healthcosts.net
Tonsillectomy (age 12+) at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$461.40
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.
$769.00
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.
$213.17 with Highmark BCBS of PA vs $3,269.06 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $213.17 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $215.32 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $215.32 | ↓ -53% |
| Humana | Medicare | $217.47 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $220.70 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $220.70 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $223.01 | ↓ -52% |
| Cigna | Medicare | $226.09 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $232.55 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $232.55 | ↓ -50% |
| Aetna | Medicare | $234.54 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicaid | $307.60 | ↓ -33% |
| Geisinger | Medicaid | $422.95 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $422.95 | ↓ -8% |
| UPMC Health Plan | Commercial | $538.30 | ↑ +17% |
| Geisinger | Commercial | $576.75 | ↑ +25% |
| Galaxy Health Plan | Commercial | $615.20 | ↑ +33% |
| Humana | Commercial | $615.20 | ↑ +33% |
| InterGroup | PPO | $615.20 | ↑ +33% |
| Multiplan | PPO/Auto | $615.20 | ↑ +33% |
| Multiplan | Worker's Compensation | $615.20 | ↑ +33% |
| Aetna | Commercial | $630.58 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $671.46 | ↑ +46% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,140.18 | ↑ +147% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,140.18 | ↑ +147% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,388.43 | ↑ +201% |
| Highmark BCBS of PA | Managed Care | $1,388.43 | ↑ +201% |
| BCBS of Western NY | Medicare Advantage | $1,470.59 | ↑ +219% |
| UPMC Health Plan | CHIP | $3,269.06 | ↑ +609% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | not published | $725.80 – $3,401.07 |
| UPMC Hamot | Erie | not published | $725.80 – $4,496.91 |
| UPMC Altoona | Altoona | not published | $671.46 – $3,339.23 |
| UPMC Bedford | Everett | not published | $671.46 – $3,339.23 |
| UPMC Community Osteopathic | Harrisburg | not published | $711.55 – $7,348.95 |
| UPMC Hanover | Hanover | not published | $711.55 – $4,956.96 |
| UPMC Memorial | York | not published | $711.55 – $4,975.65 |
| UPMC Mercy | Pittsburgh | not published | $736.81 – $3,401.07 |