Incision of tongue fold at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$2,464.80
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.
$4,108.00
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.
$45.00 with Aetna vs $3,286.40 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 | $45.00 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $47.25 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $49.50 | ↓ -98% |
| Geisinger | Medicaid | $62.55 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $66.73 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $67.86 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $70.25 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $76.69 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $144.94 | ↓ -94% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $545.04 | ↓ -78% |
| UPMC Health Plan | Managed Medicare | $1,440.18 | ↓ -42% |
| UPMC Health Plan | Partners/Select | $1,463.91 | ↓ -41% |
| United Healthcare | Medicare | $1,511.08 | ↓ -39% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,525.20 | ↓ -38% |
| Cigna | Medicare | $1,525.20 | ↓ -38% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,525.20 | ↓ -38% |
| AmeriHealth Caritas | Medicare | $1,525.20 | ↓ -38% |
| UPMC Health Plan | CHIP | $1,714.50 | ↓ -30% |
| UPMC Health Plan | Commercial | $1,868.13 | ↓ -24% |
| Cigna | Commercial | $2,054.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $2,054.00 | ↓ -17% |
| United Healthcare | Commercial | $2,105.76 | ↓ -15% |
| Aetna | Commercial | $2,177.24 | ↓ -12% |
| Geisinger | Commercial | $2,259.40 | ↓ -8% |
| Private Health Care Systems | PPO | $3,286.40 | ↑ +33% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Incision of tongue fold at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $3,333.00 | $49.50 – $2,053.97 |
| Uniontown Hospital | Uniontown | $1,634.50 | $49.50 – $3,123.56 |
| UPMC Cole | Coudersport | not published | $47.25 – $1,714.50 |
| UPMC Northwest | Seneca | not published | $49.50 – $1,482.83 |
| UPMC Somerset | Somerset | not published | $49.50 – $1,412.22 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $1,430.62 – $5,627.00 |
| WellSpan Gettysburg Hospital | Gettysburg | not published | $970.00 – $1,101.92 |