CMS Price Transparency Data

X-ray, hip

Facility: Wellspan Ephrata Community Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $324
Cash Discount Price: $630
vs. Medicare Baseline: 3.64x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Wellspan Ephrata Community Hospital is $324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $630. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.64x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.

Cash / Self-Pay

$630

Average discount available for prompt cash payment at this facility.

Insurance Median

$324

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $630 (709%)

Insurance Median: $324 (364%)

Cash: $630 (709% of Medicare)

Ins. Median: $324 (364% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 364% of the Medicare baseline (a markup of 264%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$28 - $149	31%
Medicare (plans)	$86 - $139	97%
Aetna	$88 - $609	99%
Wellspan_Capital_Blue_Cross	$108	121%
Highmark	$132 - $390	148%
Blue_Cross	$355 - $507	399%
Cigna	$464 - $502	522%
United_Healthcare	$498	560%
Geisinger	$512	576%
Independence_Blue_Cross	$512	576%
Tower Health	$512 - $539	576%
Upmc	$512 - $630	576%
Phc	$551 - $559	620%
First_Health_Network	$670	754%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $630.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Wellspan Ephrata Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73502.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.