Bx breast add lesion strtctc at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$2,923.20
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.
$4,872.00
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.
$70.38 with Aetna vs $3,897.60 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 | $70.38 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $73.90 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $77.42 | ↓ -97% |
| Geisinger | Medicaid | $97.82 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $104.37 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $106.13 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $109.87 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $119.94 | ↓ -96% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $378.58 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $721.00 | ↓ -75% |
| UPMC Health Plan | CHIP | $778.90 | ↓ -73% |
| UPMC Health Plan | Commercial | $848.70 | ↓ -71% |
| Cigna | Commercial | $2,436.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,436.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $2,436.00 | ↓ -17% |
| United Healthcare | Commercial | $2,497.39 | ↓ -15% |
| Aetna | Commercial | $2,582.16 | ↓ -12% |
| Geisinger | Commercial | $2,679.60 | ↓ -8% |
| Private Health Care Systems | PPO | $3,897.60 | ↑ +33% |
Visitor-reported prices
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Bx breast add lesion strtctc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,135.20 | $89.38 – $9,539.00 |
| UPMC Cole | Coudersport | $337.80 | $73.90 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $1,135.20 | $92.20 – $1,608.20 |
| UPMC Hamot | Erie | $7,023.60 | $77.42 – $721.00 |
| UPMC Northwest | Seneca | $5,112.00 | $77.42 – $982.57 |
| UPMC Hanover | Hanover | $1,135.20 | $89.38 – $754.53 |
| UPMC Horizon-Greenville | Greenville | $4,273.80 | $73.90 – $736.51 |
| UPMC Jameson | New Castle | $3,612.00 | $72.00 – $721.00 |