Ins/rplc spi npg/rcvr pocket at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
not published by hospital
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.
not published by hospital
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.
$301.00 with Aetna vs $31,377.14 with AmeriHealth Caritas — 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 | $301.00 | — |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $316.05 | — |
| UPMC Health Plan | Managed Medicaid | $331.10 | — |
| Geisinger | Medicaid | $418.36 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $446.38 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $453.91 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $469.89 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $512.96 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $729.80 | — |
| UPMC Work Partners | Workers Comp | $1,363.06 | — |
| UPMC Health Plan | CHIP | $2,315.82 | — |
| UPMC Health Plan | Commercial | $2,523.34 | — |
| UPMC Health Plan | Managed Medicare | $29,628.16 | — |
| UPMC Health Plan | Partners/Select | $30,116.25 | — |
| United Healthcare | Medicare | $31,086.61 | — |
| Cigna | Medicare | $31,377.14 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $31,377.14 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $31,377.14 | — |
| AmeriHealth Caritas | Medicare | $31,377.14 | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rplc spi npg/rcvr pocket at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $4,066.20 | $331.10 – $42,255.39 |
| UPMC Passavant-McCandless | Pittsburgh | $4,030.20 | $331.10 – $31,958.20 |
| Uniontown Hospital | Uniontown | $4,397.34 | $66.22 – $62,121.08 |
| UPMC Community Osteopathic | Harrisburg | not published | $406.35 – $32,074.60 |
| UPMC East | Monroeville | not published | $331.10 – $31,958.20 |
| UPMC Hanover | Hanover | not published | $382.27 – $46,578.27 |
| UPMC Lititz | Lititz | not published | $382.27 – $46,829.86 |
| UPMC McKeesport | Mckeesport | not published | $331.10 – $31,958.20 |