Ot evaluation low complexity patient/family at Garrett Regional Medical Center
251 N 4th St, Oakland, MD · Wvumedicine · · NPI 1598417412
not published by hospital
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$164.80
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$116.21 with caresource wv vs $129.12 with united mine workers of america — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| caresource wv | all plans | $116.21 | — |
| senior advantage | isnp | $119.18 | — |
| unitedhealthcare medicare advantage | all plans | $119.18 | — |
| provider partners | all plans | $119.18 | — |
| the health plan medicare advantage | all plans | $119.18 | — |
| united mine workers of america | retirees | $119.18 | — |
| upmc for you medicare advantage | all plans | $119.18 | — |
| vibra health plan medicare advantage | all plans | $119.18 | — |
| aetna medicare advantage | all plans | $119.18 | — |
| carefirst d-snp | all plans | $119.18 | — |
| carefirst ppo | all plans | $119.18 | — |
| highmark wv medicare advantage | all plans | $119.18 | — |
| highmark wholecare medicare advantage | all plans | $119.18 | — |
| humana military | tricare | $119.18 | — |
| humana medicare advantage | all plans | $119.18 | — |
| pa health & wellness medicare advantage | all plans | $119.18 | — |
| highmark health options wv | chip | $121.76 | — |
| aetna better health wv | chip | $121.76 | — |
| carefirst community health plan | medicaid | $121.76 | — |
| highmark health options wv | managed medicaid | $121.76 | — |
| wellpoint wv | chip | $121.76 | — |
| aetna better health maryland | medicaid | $121.76 | — |
| amerigroup | medicaid | $121.76 | — |
| the health plan of wv | chip | $121.76 | — |
| the health plan of wv | managed medicaid | $121.76 | — |
| uhc community health plan md | managed medicaid | $121.76 | — |
| wellpoint wv | managed medicaid | $121.76 | — |
| aetna better health wv | managed medicaid | $121.76 | — |
| coventry | workers comp | $121.76 | — |
| maryland physicians care | managed medicaid | $121.76 | — |
| multiplan | all plans | $122.66 | — |
| upmc commercial | all plans | $127.83 | — |
| john hopkins healthcare | all plans | $129.12 | — |
| cigna | all plans | $129.12 | — |
| cigna | rental | $129.12 | — |
| alliance coal | all plans | $129.12 | — |
| united healthcare | all plans | $129.12 | — |
| american correctional healthcare | government | $129.12 | — |
| carefirst commercial | all plans | $129.12 | — |
| first health | all plans | $129.12 | — |
| aetna | all plans | $129.12 | — |
| peak commercial | all plans | $129.12 | — |
| stratose/ 4 most | all plans | $129.12 | — |
| the health plan | peia | $129.12 | — |
| the health plan commercial | all plans | $129.12 | — |
| united mine workers of america | active employees | $129.12 | — |
Visitor-reported prices
Comments
Ot evaluation low complexity patient/family at other Maryland hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Western Maryland | Cumberland | $55.20 | $92.00 – $92.00 |