Whfo nontorsion joint prefab at UPMC Altoona
620 Howard Avenue, Altoona, PA · UPMC · · NPI 112418570
$159.00
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.
$265.00
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.
$50.35 with Health Partners Plans (Jefferson Health Plan) vs $876.95 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $50.35 | ↓ -68% |
| Geisinger | Medicaid | $87.45 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicaid | $103.35 | ↓ -35% |
| Cigna | Commercial | $132.50 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $132.50 | ↓ -17% |
| Preferred Healthcare System | PPO | $132.50 | ↓ -17% |
| Aetna | Commercial | $140.45 | ↓ -12% |
| Geisinger | Commercial | $145.75 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $145.75 | ↓ -8% |
| Private Health Care Systems | PPO | $212.00 | ↑ +33% |
| UPMC Work Partners | Workers Comp | $233.39 | ↑ +47% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $267.44 | ↑ +68% |
| UPMC Health Plan | CHIP | $804.83 | ↑ +406% |
| UPMC Health Plan | Commercial | $876.95 | ↑ +452% |
Visitor-reported prices
Comments
Whfo nontorsion joint prefab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $585.60 | $180.12 – $853.20 |
| UPMC Cole | Coudersport | $670.80 | $212.42 – $894.40 |
| UPMC East | Monroeville | $201.60 | $16.72 – $804.83 |
| UPMC Hamot | Erie | $537.00 | $233.39 – $267.44 |
| UPMC Northwest | Seneca | $547.20 | $233.39 – $973.92 |
| UPMC Horizon-Greenville | Greenville | $339.60 | $233.39 – $804.83 |
| UPMC Jameson | New Castle | $106.20 | $96.81 – $804.83 |
| UPMC Magee | Pittsburgh | $165.60 | $106.49 – $804.83 |