healthcosts.net
Established Patient Office Visit (level 3) at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$230.40
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.
?
What you pay up front if you don't use insurance.
$384.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$20.00 with Aetna vs $307.20 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $20.00 | ↓ -91% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $21.00 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $22.00 | ↓ -90% |
| Geisinger | Medicaid | $27.80 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.66 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $30.16 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.22 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $34.08 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $53.87 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $82.05 | ↓ -64% |
| UPMC Health Plan | CHIP | $155.85 | ↓ -32% |
| Cigna | Commercial | $192.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $192.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $192.00 | ↓ -17% |
| Aetna | Commercial | $203.52 | ↓ -12% |
| Geisinger | Commercial | $211.20 | ↓ -8% |
| Private Health Care Systems | PPO | $307.20 | ↑ +33% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $179.40 | $38.50 – $254.15 |
| UPMC East | Monroeville | $186.60 | $36.08 – $248.80 |
| UPMC Bedford | Everett | $121.20 | $36.08 – $181.80 |
| UPMC Cole | Coudersport | $183.00 | $36.75 – $128.00 |
| UPMC Hamot | Erie | $156.60 | $38.50 – $182.70 |
| UPMC Community Osteopathic | Harrisburg | $240.60 | $20.60 – $288.22 |
| UPMC Hanover | Hanover | $61.80 | $19.57 – $89.61 |
| UPMC Horizon-Greenville | Greenville | $216.00 | $36.75 – $306.00 |