Wellspan Health · Ephrata, PA
38
In-network payers
356
Disclosed rate categories
141
Beds
4
Care quality
Wellspan Ephrata Community Hospital is a 141-bed voluntary non-profit - other hospital in Ephrata, PA, affiliated with Wellspan Health. Below you'll find publicly disclosed negotiated rates and facility details, including 38 in-network payers and 356 disclosed rate categories.
CCN (Medicare provider number)
390225
NPI
1083615587
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Other
Beds
141
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Wellspan Ephrata Community Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$9,900 - $15,900
from 4 insurers · median $15,117
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$12,218 - $28,500
from 4 insurers · median $20,697
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Gynecology
CPT 58558
$10,638 - $14,670
from 2 insurers · median $12,654
17 Medicare claims in Level 4 Gynecologic Procedures (CMS 2024)
Medicine & Surgery · Inpatient
MS-DRG 460
$70,671 - $85,041
from 3 insurers · median $79,339
16 Medicare discharges for this DRG in CMS hospital data
Medicine & Surgery
CPT 47562
$10,112 - $45,174
from 2 insurers · median $27,643
46 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 49505
$9,047 - $51,705
from 2 insurers · median $30,376
32 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
Digestive procedures
CPT 45385
$8,754 - $17,352
from 2 insurers · median $13,053
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$6,333 - $20,596
from 2 insurers · median $13,464
Common here, based on CMS Medicare volume
CT imaging
CPT 74177
$957 - $2,125
from 3 insurers · median $2,107
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$13,473 - $106,817
from 2 insurers · median $60,145
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$40,445 - $53,480
from 3 insurers · median $43,802
14 Medicare discharges for this DRG in CMS hospital data
Orthopedics and pain
CPT 63030
$12,393 - $127,689
from 2 insurers · median $70,041
60 Medicare claims in Level 4 Musculoskeletal Procedures (CMS 2024)
Digestive procedures
CPT 43239
$6,333 - $8,159
from 2 insurers · median $7,246
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$214 - $4,053
from 3 insurers · median $2,674
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$10,776 - $21,447
from 2 insurers · median $16,111
46 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Childbirth · Inpatient
MS-DRG 807
$9,900 - $15,900
from 4 insurers · median $15,117
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Medicine & Surgery
CPT 66984
$14,381 - $19,184
from 2 insurers · median $16,783
Typical for a hospital with this service line
CT imaging
CPT 70450
$445 - $948
from 4 insurers · median $769
Common here, based on CMS Medicare volume
Gynecology
CPT 58662
$12,393 - $84,453
from 2 insurers · median $48,423
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$548 - $8,672
from 4 insurers · median $6,187
Common here, based on CMS Medicare volume
Gynecology
CPT 58661
$12,393 - $49,229
from 2 insurers · median $30,811
Typical for a hospital with this service line
CT imaging
CPT 74176
$936 - $1,368
from 3 insurers · median $1,342
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$43 - $1,582
from 4 insurers · median $373
Common here, based on CMS Medicare volume
Urology
CPT 50590
$12,852 - $67,198
from 2 insurers · median $40,025
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 21 | 932% | 17 | 1 |
| Insurer B* | 11 | 576% | 7 | 1 |
| Insurer C* | 9 | 520% | 5 | 1 |
| Insurer D* | 24 | 247% | 8 | 12 |
How we chose these services: 7 appear in this hospital's own Medicare claims, 9 are common here based on CMS Medicare volume, and 8 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Wellspan Ephrata Community Hospital.
169 Martin Avenue, Ephrata, PA 17522
(717) 733-0311
The nearest hospitals of similar type and size. Their rates are compared with Wellspan Ephrata Community Hospital for the same insurers and services above.
Upmc Lititz
▼ Rates typically 33% lower than Wellspan Ephrata Community Hospital (19 services)
St. Joseph Medical Center
▼ Rates typically 11% lower than Wellspan Ephrata Community Hospital (21 services)
Pottstown Hospital
▼ Rates typically 65% lower than Wellspan Ephrata Community Hospital (21 services)
Upmc Memorial
▼ Rates typically 57% lower than Wellspan Ephrata Community Hospital (21 services)
Penn Medicine Chester County Hospital
▼ Rates typically 62% lower than Wellspan Ephrata Community Hospital (21 services)
Lehigh Valley Hospital - Schuylkill
▼ Rates typically 14% lower than Wellspan Ephrata Community Hospital (21 services)
Wellspan Surgery & Rehabilitation Hospital
Wellspan Good Samaritan Hospital
Wellspan York Hospital
Wellspan Gettysburg Hospital
About Wellspan Ephrata Community Hospital's rates and hospital price transparency.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Wellspan Ephrata Community Hospital range from $957 to $2,125 across 3 insurers. UnitedHealthcare's rate is $2,107. The median at nearby comparable hospitals is $1,209. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Wellspan Ephrata Community Hospital range from $8,754 to $17,352 across 2 insurers. Aetna's rate is $8,754. The median at nearby comparable hospitals is $3,609. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Wellspan Ephrata Community Hospital range from $9,900 to $15,900 across 4 insurers. Cigna's rate is $15,900. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Wellspan Ephrata Community Hospital range from $40,445 to $53,480 across 3 insurers. Aetna's rate is $43,802. The median at nearby comparable hospitals is $33,525. What a patient pays depends on their plan's deductible, coinsurance and network status.
Wellspan Ephrata Community Hospital has 141 beds. Facility type: Short Term Acute Care Hospital.
Wellspan Ephrata Community Hospital is located at 169 Martin Avenue, Ephrata, PA 17522. Its main phone number is (717) 733-0311.
Wellspan Ephrata Community Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 390225.
The National Provider Identifier (NPI) on file for Wellspan Ephrata Community Hospital is 1083615587.
Wellspan Ephrata Community Hospital is affiliated with Wellspan Health.
Wellspan Ephrata Community Hospital lists 38 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
356 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers