CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$22,849
about 1.6× the $14,044 Medicare rate · typically $15,879–$36,802
modeled estimate · not a bill or quote
What this hospital charges insurers
$26,365
Above the fair price
about $3,516 over the fair price · 1.9× Medicare
Medicare pays $14,044 Fair price $22,849 This hospital $26,365

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $13,221 Priciest $26,365

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $22,849 (about 1.6× the $14,044 Medicare rate). Wellspan Ephrata Community Hospital charges insurers about $26,365 — above the fair price. Located in Ephrata, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $22,849. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $40,445 288%
Blue Cross Blue Shieldmajor $20,127 - $31,765 143%
Aetnamajor $13,353 - $45,958 95%
Geisinger $46,005 328%
Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

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