Ins/rpl pm gen exist dual lead at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$5,344.20
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.
$8,907.00
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.
$1,140.25 with UPMC Work Partners vs $10,775.64 with Highmark Wholecare (prev Gateway) — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $1,140.25 | ↓ -79% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,631.43 | ↓ -69% |
| Cigna | Commercial | $4,453.50 | ↓ -17% |
| Preferred Healthcare System | PPO | $4,453.50 | ↓ -17% |
| United Healthcare | Commercial | $4,565.73 | ↓ -15% |
| Aetna | Commercial | $4,720.71 | ↓ -12% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4,898.85 | ↓ -8% |
| Geisinger | Commercial | $4,898.85 | ↓ -8% |
| Geisinger | Medicaid | $4,898.85 | ↓ -8% |
| UPMC Health Plan | CHIP | $5,149.48 | ↓ -4% |
| UPMC Health Plan | Commercial | $5,610.91 | ↑ +5% |
| Private Health Care Systems | PPO | $7,125.60 | ↑ +33% |
| UPMC Health Plan | Managed Medicare | $10,174.99 | ↑ +90% |
| UPMC Health Plan | Partners/Select | $10,342.61 | ↑ +94% |
| United Healthcare | Medicare | $10,675.86 | ↑ +100% |
| Cigna | Medicare | $10,775.64 | ↑ +102% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | ↑ +102% |
| AmeriHealth Caritas | Medicare | $10,775.64 | ↑ +102% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,775.64 | ↑ +102% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $15,540.60 | $1,016.56 – $22,015.85 |
| UPMC Cole | Coudersport | $787.80 | $363.96 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $15,540.60 | $1,016.56 – $22,015.85 |
| UPMC East | Monroeville | $6,828.00 | $1,212.63 – $10,775.64 |
| UPMC Hamot | Erie | $9,586.80 | $1,212.63 – $14,511.47 |
| UPMC Hanover | Hanover | $15,540.60 | $1,016.56 – $15,996.05 |
| UPMC Lititz | Lititz | $15,540.60 | $1,016.56 – $16,082.45 |
| UPMC Memorial | York | $15,540.60 | $1,016.56 – $16,056.32 |