +171% |
Visitor-reported prices
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Rmvl pm gen w/rplc pm gen sgl lead sys at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,816.40 | $429.35 – $8,521.36 |
| UPMC Carlisle | Carlisle | $17,467.80 | $520.11 – $24,746.05 |
| UPMC Community Osteopathic | Harrisburg | $17,467.80 | $520.11 – $24,746.05 |
| UPMC Hamot | Erie | $8,749.20 | $429.35 – $11,475.67 |
| UPMC Hanover | Hanover | $17,467.80 | $520.11 – $1,016.56 |
| UPMC Lititz | Lititz | $17,467.80 | $362.74 – $1,016.56 |
| UPMC Memorial | York | $17,467.80 | $349.93 – $1,016.56 |
| UPMC Mercy | Pittsburgh | $27,025.20 | $429.35 – $8,679.17 |