Hlth bhv assmt/reassessment at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$154.20
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.
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What you pay up front if you don't use insurance.
$257.00
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.
$55.15 with Highmark BCBS of PA vs $205.60 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 | $55.15 | ↓ -64% |
| Aetna | Medicaid | $61.14 | ↓ -60% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $64.20 | ↓ -58% |
| UPMC Health Plan | Managed Medicaid | $67.25 | ↓ -56% |
| Geisinger | Medicaid | $84.98 | ↓ -45% |
| UPMC Health Plan | CHIP | $89.95 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicaid | $90.67 | ↓ -41% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $92.20 | ↓ -40% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $95.45 | ↓ -38% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $104.19 | ↓ -32% |
| UPMC Work Partners | Workers Comp | $118.71 | ↓ -23% |
| Cigna | Commercial | $128.50 | ↓ -17% |
| UPMC Health Plan | Commercial | $128.50 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $128.50 | ↓ -17% |
| Preferred Healthcare System | PPO | $128.50 | ↓ -17% |
| Aetna | Commercial | $136.21 | ↓ -12% |
| Geisinger | Commercial | $141.35 | ↓ -8% |
| Private Health Care Systems | PPO | $205.60 | ↑ +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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Hlth bhv assmt/reassessment at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Horizon-Greenville | Greenville | $384.00 | $78.96 – $165.49 |
| UPMC Jameson | New Castle | $384.00 | $45.86 – $118.71 |
| UPMC Magee | Pittsburgh | $156.00 | $55.68 – $118.71 |
| UPMC Passavant-McCandless | Pittsburgh | $156.00 | $55.68 – $138.03 |
| UPMC Presbyterian | Pittsburgh | $156.00 | $47.86 – $146.82 |
| UPMC St. Margaret | Pittsburgh | $156.00 | $55.68 – $118.71 |
| Uniontown Hospital | Uniontown | $117.00 | $68.46 – $204.52 |