Repair of achilles tendon at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$1,296.00
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.
$2,160.00
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.
$500.85 with Aetna vs $3,871.94 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $500.85 | ↓ -61% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $598.75 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $604.80 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $604.80 | ↓ -53% |
| Humana | Medicare | $610.85 | ↓ -53% |
| AmeriHealth Caritas | Medicaid | $619.92 | ↓ -52% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $619.92 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $626.40 | ↓ -52% |
| Cigna | Medicare | $635.04 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $653.18 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $653.18 | ↓ -50% |
| Aetna | Medicare | $658.80 | ↓ -49% |
| Geisinger | Medicaid | $662.98 | ↓ -49% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $719.32 | ↓ -44% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $812.90 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicaid | $864.00 | ↓ -33% |
| BCBS of Western NY | Medicare Advantage | $1,192.92 | ↓ -8% |
| UPMC Health Plan | Commercial | $1,512.00 | ↑ +17% |
| Geisinger | Commercial | $1,620.00 | ↑ +25% |
| InterGroup | PPO | $1,728.00 | ↑ +33% |
| Humana | Commercial | $1,728.00 | ↑ +33% |
| Galaxy Health Plan | Commercial | $1,728.00 | ↑ +33% |
| Multiplan | Worker's Compensation | $1,728.00 | ↑ +33% |
| Multiplan | PPO/Auto | $1,728.00 | ↑ +33% |
| Aetna | Commercial | $1,771.20 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $1,970.19 | ↑ +52% |
| UPMC Health Plan | CHIP | $2,654.51 | ↑ +105% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,179.63 | ↑ +145% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,179.63 | ↑ +145% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,871.94 | ↑ +199% |
| Highmark BCBS of PA | Managed Care | $3,871.94 | ↑ +199% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Repair of achilles tendon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $9,067.20 | $605.79 – $12,845.20 |
| UPMC Community Osteopathic | Harrisburg | $9,067.20 | $605.79 – $12,845.20 |
| UPMC Hanover | Hanover | $9,067.20 | $605.79 – $10,919.06 |
| UPMC Lititz | Lititz | $9,067.20 | $605.79 – $10,978.03 |
| UPMC Memorial | York | $9,067.20 | $605.79 – $10,960.19 |
| UPMC Somerset | Somerset | $9,067.20 | $524.70 – $6,810.69 |
| Uniontown Hospital | Uniontown | $5,326.50 | $7,033.14 – $16,387.22 |
| UPMC Altoona | Altoona | not published | $477.00 – $7,355.55 |