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Shoulder Arthroscopy (Rotator Cuff Repair) at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$2,174.40
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.
$3,624.00
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.
$1,004.57 with Highmark BCBS of PA vs $5,782.59 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 | $1,004.57 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $1,014.72 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $1,014.72 | ↓ -53% |
| Humana | Medicare | $1,024.87 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $1,040.09 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $1,040.09 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $1,050.96 | ↓ -52% |
| Cigna | Medicare | $1,065.46 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $1,095.90 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $1,095.90 | ↓ -50% |
| Aetna | Medicare | $1,105.32 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,449.60 | ↓ -33% |
| BCBS of Western NY | Medicare Advantage | $1,470.59 | ↓ -32% |
| UPMC Work Partners | Workers Comp | $1,952.98 | ↓ -10% |
| Geisinger | Medicaid | $1,993.20 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,993.20 | ↓ -8% |
| UPMC Health Plan | Commercial | $2,536.80 | ↑ +17% |
| Geisinger | Commercial | $2,718.00 | ↑ +25% |
| Galaxy Health Plan | Commercial | $2,899.20 | ↑ +33% |
| Humana | Commercial | $2,899.20 | ↑ +33% |
| InterGroup | PPO | $2,899.20 | ↑ +33% |
| Multiplan | PPO/Auto | $2,899.20 | ↑ +33% |
| Multiplan | Worker's Compensation | $2,899.20 | ↑ +33% |
| Aetna | Commercial | $2,971.68 | ↑ +37% |
| UPMC Health Plan | CHIP | $3,602.54 | ↑ +66% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,748.66 | ↑ +118% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,748.66 | ↑ +118% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,782.59 | ↑ +166% |
| Highmark BCBS of PA | Managed Care | $5,782.59 | ↑ +166% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Shoulder Arthroscopy (Rotator Cuff Repair) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | not published | $1,274.16 – $7,491.76 |
| UPMC East | Monroeville | not published | $1,274.16 – $7,491.76 |
| UPMC Hamot | Erie | not published | $1,262.14 – $9,905.66 |
| UPMC Carlisle | Carlisle | not published | $1,016.56 – $10,934.13 |
| UPMC Altoona | Altoona | not published | $1,262.14 – $7,355.55 |
| UPMC Community Osteopathic | Harrisburg | not published | $1,016.56 – $11,127.90 |
| UPMC Hanover | Hanover | not published | $1,016.56 – $10,919.06 |
| UPMC Horizon-Greenville | Greenville | not published | $1,952.98 – $7,355.55 |