healthcosts.net
Lower Back (Lumbar Spine) MRI (without contrast) at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$1,699.20
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.
?
What you pay up front if you don't use insurance.
$2,832.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$187.20 with Aetna vs $2,265.60 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $187.20 | ↓ -89% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $196.56 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $205.92 | ↓ -88% |
| Geisinger | Medicaid | $260.19 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $277.62 | ↓ -84% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $282.30 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $292.24 | ↓ -83% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $319.03 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $400.00 | ↓ -76% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $619.48 | ↓ -64% |
| Cigna | Commercial | $1,416.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,416.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $1,416.00 | ↓ -17% |
| United Healthcare | Commercial | $1,451.68 | ↓ -15% |
| Aetna | Commercial | $1,500.96 | ↓ -12% |
| Geisinger | Commercial | $1,557.60 | ↓ -8% |
| UPMC Health Plan | CHIP | $1,948.86 | ↑ +15% |
| UPMC Health Plan | Commercial | $2,123.49 | ↑ +25% |
| Private Health Care Systems | PPO | $2,265.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,801.60 | $214.16 – $5,385.60 |
| UPMC East | Monroeville | $3,940.80 | $231.07 – $5,254.40 |
| UPMC Hamot | Erie | $1,623.00 | $183.52 – $1,893.50 |
| UPMC Horizon-Greenville | Greenville | $4,861.20 | $206.32 – $6,886.70 |
| UPMC Jameson | New Castle | $1,519.80 | $197.92 – $2,229.04 |
| UPMC Kane | Kane | $2,338.80 | $93.80 – $1,227.91 |
| UPMC McKeesport | Mckeesport | $3,834.60 | $213.60 – $5,432.35 |
| UPMC Carlisle | Carlisle | $1,656.00 | $228.92 – $2,346.00 |