Expl lap celiotomy w/wo bx 49000 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
not published by hospital
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.
not published by hospital
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.
$1,030.96 with Highmark BCBS of PA vs $3,543.01 with UPMC Health Plan — 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 | $1,030.96 | — |
| UPMC Work Partners | Workers Comp | $1,553.01 | — |
| UPMC Health Plan | CHIP | $3,251.64 | — |
| UPMC Health Plan | Commercial | $3,543.01 | — |
Visitor-reported prices
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Expl lap celiotomy w/wo bx 49000 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,378.80 | $637.01 – $1,838.40 |
| UPMC Community Osteopathic | Harrisburg | $1,389.00 | $1,967.75 – $1,967.75 |
| UPMC Mercy | Pittsburgh | $4,482.60 | $1,030.96 – $1,797.46 |
| UPMC Passavant-McCandless | Pittsburgh | $5,776.80 | $1,040.78 – $1,962.00 |
| UPMC Presbyterian | Pittsburgh | $7,111.20 | $399.60 – $1,994.88 |
| UPMC Somerset | Somerset | $1,389.00 | $726.88 – $784.96 |
| UPMC Williamsport | Williamsport | $6,630.60 | $426.24 – $1,863.90 |
| Uniontown Hospital | Uniontown | $2,948.00 | $205.80 – $1,464.80 |