Ghs simple repair 7.6 - 12.5 cm - 12004 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$819.60
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.
$1,366.00
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.
$48.50 with Aetna vs $1,092.80 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 |
|---|---|---|---|
| Aetna | Medicaid | $48.50 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $50.92 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $53.35 | ↓ -93% |
| Geisinger | Medicaid | $67.41 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $71.93 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $73.14 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $75.71 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $82.65 | ↓ -90% |
| UPMC Health Plan | Managed Medicare | $193.19 | ↓ -76% |
| UPMC Health Plan | Partners/Select | $196.37 | ↓ -76% |
| United Healthcare | Medicare | $202.70 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $204.47 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.60 | ↓ -75% |
| Cigna | Medicare | $204.60 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | ↓ -75% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $332.97 | ↓ -59% |
| UPMC Health Plan | CHIP | $635.66 | ↓ -22% |
| Cigna | Commercial | $683.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $683.00 | ↓ -17% |
| UPMC Health Plan | Commercial | $692.62 | ↓ -15% |
| United Healthcare | Commercial | $700.21 | ↓ -15% |
| Aetna | Commercial | $723.98 | ↓ -12% |
| Geisinger | Commercial | $751.30 | ↓ -8% |
| Private Health Care Systems | PPO | $1,092.80 | ↑ +33% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 7.6 - 12.5 cm - 12004 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $454.20 | $50.92 – $681.30 |
| UPMC Carlisle | Carlisle | $808.20 | $61.59 – $1,144.95 |
| UPMC Cole | Coudersport | $554.40 | $50.92 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $808.20 | $61.59 – $1,144.95 |
| UPMC East | Monroeville | $856.80 | $53.35 – $1,142.40 |
| UPMC Hamot | Erie | $856.20 | $53.35 – $333.58 |
| UPMC Northwest | Seneca | $610.80 | $53.35 – $327.02 |
| UPMC Hanover | Hanover | $808.20 | $61.59 – $966.78 |