Cyclosporine modified 25 mg capsule at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$12.40
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.
$15.50
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.
$0.34 with Aetna vs $2.77 with Highmark BCBS of PA — 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 | $0.34 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $0.34 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $0.37 | ↓ -97% |
| Cigna | Commercial | $0.50 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicare | $0.50 | ↓ -96% |
| Preferred Healthcare System | PPO | $0.50 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $0.51 | ↓ -96% |
| Aetna | Commercial | $0.53 | ↓ -96% |
| Geisinger | Commercial | $0.55 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.80 | ↓ -94% |
| Private Health Care Systems | PPO | $0.80 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $0.80 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $0.80 | ↓ -94% |
| Geisinger | Medicaid | $0.80 | ↓ -94% |
| UPMC Health Plan | CHIP | $0.97 | ↓ -92% |
| UPMC Health Plan | Commercial | $0.99 | ↓ -92% |
| United Healthcare | Commercial | $2.49 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2.77 | ↓ -78% |
Visitor-reported prices
Comments
Cyclosporine modified 25 mg capsule at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2.40 | $0.14 – $1.18 |
| UPMC Community Osteopathic | Harrisburg | $2.40 | $0.20 – $4.61 |
| UPMC East | Monroeville | $16.40 | $0.34 – $13.60 |
| UPMC Hamot | Erie | $20.80 | $0.34 – $2.29 |
| UPMC Northwest | Seneca | $20.20 | $0.36 – $7.19 |
| UPMC Hanover | Hanover | $2.40 | $0.34 – $1.18 |
| UPMC Horizon-Greenville | Greenville | $54.00 | $0.34 – $7.06 |
| UPMC Jameson | New Castle | $9.00 | $0.51 – $2.82 |