Tx closed distal humerus fx at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$121.20
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.
?
What you pay up front if you don't use insurance.
$202.00
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.
$18.59 with Highmark BCBS of PA vs $247.00 with AmeriHealth Caritas — 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 | $18.59 | ↓ -85% |
| UPMC Health Plan | CHIP | $47.94 | ↓ -60% |
| UPMC Health Plan | Commercial | $52.23 | ↓ -57% |
| Cigna | Commercial | $101.00 | ↓ -17% |
| Preferred Healthcare System | PPO | $101.00 | ↓ -17% |
| United Healthcare | Commercial | $103.55 | ↓ -15% |
| Aetna | Commercial | $107.06 | ↓ -12% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $111.10 | ↓ -8% |
| Geisinger | Medicaid | $111.10 | ↓ -8% |
| Geisinger | Commercial | $111.10 | ↓ -8% |
| Private Health Care Systems | PPO | $161.60 | ↑ +33% |
| UPMC Health Plan | Managed Medicare | $233.23 | ↑ +92% |
| UPMC Health Plan | Partners/Select | $237.07 | ↑ +96% |
| United Healthcare | Medicare | $244.71 | ↑ +102% |
| Highmark Wholecare (prev Gateway) | Medicare | $247.00 | ↑ +104% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.00 | ↑ +104% |
| Cigna | Medicare | $247.00 | ↑ +104% |
| AmeriHealth Caritas | Medicare | $247.00 | ↑ +104% |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Tx closed distal humerus fx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $122.40 | $35.45 – $247.00 |
| UPMC Hamot | Erie | $104.40 | $18.59 – $332.62 |
| UPMC Northwest | Seneca | $134.40 | $34.54 – $247.00 |
| UPMC Horizon-Greenville | Greenville | $255.60 | $26.85 – $247.00 |
| UPMC Mercy | Pittsburgh | $75.60 | $18.59 – $251.57 |
| UPMC Muncy | Muncy | $114.60 | $161.64 – $161.64 |
| UPMC Passavant-McCandless | Pittsburgh | $90.60 | $18.77 – $251.57 |
| UPMC Presbyterian | Pittsburgh | $337.20 | $18.77 – $251.57 |