CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Wellspan Ephrata Community Hospital
Billing Code: 99203 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$152
about 1.3× the $118 Medicare rate · typically $72–$442
modeled estimate · not a bill or quote
Medicare pays $118 Fair price $152 Cash price $210 Hospital's list price $262
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 | $144 - $350 | 122% |
| Blue Cross Blue Shieldmajor | $98 - $571 | 83% |
| Aetnamajor | $136 | 116% |
| Cignamajor | $98 - $237 | 83% |
| Geisinger | $99 - $241 | 84% |
| UPMC Health Plan | $99 - $297 | 84% |
| + 1 smaller / regional plan | $99 - $254 |
Government programs also on file: Medicare, Medicaid.
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Other Procedures at Wellspan Ephrata Community Hospital
Compare: New patient office visit (30-44 min) at other PA hospitals
- Penn State Health St. Joseph · Reading $25
- Surgical Institute of Reading · Wyomissing $54
- UPMC Altoona · Altoona $57
- Lower Bucks Hospital · Bristol $58
- Roxborough Memorial Hospital · Philadelphia $58
- UPMC Wellsboro · Wellsboro $60
- Geisinger-Community Medical Center · Scranton $64
- Geisinger-Bloomsburg Hospital · Bloomsburg $64
Insurance negotiated median for the same procedure, sorted lowest first.