Pegunigalsidase alfa-iwxj at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$548.00
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.
$685.00
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.
$88.01 with Highmark BCBS of PA vs $680.37 with United Healthcare — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $88.01 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $144.06 | ↓ -74% |
| Highmark Wholecare (prev Gateway) | Medicaid | $228.16 | ↓ -58% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $228.16 | ↓ -58% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $228.16 | ↓ -58% |
| Geisinger | Medicaid | $228.16 | ↓ -58% |
| UPMC Health Plan | Managed Medicare | $232.68 | ↓ -58% |
| UPMC Health Plan | Partners/Select | $236.51 | ↓ -57% |
| UPMC Health Plan | CHIP | $239.75 | ↓ -56% |
| United Healthcare | Medicare | $244.13 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $246.41 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $246.41 | ↓ -55% |
| Cigna | Medicare | $246.41 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $246.41 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $254.68 | ↓ -54% |
| UPMC Health Plan | Commercial | $280.63 | ↓ -49% |
| Preferred Healthcare System | PPO | $342.50 | ↓ -38% |
| Cigna | Commercial | $342.50 | ↓ -38% |
| Aetna | Commercial | $363.05 | ↓ -34% |
| Geisinger | Commercial | $376.75 | ↓ -31% |
| Private Health Care Systems | PPO | $548.00 | ↑ +0% |
| United Healthcare | Commercial | $680.37 | ↑ +24% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pegunigalsidase alfa-iwxj at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $526.20 | $88.85 – $246.41 |
| UPMC Muncy | Muncy | $548.00 | $228.16 – $250.97 |
| UPMC Passavant-McCandless | Pittsburgh | $526.20 | $88.85 – $250.98 |
| UPMC Presbyterian | Pittsburgh | $526.20 | $88.85 – $250.98 |
| UPMC Wellsboro | Wellsboro | $548.00 | $228.16 – $250.97 |
| UPMC Western Psychiatric | Pittsburgh | $526.20 | $87.07 – $250.98 |
| UPMC Williamsport | Williamsport | $548.00 | $228.16 – $244.13 |