Rmvl icd gen w/rplc icd gen dual lead sys at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$10,107.60
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.
$16,846.00
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.
$485.56 with Highmark BCBS of PA vs $48,751.73 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $485.56 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $562.05 | ↓ -94% |
| Cigna | Commercial | $8,423.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $8,423.00 | ↓ -17% |
| United Healthcare | Commercial | $8,635.26 | ↓ -15% |
| Aetna | Commercial | $8,928.38 | ↓ -12% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $9,265.30 | ↓ -8% |
| Geisinger | Commercial | $9,265.30 | ↓ -8% |
| Geisinger | Medicaid | $9,265.30 | ↓ -8% |
| Private Health Care Systems | PPO | $13,476.80 | ↑ +33% |
| UPMC Health Plan | Managed Medicare | $21,823.47 | ↑ +116% |
| UPMC Health Plan | Partners/Select | $22,182.98 | ↑ +119% |
| United Healthcare | Medicare | $22,897.73 | ↑ +127% |
| Cigna | Medicare | $23,111.73 | ↑ +129% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $23,111.73 | ↑ +129% |
| AmeriHealth Caritas | Medicare | $23,111.73 | ↑ +129% |
| Highmark Wholecare (prev Gateway) | Medicare | $23,111.73 | ↑ +129% |
| UPMC Health Plan | CHIP | $44,742.49 | ↑ +343% |
| UPMC Health Plan | Commercial | $48,751.73 | ↑ +382% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Rmvl icd gen w/rplc icd gen dual lead sys at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $34,564.20 | $588.20 – $48,965.95 |
| UPMC Community Osteopathic | Harrisburg | $34,564.20 | $588.20 – $48,965.95 |
| UPMC East | Monroeville | $51,008.40 | $490.18 – $68,011.20 |
| UPMC Hamot | Erie | $32,186.40 | $485.56 – $31,124.41 |
| UPMC Hanover | Hanover | $34,564.20 | $588.20 – $44,742.49 |
| UPMC Lititz | Lititz | $34,564.20 | $588.20 – $44,742.49 |
| UPMC Memorial | York | $34,564.20 | $395.75 – $44,742.49 |
| UPMC Mercy | Pittsburgh | $36,067.20 | $485.56 – $23,539.72 |