healthcosts.net
Total Knee Replacement at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$3,271.80
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.
$5,453.00
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.
$1,511.57 with Highmark BCBS of PA vs $14,888.05 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 | $1,511.57 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $1,526.84 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $1,526.84 | ↓ -53% |
| Humana | Medicare | $1,542.11 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $1,565.01 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $1,565.01 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $1,581.37 | ↓ -52% |
| Cigna | Medicare | $1,603.18 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $1,648.99 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $1,648.99 | ↓ -50% |
| Aetna | Medicare | $1,663.16 | ↓ -49% |
| BCBS of Western NY | Medicare Advantage | $1,677.17 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2,181.20 | ↓ -33% |
| Geisinger | Medicaid | $2,999.15 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,999.15 | ↓ -8% |
| UPMC Health Plan | Commercial | $3,817.10 | ↑ +17% |
| Geisinger | Commercial | $4,089.75 | ↑ +25% |
| Galaxy Health Plan | Commercial | $4,362.40 | ↑ +33% |
| Humana | Commercial | $4,362.40 | ↑ +33% |
| InterGroup | PPO | $4,362.40 | ↑ +33% |
| Multiplan | PPO/Auto | $4,362.40 | ↑ +33% |
| Multiplan | Worker's Compensation | $4,362.40 | ↑ +33% |
| Aetna | Commercial | $4,471.46 | ↑ +37% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,690.48 | ↑ +74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5,690.48 | ↑ +74% |
| UPMC Work Partners | Workers Comp | $5,731.96 | ↑ +75% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,929.48 | ↑ +112% |
| Highmark BCBS of PA | Managed Care | $6,929.48 | ↑ +112% |
| UPMC Health Plan | CHIP | $14,888.05 | ↑ +355% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Total Knee Replacement at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | not published | $2,690.84 – $13,493.67 |
| UPMC East | Monroeville | not published | $2,690.84 – $13,493.67 |
| UPMC Hamot | Erie | not published | $2,665.46 – $17,841.43 |
| UPMC Carlisle | Carlisle | not published | $1,016.56 – $19,693.86 |
| UPMC Altoona | Altoona | not published | $2,665.46 – $13,248.33 |
| UPMC Community Osteopathic | Harrisburg | not published | $1,016.56 – $23,763.60 |
| UPMC Hanover | Hanover | not published | $1,016.56 – $19,666.67 |
| UPMC Horizon-Greenville | Greenville | not published | $5,185.52 – $13,248.33 |