Ercp remove duct calculi 43264 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$3,517.80
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.
$5,863.00
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.
$729.80 with Highmark BCBS of PA vs $4,690.40 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 | $729.80 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $1,617.74 | ↓ -54% |
| UPMC Health Plan | CHIP | $2,315.38 | ↓ -34% |
| UPMC Health Plan | Commercial | $2,522.85 | ↓ -28% |
| Cigna | Commercial | $2,931.50 | ↓ -17% |
| Preferred Healthcare System | PPO | $2,931.50 | ↓ -17% |
| United Healthcare | Commercial | $3,005.37 | ↓ -15% |
| Aetna | Commercial | $3,107.39 | ↓ -12% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,224.65 | ↓ -8% |
| Geisinger | Commercial | $3,224.65 | ↓ -8% |
| Geisinger | Medicaid | $3,224.65 | ↓ -8% |
| UPMC Health Plan | Managed Medicare | $3,698.98 | ↑ +5% |
| UPMC Health Plan | Partners/Select | $3,759.91 | ↑ +7% |
| United Healthcare | Medicare | $3,881.06 | ↑ +10% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,917.33 | ↑ +11% |
| Cigna | Medicare | $3,917.33 | ↑ +11% |
| AmeriHealth Caritas | Medicare | $3,917.33 | ↑ +11% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,917.33 | ↑ +11% |
| Private Health Care Systems | PPO | $4,690.40 | ↑ +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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Ercp remove duct calculi 43264 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,546.20 | $1,016.56 – $6,440.45 |
| UPMC Cole | Coudersport | $1,431.00 | $661.12 – $1,908.00 |
| UPMC Community Osteopathic | Harrisburg | $4,546.20 | $1,016.56 – $6,440.45 |
| UPMC East | Monroeville | $3,055.20 | $736.75 – $4,073.60 |
| UPMC Hamot | Erie | $4,144.80 | $729.80 – $5,275.45 |
| UPMC Hanover | Hanover | $4,546.20 | $1,016.56 – $5,815.15 |
| UPMC Jameson | New Castle | $2,311.20 | $742.68 – $4,896.67 |
| UPMC Lititz | Lititz | $4,546.20 | $1,016.56 – $5,846.56 |