Close lac/mouth vest/2.5 cm or < 40830 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$530.40
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.
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What you pay up front if you don't use insurance.
$884.00
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.
$31.50 with Aetna vs $707.20 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 | $31.50 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $33.08 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $34.65 | ↓ -93% |
| Geisinger | Medicaid | $43.78 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $46.71 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $47.50 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $49.17 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $53.68 | ↓ -90% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $130.12 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $208.99 | ↓ -61% |
| UPMC Health Plan | Managed Medicare | $225.77 | ↓ -57% |
| UPMC Health Plan | Partners/Select | $229.49 | ↓ -57% |
| United Healthcare | Medicare | $236.89 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $239.10 | ↓ -55% |
| Cigna | Medicare | $239.10 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $239.10 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $239.10 | ↓ -55% |
| UPMC Health Plan | CHIP | $401.80 | ↓ -24% |
| UPMC Health Plan | Commercial | $437.80 | ↓ -17% |
| Cigna | Commercial | $442.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $442.00 | ↓ -17% |
| United Healthcare | Commercial | $453.14 | ↓ -15% |
| Aetna | Commercial | $468.52 | ↓ -12% |
| Geisinger | Commercial | $486.20 | ↓ -8% |
| Private Health Care Systems | PPO | $707.20 | ↑ +33% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Close lac/mouth vest/2.5 cm or < 40830 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $898.20 | $33.08 – $1,347.30 |
| UPMC Carlisle | Carlisle | $777.60 | $40.01 – $1,101.60 |
| UPMC Community Osteopathic | Harrisburg | $777.60 | $40.01 – $1,101.60 |
| UPMC East | Monroeville | $660.00 | $34.65 – $880.00 |
| UPMC Hamot | Erie | $496.80 | $34.65 – $322.01 |
| UPMC Northwest | Seneca | $388.80 | $34.65 – $232.46 |
| UPMC Hanover | Hanover | $777.60 | $40.01 – $645.83 |
| UPMC Horizon-Greenville | Greenville | $550.80 | $34.65 – $253.13 |