Tx phalangeal shaft fx open prox/middle ea at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$6,497.40
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.
$10,829.00
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.
$224.00 with Aetna vs $8,663.20 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 | $224.00 | ↓ -97% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $235.20 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $246.40 | ↓ -96% |
| Geisinger | Medicaid | $311.34 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $332.19 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $337.79 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $349.69 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $381.74 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $948.68 | ↓ -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 | $1,030.96 | ↓ -84% |
| UPMC Health Plan | Managed Medicare | $3,154.60 | ↓ -51% |
| UPMC Health Plan | Partners/Select | $3,206.57 | ↓ -51% |
| UPMC Health Plan | CHIP | $3,251.42 | ↓ -50% |
| United Healthcare | Medicare | $3,309.88 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,340.82 | ↓ -49% |
| Cigna | Medicare | $3,340.82 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,340.82 | ↓ -49% |
| AmeriHealth Caritas | Medicare | $3,340.82 | ↓ -49% |
| UPMC Health Plan | Commercial | $3,542.77 | ↓ -45% |
| Cigna | Commercial | $5,414.50 | ↓ -17% |
| Preferred Healthcare System | PPO | $5,414.50 | ↓ -17% |
| United Healthcare | Commercial | $5,550.95 | ↓ -15% |
| Aetna | Commercial | $5,739.37 | ↓ -12% |
| Geisinger | Commercial | $5,955.95 | ↓ -8% |
| Private Health Care Systems | PPO | $8,663.20 | ↑ +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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Tx phalangeal shaft fx open prox/middle ea at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $918.60 | $235.20 – $1,470.59 |
| UPMC Hamot | Erie | $7,082.40 | $246.40 – $4,499.05 |
| UPMC Northwest | Seneca | $6,170.40 | $246.40 – $3,248.02 |
| UPMC Magee | Pittsburgh | $4,282.80 | $246.40 – $3,340.82 |
| UPMC Mercy | Pittsburgh | $4,706.40 | $246.40 – $3,402.68 |
| UPMC Muncy | Muncy | $6,497.40 | $246.40 – $1,152.00 |
| UPMC Passavant-McCandless | Pittsburgh | $5,776.80 | $246.40 – $3,402.68 |
| UPMC Presbyterian | Pittsburgh | $5,854.20 | $246.40 – $3,402.68 |