Bx breast 1st lesion mr imag at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$2,606.40
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.
?
What you pay up front if you don't use insurance.
$4,344.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$162.10 with Aetna vs $3,475.20 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $162.10 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $170.21 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $178.31 | ↓ -93% |
| Geisinger | Medicaid | $225.30 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $240.39 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $244.45 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $253.05 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $276.25 | ↓ -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 | $706.75 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $1,345.99 | ↓ -48% |
| UPMC Health Plan | Managed Medicare | $1,575.29 | ↓ -40% |
| UPMC Health Plan | Partners/Select | $1,601.24 | ↓ -39% |
| United Healthcare | Medicare | $1,652.83 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.28 | ↓ -36% |
| Cigna | Medicare | $1,668.28 | ↓ -36% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↓ -36% |
| AmeriHealth Caritas | Medicare | $1,668.28 | ↓ -36% |
| UPMC Health Plan | CHIP | $1,979.77 | ↓ -24% |
| UPMC Health Plan | Commercial | $2,157.17 | ↓ -17% |
| Cigna | Commercial | $2,172.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $2,172.00 | ↓ -17% |
| United Healthcare | Commercial | $2,226.73 | ↓ -15% |
| Aetna | Commercial | $2,302.32 | ↓ -12% |
| Geisinger | Commercial | $2,389.20 | ↓ -8% |
| Private Health Care Systems | PPO | $3,475.20 | ↑ +33% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bx breast 1st lesion mr imag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,087.40 | $205.87 – $6,413.00 |
| UPMC Community Osteopathic | Harrisburg | $2,087.40 | $218.84 – $2,957.15 |
| UPMC Hamot | Erie | $6,429.60 | $178.31 – $1,345.99 |
| UPMC Hanover | Hanover | $2,087.40 | $205.87 – $1,408.59 |
| UPMC Kane | Kane | $1,858.80 | $178.31 – $3,215.29 |
| UPMC Lititz | Lititz | $2,087.40 | $156.69 – $1,408.59 |
| UPMC Magee | Pittsburgh | $5,692.20 | $178.31 – $1,668.28 |
| UPMC Memorial | York | $2,087.40 | $156.69 – $1,408.59 |