CMS Price Transparency Data

Blood test, thyroid (TSH)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 84443 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84443
  • Insurance Median: $63
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 3.75x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Wellspan Ephrata Community Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 3.75x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$16.8

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $16.8 (100%)
Cash / Self-Pay: $40 (238%)
Insurance Median: $63 (375%)
Cash: $40 (238% of Medicare)
Ins. Median: $63 (375% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $16.8 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 375% of the Medicare baseline (a markup of 275%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $17 - $79 101%
Medicare (plans) $17 - $21 101%
Medicaid / KanCare $23 - $29 137%
Highmark $26 - $77 155%
Wellspan_Capital_Blue_Cross $31 185%
Phc $48 - $84 286%
United_Healthcare $50 298%
Blue_Cross $54 - $77 321%
Cigna $76 - $99 452%
First_Health_Network $76 452%
Geisinger $77 458%
Independence_Blue_Cross $77 458%
Tower Health $77 - $82 458%
Upmc $77 - $95 458%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 169 Martin Avenue, Ephrata, PA 17522
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals