Sialolithotomy 42330 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$1,941.60
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.
$3,236.00
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.
$67.20 with Aetna vs $2,654.46 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $67.20 | ↓ -97% |
| Geisinger | Medicaid | $88.95 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $96.51 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $109.07 | ↓ -94% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $138.88 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $140.28 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $140.28 | ↓ -93% |
| Humana | Medicare | $141.68 | ↓ -93% |
| AmeriHealth Caritas | Medicaid | $143.79 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $143.79 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $145.29 | ↓ -93% |
| Cigna | Medicare | $147.29 | ↓ -92% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $151.50 | ↓ -92% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $151.50 | ↓ -92% |
| Aetna | Medicare | $152.81 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $200.40 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $343.24 | ↓ -82% |
| UPMC Health Plan | Commercial | $350.70 | ↓ -82% |
| Geisinger | Commercial | $375.75 | ↓ -81% |
| InterGroup | PPO | $400.80 | ↓ -79% |
| Humana | Commercial | $400.80 | ↓ -79% |
| Galaxy Health Plan | Commercial | $400.80 | ↓ -79% |
| Multiplan | Worker's Compensation | $400.80 | ↓ -79% |
| Multiplan | PPO/Auto | $400.80 | ↓ -79% |
| Aetna | Commercial | $410.82 | ↓ -79% |
| United Healthcare | Medicare | $906.08 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,035.44 | ↓ -47% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,035.44 | ↓ -47% |
| Highmark BCBS of PA | Managed Care | $1,260.88 | ↓ -35% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,260.88 | ↓ -35% |
| BCBS of Western NY | Medicare Advantage | $2,325.85 | ↑ +20% |
| UPMC Health Plan | CHIP | $2,654.46 | ↑ +37% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Sialolithotomy 42330 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $3,971.40 | $81.28 – $5,626.15 |
| UPMC Community Osteopathic | Harrisburg | $3,971.40 | $81.28 – $5,626.15 |
| UPMC Hanover | Hanover | $3,971.40 | $81.28 – $4,956.96 |
| UPMC Lititz | Lititz | $3,971.40 | $81.28 – $4,983.74 |
| UPMC Memorial | York | $3,971.40 | $81.28 – $4,975.65 |
| UPMC Somerset | Somerset | $3,971.40 | $70.40 – $3,091.88 |
| Uniontown Hospital | Uniontown | $1,244.00 | $3,213.54 – $7,487.55 |
| UPMC Bedford | Everett | not published | $67.20 – $3,339.23 |