Small bowel endoscopy 44365 at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$3,893.40
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.
$6,489.00
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.
$170.51 with Aetna vs $5,191.20 with Private Health Care Systems — 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 |
|---|---|---|---|
| Aetna | Medicaid | $170.51 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $179.04 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $187.56 | ↓ -95% |
| Geisinger | Medicaid | $236.99 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $252.87 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $257.13 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $266.18 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $290.58 | ↓ -93% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $729.80 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $797.11 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $1,844.36 | ↓ -53% |
| UPMC Health Plan | Partners/Select | $1,874.74 | ↓ -52% |
| United Healthcare | Medicare | $1,935.15 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,953.23 | ↓ -50% |
| AmeriHealth Caritas | Medicare | $1,953.23 | ↓ -50% |
| Cigna | Medicare | $1,953.23 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,953.23 | ↓ -50% |
| UPMC Health Plan | CHIP | $2,299.64 | ↓ -41% |
| UPMC Health Plan | Commercial | $2,505.70 | ↓ -36% |
| Preferred Healthcare System | PPO | $3,244.50 | ↓ -17% |
| Cigna | Commercial | $3,244.50 | ↓ -17% |
| United Healthcare | Commercial | $3,326.26 | ↓ -15% |
| Aetna | Commercial | $3,439.17 | ↓ -12% |
| Geisinger | Commercial | $3,568.95 | ↓ -8% |
| Private Health Care Systems | PPO | $5,191.20 | ↑ +33% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Small bowel endoscopy 44365 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| AHN WEXFORD HOSPITAL | WEXFORD | $131.04 | $28.64 – $6,055.25 |
| GROVE CITY HOSPITAL | GROVE CITY | $115.92 | $27.28 – $5,196.41 |
| UPMC Cole | Coudersport | $550.20 | $179.04 – $1,041.88 |