Clsd tx trimall ankle fx without manip 27816 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$3,505.20
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.
$5,842.00
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.
$233.23 with UPMC Health Plan vs $4,673.60 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicare | $233.23 | ↓ -93% |
| UPMC Health Plan | Partners/Select | $237.07 | ↓ -93% |
| United Healthcare | Medicare | $244.71 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $247.00 | ↓ -93% |
| Cigna | Medicare | $247.00 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $247.00 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.00 | ↓ -93% |
| 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 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $731.96 | ↓ -79% |
| UPMC Health Plan | CHIP | $1,712.37 | ↓ -51% |
| UPMC Health Plan | Commercial | $1,865.81 | ↓ -47% |
| Cigna | Commercial | $2,921.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $2,921.00 | ↓ -17% |
| United Healthcare | Commercial | $2,994.61 | ↓ -15% |
| Aetna | Commercial | $3,096.26 | ↓ -12% |
| Geisinger | Medicaid | $3,213.10 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,213.10 | ↓ -8% |
| Geisinger | Commercial | $3,213.10 | ↓ -8% |
| Private Health Care Systems | PPO | $4,673.60 | ↑ +33% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Clsd tx trimall ankle fx without manip 27816 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $3,647.40 | $82.51 – $5,471.10 |
| UPMC Carlisle | Carlisle | $488.40 | $111.52 – $1,016.56 |
| UPMC Cole | Coudersport | $1,266.00 | $66.81 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $488.40 | $162.80 – $1,712.37 |
| UPMC East | Monroeville | $2,812.80 | $229.32 – $3,750.40 |
| UPMC Hamot | Erie | $2,223.60 | $263.94 – $755.74 |
| UPMC Hanover | Hanover | $488.40 | $226.87 – $1,712.37 |
| UPMC Jameson | New Castle | $379.80 | $228.70 – $892.40 |