Duplex scan unilateral study 93986 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$493.80
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.
$823.00
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.
$76.53 with Highmark BCBS of PA vs $658.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $76.53 | ↓ -85% |
| Aetna | Medicaid | $99.03 | ↓ -80% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $103.98 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $108.93 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $127.42 | ↓ -74% |
| Geisinger | Medicaid | $137.64 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicaid | $146.86 | ↓ -70% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $149.34 | ↓ -70% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $154.60 | ↓ -69% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $168.77 | ↓ -66% |
| UPMC Health Plan | CHIP | $288.05 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $411.50 | ↓ -17% |
| Cigna | Commercial | $411.50 | ↓ -17% |
| Preferred Healthcare System | PPO | $411.50 | ↓ -17% |
| UPMC Health Plan | Commercial | $411.50 | ↓ -17% |
| United Healthcare | Commercial | $421.87 | ↓ -15% |
| Aetna | Commercial | $436.19 | ↓ -12% |
| Geisinger | Commercial | $452.65 | ↓ -8% |
| Private Health Care Systems | PPO | $658.40 | ↑ +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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Duplex scan unilateral study 93986 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $406.20 | $36.58 – $609.30 |
| UPMC Carlisle | Carlisle | $375.60 | $85.76 – $532.10 |
| UPMC Community Osteopathic | Harrisburg | $375.60 | $103.55 – $532.10 |
| UPMC East | Monroeville | $395.40 | $77.26 – $527.20 |
| UPMC Hamot | Erie | $615.00 | $76.53 – $179.75 |
| UPMC Northwest | Seneca | $831.00 | $91.94 – $157.82 |
| UPMC Hanover | Hanover | $375.60 | $100.57 – $165.16 |
| UPMC Horizon-Greenville | Greenville | $697.20 | $90.77 – $185.61 |