Pml/raralpha 1 breakpoint at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$1,534.20
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.
$2,557.00
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.
$204.89 with UPMC Work Partners vs $3,569.61 with UPMC Health Plan — 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 | $204.89 | ↓ -87% |
| UPMC Health Plan | Managed Medicare | $211.41 | ↓ -86% |
| UPMC Health Plan | Partners/Select | $214.90 | ↓ -86% |
| United Healthcare | Medicare | $221.82 | ↓ -86% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $223.89 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $223.89 | ↓ -85% |
| Cigna | Medicare | $223.89 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $223.89 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $254.73 | ↓ -83% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $345.11 | ↓ -78% |
| Aetna | Medicaid | $345.11 | ↓ -78% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $362.37 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $379.62 | ↓ -75% |
| Geisinger | Medicaid | $479.67 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicaid | $511.80 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $538.75 | ↓ -65% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $588.14 | ↓ -62% |
| Preferred Healthcare System | PPO | $1,278.50 | ↓ -17% |
| Cigna | Commercial | $1,278.50 | ↓ -17% |
| United Healthcare | Commercial | $1,310.72 | ↓ -15% |
| Aetna | Commercial | $1,355.21 | ↓ -12% |
| Geisinger | Commercial | $1,406.35 | ↓ -8% |
| Private Health Care Systems | PPO | $2,045.60 | ↑ +33% |
| UPMC Health Plan | CHIP | $3,276.06 | ↑ +114% |
| UPMC Health Plan | Commercial | $3,569.61 | ↑ +133% |
Visitor-reported prices
Comments
Pml/raralpha 1 breakpoint at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $1,009.20 | $204.89 – $1,345.60 |
| UPMC Northwest | Seneca | $1,114.20 | $188.01 – $396.88 |
| UPMC Magee | Pittsburgh | $1,114.20 | $194.02 – $588.14 |
| UPMC McKeesport | Mckeesport | $1,671.60 | $192.16 – $379.62 |
| UPMC Mercy | Pittsburgh | $1,114.20 | $172.81 – $396.88 |
| UPMC Passavant-McCandless | Pittsburgh | $1,180.80 | $192.65 – $396.88 |
| UPMC Presbyterian | Pittsburgh | $1,671.60 | $204.89 – $537.23 |
| UPMC St. Margaret | Pittsburgh | $1,671.60 | $178.99 – $538.75 |