Repair av fistula ext 35190 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$9,171.00
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.
$15,285.00
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.
$715.44 with Aetna vs $40,724.33 with UPMC Health Plan — 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 | $715.44 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $751.21 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $786.98 | ↓ -91% |
| Geisinger | Medicaid | $994.39 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,061.00 | ↓ -88% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,078.88 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,116.87 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,219.25 | ↓ -87% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,414.18 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $3,010.36 | ↓ -67% |
| UPMC Health Plan | Managed Medicare | $5,255.73 | ↓ -43% |
| UPMC Health Plan | Partners/Select | $5,342.32 | ↓ -42% |
| United Healthcare | Medicare | $5,514.45 | ↓ -40% |
| Highmark Wholecare (prev Gateway) | Medicare | $5,565.99 | ↓ -39% |
| Cigna | Medicare | $5,565.99 | ↓ -39% |
| AmeriHealth Caritas | Medicare | $5,565.99 | ↓ -39% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5,565.99 | ↓ -39% |
| Preferred Healthcare System | PPO | $7,642.50 | ↓ -17% |
| Cigna | Commercial | $7,642.50 | ↓ -17% |
| United Healthcare | Commercial | $7,835.09 | ↓ -15% |
| Aetna | Commercial | $8,101.05 | ↓ -12% |
| Geisinger | Commercial | $8,406.75 | ↓ -8% |
| Private Health Care Systems | PPO | $12,228.00 | ↑ +33% |
| UPMC Health Plan | CHIP | $37,375.24 | ↑ +308% |
| UPMC Health Plan | Commercial | $40,724.33 | ↑ +344% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Repair av fistula ext 35190 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $9,742.80 | $751.21 – $14,614.20 |
| UPMC Hamot | Erie | $7,765.20 | $786.98 – $7,495.67 |
| UPMC Horizon-Greenville | Greenville | $7,024.20 | $786.98 – $5,565.99 |
| UPMC Presbyterian | Pittsburgh | $9,434.40 | $786.98 – $5,669.06 |
| UPMC St. Margaret | Pittsburgh | $8,080.20 | $786.98 – $5,669.06 |