Aqua therapy w/exercise/ea 15 min 97113 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$126.00
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.
$210.00
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.
$9.60 with Aetna vs $168.00 with Private Health Care Systems — 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 |
|---|---|---|---|
| Aetna | Medicaid | $9.60 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $10.08 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $10.56 | ↓ -92% |
| Geisinger | Medicaid | $13.34 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.24 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $14.48 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $14.99 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $16.36 | ↓ -87% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $25.48 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $55.93 | ↓ -56% |
| UPMC Health Plan | CHIP | $86.63 | ↓ -31% |
| UPMC Health Plan | Commercial | $94.39 | ↓ -25% |
| Cigna | Commercial | $105.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $105.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $105.00 | ↓ -17% |
| United Healthcare | Commercial | $107.65 | ↓ -15% |
| Aetna | Commercial | $111.30 | ↓ -12% |
| Geisinger | Commercial | $115.50 | ↓ -8% |
| Private Health Care Systems | PPO | $168.00 | ↑ +33% |
Visitor-reported prices
Comments
Aqua therapy w/exercise/ea 15 min 97113 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $69.60 | $10.96 – $387.00 |
| UPMC Cole | Coudersport | $98.40 | $10.08 – $131.20 |
| UPMC East | Monroeville | $110.40 | $10.56 – $147.20 |
| UPMC Hanover | Hanover | $69.60 | $12.19 – $148.00 |
| UPMC Kane | Kane | $72.00 | $10.56 – $154.77 |
| UPMC Lititz | Lititz | $48.00 | $12.19 – $148.00 |
| UPMC Memorial | York | $48.00 | $12.19 – $148.00 |
| UPMC Mercy | Pittsburgh | $126.60 | $10.56 – $60.66 |