Closed tx sesamoid fx 28530 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$478.20
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.
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What you pay up front if you don't use insurance.
$797.00
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.
$29.11 with Highmark BCBS of PA vs $635.71 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/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $29.11 | ↓ -94% |
| United Healthcare | Medicare | $29.40 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $29.40 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $29.40 | ↓ -94% |
| Humana | Medicare | $29.69 | ↓ -94% |
| AmeriHealth Caritas | Medicaid | $30.14 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $30.14 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $30.45 | ↓ -94% |
| Cigna | Medicare | $30.87 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $31.75 | ↓ -93% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $31.75 | ↓ -93% |
| Aetna | Medicare | $32.02 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $42.00 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $57.75 | ↓ -88% |
| Geisinger | Medicaid | $57.75 | ↓ -88% |
| UPMC Health Plan | Commercial | $73.50 | ↓ -85% |
| Geisinger | Commercial | $78.75 | ↓ -84% |
| Multiplan | PPO/Auto | $84.00 | ↓ -82% |
| Multiplan | Worker's Compensation | $84.00 | ↓ -82% |
| Galaxy Health Plan | Commercial | $84.00 | ↓ -82% |
| InterGroup | PPO | $84.00 | ↓ -82% |
| Humana | Commercial | $84.00 | ↓ -82% |
| Aetna | Commercial | $86.10 | ↓ -82% |
| BCBS of Western NY | Medicare Advantage | $106.92 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $189.47 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $513.38 | ↑ +7% |
| Highmark BCBS of PA | Managed Care - Social Mission | $513.38 | ↑ +7% |
| Highmark BCBS of PA | Commercial - Indemnity | $625.16 | ↑ +31% |
| Highmark BCBS of PA | Managed Care | $625.16 | ↑ +31% |
| UPMC Health Plan | CHIP | $635.71 | ↑ +33% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Closed tx sesamoid fx 28530 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $759.00 | $117.18 – $1,075.25 |
| UPMC Community Osteopathic | Harrisburg | $759.00 | $117.18 – $1,075.25 |
| UPMC Hanover | Hanover | $759.00 | $117.18 – $635.71 |
| UPMC Kane | Kane | $397.80 | $189.47 – $488.05 |
| UPMC Lititz | Lititz | $759.00 | $117.18 – $635.71 |
| UPMC Memorial | York | $759.00 | $117.18 – $635.71 |
| UPMC Somerset | Somerset | $759.00 | $102.87 – $246.97 |
| UPMC Williamsport | Williamsport | $1,258.80 | $114.50 – $247.00 |