Tonsillectomy (age 12+) at WellSpan Evangelical Community Hospital
1 Hospital Drive, Lewisburg, PA · Wellspan · · NPI 1124076039
not published by hospital
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.
not published by hospital
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.
$853.60 with UPMC_Medicaid vs $13,307.93 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 |
|---|---|---|---|
| UPMC_Medicaid | All_Plans | $853.60 | — |
| Amerihealth_Caritas_Medicaid | All_Plans | $915.68 | — |
| Health_Partners_Medicaid | All_Plans | $970.00 | — |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $970.00 | — |
| Geisinger_Medicaid | All_Plans | $1,006.86 | — |
| PA_Health_&_Wellness_Medicaid | All_Plans | $1,008.80 | — |
| UPMC | UPMC_For_Kids | $1,008.80 | — |
| Aetna | All_Plans | $3,119.90 | — |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $3,119.90 | — |
| First_Health_Network | All_Plans | $3,119.90 | — |
| Highmark_Medicare | All_Plans | $3,151.10 | — |
| Aetna_Advantra_Medicare | All_Plans | $3,182.30 | — |
| Humana_Medicare | All_Plans | $3,182.30 | — |
| Geisinger_Gold_Medicare | All_Plans | $3,213.50 | — |
| Amerihealth_Medicare | All_Plans | $3,244.70 | — |
| UPMC_for_Life_Community_HealthChoices | UPMC_for_Life_Complete_Care | $3,275.90 | — |
| Devoted_Medicare | All_Plans | $3,275.90 | — |
| United_Medicare | ISNP_DSNP_Plans | $3,275.90 | — |
| Jefferson_Health_Medicare_Advantage | All_Plans | $3,369.49 | — |
| PA_Health_&_Wellness_Medicare | All_Plans | $3,369.49 | — |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $3,494.29 | — |
| Highmark | Higmark_Healthy_Kids | $4,679.85 | — |
| United_Medicaid | Community_Plan_For_Kids | $5,459.83 | — |
| UPMC | All_Plans | $5,979.33 | — |
| Geisinger | All_Plans | $10,185.54 | — |
| Blue_Cross | All_Other_Plans | $11,091.00 | — |
| Blue_Cross | Capital_Cares_4_kids | $11,091.00 | — |
| Performance_Blue | Blue_Cross_High_Performance_Network | $11,977.30 | — |
| Highmark | All_Other_Plans | $13,307.93 | — |
| United_Healthcare | All_Plans | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $461.40 | $213.17 – $1,470.59 |
| Uniontown Hospital | Uniontown | $2,425.00 | $205.80 – $6,674.52 |
| UPMC Altoona | Altoona | not published | $671.46 – $3,339.23 |
| UPMC Bedford | Everett | not published | $671.46 – $3,339.23 |
| UPMC Community Osteopathic | Harrisburg | not published | $711.55 – $7,348.95 |
| UPMC East | Monroeville | not published | $725.80 – $3,401.07 |
| UPMC Hamot | Erie | not published | $725.80 – $4,496.91 |
| UPMC Northwest | Seneca | not published | $679.92 – $3,339.23 |