Incision of achilles tendon at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$327.00
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.
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What you pay up front if you don't use insurance.
$545.00
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.
$151.07 with Highmark BCBS of PA vs $1,758.73 with Highmark BCBS of PA — 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 | $151.07 | ↓ -54% |
| UPMC Health Plan | Managed Medicare | $152.60 | ↓ -53% |
| AmeriHealth Caritas | Medicare | $152.60 | ↓ -53% |
| Humana | Medicare | $154.13 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $156.41 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $156.41 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $158.05 | ↓ -52% |
| Cigna | Medicare | $160.23 | ↓ -51% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $164.81 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $164.81 | ↓ -50% |
| Aetna | Medicare | $166.22 | ↓ -49% |
| Aetna | CHIP/Medicaid | $191.16 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicaid | $218.00 | ↓ -33% |
| Geisinger | Medicaid | $253.05 | ↓ -23% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $274.55 | ↓ -16% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $310.27 | ↓ -5% |
| UPMC Work Partners | Workers Comp | $375.30 | ↑ +15% |
| UPMC Health Plan | Commercial | $381.50 | ↑ +17% |
| Geisinger | Commercial | $408.75 | ↑ +25% |
| InterGroup | PPO | $436.00 | ↑ +33% |
| Humana | Commercial | $436.00 | ↑ +33% |
| Galaxy Health Plan | Commercial | $436.00 | ↑ +33% |
| Multiplan | Worker's Compensation | $436.00 | ↑ +33% |
| Multiplan | PPO/Auto | $436.00 | ↑ +33% |
| Aetna | Commercial | $446.90 | ↑ +37% |
| BCBS of Western NY | Medicare Advantage | $771.51 | ↑ +136% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,444.26 | ↑ +342% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,444.26 | ↑ +342% |
| UPMC Health Plan | CHIP | $1,712.93 | ↑ +424% |
| Highmark BCBS of PA | Managed Care | $1,758.73 | ↑ +438% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,758.73 | ↑ +438% |
Visitor-reported prices
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Incision of achilles tendon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,284.60 | $231.22 – $6,069.85 |
| UPMC Community Osteopathic | Harrisburg | $4,284.60 | $245.78 – $6,069.85 |
| UPMC Hanover | Hanover | $4,284.60 | $231.22 – $2,446.19 |
| UPMC Lititz | Lititz | $4,284.60 | $231.22 – $2,459.41 |
| UPMC Memorial | York | $4,284.60 | $231.22 – $2,455.41 |
| UPMC Somerset | Somerset | $4,284.60 | $200.27 – $1,525.80 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | $1,291.20 | $227.58 – $619.00 |
| Uniontown Hospital | Uniontown | $2,853.75 | $200.27 – $3,237.13 |