Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$559.20
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.
$932.00
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.
$76.74 with Aetna vs $745.60 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 | $76.74 | ↓ -86% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $80.58 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $84.41 | ↓ -85% |
| Geisinger | Medicaid | $106.66 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $113.81 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $115.72 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $119.80 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $130.78 | ↓ -77% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $169.62 | ↓ -70% |
| UPMC Health Plan | CHIP | $326.20 | ↓ -42% |
| UPMC Work Partners | Workers Comp | $336.48 | ↓ -40% |
| Preferred Healthcare System | PPO | $466.00 | ↓ -17% |
| Cigna | Commercial | $466.00 | ↓ -17% |
| UPMC Health Plan | Commercial | $466.00 | ↓ -17% |
| United Healthcare | Commercial | $477.74 | ↓ -15% |
| Aetna | Commercial | $493.96 | ↓ -12% |
| Geisinger | Commercial | $512.60 | ↓ -8% |
| UPMC Health Plan | Managed Medicare | $684.07 | ↑ +22% |
| UPMC Health Plan | Partners/Select | $695.34 | ↑ +24% |
| United Healthcare | Medicare | $717.75 | ↑ +28% |
| Highmark Wholecare (prev Gateway) | Medicare | $724.45 | ↑ +30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $724.45 | ↑ +30% |
| AmeriHealth Caritas | Medicare | $724.45 | ↑ +30% |
| Cigna | Medicare | $724.45 | ↑ +30% |
| Private Health Care Systems | PPO | $745.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,597.80 | $80.58 – $2,396.70 |
| UPMC Carlisle | Carlisle | $2,287.20 | $97.46 – $3,240.20 |
| UPMC Community Osteopathic | Harrisburg | $2,287.20 | $103.60 – $3,240.20 |
| UPMC East | Monroeville | $570.60 | $84.41 – $760.80 |
| UPMC Hamot | Erie | $543.60 | $84.41 – $975.61 |
| UPMC Northwest | Seneca | $777.00 | $84.41 – $704.33 |
| UPMC Hanover | Hanover | $2,287.20 | $97.46 – $1,075.42 |
| UPMC Horizon-Greenville | Greenville | $741.00 | $84.41 – $724.45 |