Biopsy abdominal mass at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$1,224.60
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.
$2,041.00
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.
$80.97 with Aetna vs $1,868.13 with UPMC Health Plan — 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 | $80.97 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $85.02 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $89.07 | ↓ -93% |
| Geisinger | Medicaid | $112.54 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.08 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $122.10 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.40 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $137.99 | ↓ -89% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $545.04 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $650.93 | ↓ -47% |
| Preferred Healthcare System | PPO | $1,020.50 | ↓ -17% |
| Cigna | Commercial | $1,020.50 | ↓ -17% |
| United Healthcare | Commercial | $1,046.22 | ↓ -15% |
| Aetna | Commercial | $1,081.73 | ↓ -12% |
| Geisinger | Commercial | $1,122.55 | ↓ -8% |
| UPMC Health Plan | Managed Medicare | $1,575.29 | ↑ +29% |
| UPMC Health Plan | Partners/Select | $1,601.24 | ↑ +31% |
| Private Health Care Systems | PPO | $1,632.80 | ↑ +33% |
| United Healthcare | Medicare | $1,652.83 | ↑ +35% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↑ +36% |
| AmeriHealth Caritas | Medicare | $1,668.28 | ↑ +36% |
| Cigna | Medicare | $1,668.28 | ↑ +36% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.28 | ↑ +36% |
| UPMC Health Plan | CHIP | $1,714.50 | ↑ +40% |
| UPMC Health Plan | Commercial | $1,868.13 | ↑ +53% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Biopsy abdominal mass at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,461.20 | $102.83 – $3,486.70 |
| UPMC Community Osteopathic | Harrisburg | $2,461.20 | $102.83 – $3,486.70 |
| UPMC East | Monroeville | $1,689.60 | $89.07 – $2,252.80 |
| UPMC Hamot | Erie | $2,312.40 | $89.07 – $2,246.66 |
| UPMC Northwest | Seneca | $2,419.20 | $89.07 – $1,621.93 |
| UPMC Hanover | Hanover | $2,461.20 | $102.83 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $2,304.60 | $89.07 – $1,668.28 |
| UPMC Jameson | New Castle | $2,304.60 | $89.07 – $2,085.34 |