Metatarsal joint implant at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$3,246.00
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.
$5,410.00
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.
$1,027.90 with Health Partners Plans (Jefferson Health Plan) vs $4,436.20 with Aetna — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,027.90 | ↓ -68% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,499.65 | ↓ -54% |
| UPMC Health Plan | Managed Medicare | $1,514.80 | ↓ -53% |
| AmeriHealth Caritas | Medicare | $1,514.80 | ↓ -53% |
| United Healthcare | Medicare | $1,514.80 | ↓ -53% |
| Humana | Medicare | $1,529.95 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $1,552.67 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $1,552.67 | ↓ -52% |
| Cigna | Medicare | $1,590.54 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $1,635.98 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $1,635.98 | ↓ -50% |
| Aetna | Medicare | $1,650.05 | ↓ -49% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,785.30 | ↓ -45% |
| Geisinger | Medicaid | $1,785.30 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,947.60 | ↓ -40% |
| UPMC Health Plan | CHIP | $2,302.89 | ↓ -29% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,358.93 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,358.93 | ↓ -27% |
| Highmark BCBS of PA | Managed Care | $2,872.52 | ↓ -12% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,872.52 | ↓ -12% |
| United Healthcare | Commercial | $2,975.50 | ↓ -8% |
| UPMC Health Plan | Managed Medicaid | $3,354.20 | ↑ +3% |
| UPMC Health Plan | Commercial | $3,787.00 | ↑ +17% |
| Geisinger | Commercial | $4,057.50 | ↑ +25% |
| Humana | Commercial | $4,328.00 | ↑ +33% |
| Multiplan | Worker's Compensation | $4,328.00 | ↑ +33% |
| Multiplan | PPO/Auto | $4,328.00 | ↑ +33% |
| InterGroup | PPO | $4,328.00 | ↑ +33% |
| Galaxy Health Plan | Commercial | $4,328.00 | ↑ +33% |
| Aetna | Commercial | $4,436.20 | ↑ +37% |
| BCBS of Western NY | Medicare Advantage | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Metatarsal joint implant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $3,833.40 | $487.68 – $3,723.36 |
| UPMC St. Margaret | Pittsburgh | $1,999.80 | $487.68 – $2,825.81 |