Treatment of fibula fracture 27780 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$1,266.00
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.
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What you pay up front if you don't use insurance.
$2,110.00
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.
$66.25 with Highmark BCBS of PA vs $1,732.75 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 | $66.25 | ↓ -95% |
| AmeriHealth Caritas | Medicare | $66.92 | ↓ -95% |
| UPMC Health Plan | Managed Medicare | $66.92 | ↓ -95% |
| United Healthcare | Medicare | $66.92 | ↓ -95% |
| Humana | Medicare | $67.59 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $68.59 | ↓ -95% |
| AmeriHealth Caritas | Medicaid | $68.59 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $69.31 | ↓ -95% |
| Cigna | Medicare | $70.27 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $72.27 | ↓ -94% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $72.27 | ↓ -94% |
| Aetna | Medicare | $72.89 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $95.60 | ↓ -92% |
| Geisinger | Medicaid | $131.45 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $131.45 | ↓ -90% |
| UPMC Health Plan | Commercial | $167.30 | ↓ -87% |
| Geisinger | Commercial | $179.25 | ↓ -86% |
| InterGroup | PPO | $191.20 | ↓ -85% |
| Humana | Commercial | $191.20 | ↓ -85% |
| Galaxy Health Plan | Commercial | $191.20 | ↓ -85% |
| Multiplan | Worker's Compensation | $191.20 | ↓ -85% |
| Multiplan | PPO/Auto | $191.20 | ↓ -85% |
| Aetna | Commercial | $195.98 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $511.11 | ↓ -60% |
| BCBS of Western NY | Medicare Advantage | $771.51 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,394.87 | ↑ +10% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,394.87 | ↑ +10% |
| Highmark BCBS of PA | Managed Care | $1,698.58 | ↑ +34% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,698.58 | ↑ +34% |
| UPMC Health Plan | CHIP | $1,732.75 | ↑ +37% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of fibula fracture 27780 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,537.20 | $82.51 – $2,305.80 |
| UPMC Carlisle | Carlisle | $769.80 | $126.21 – $1,090.55 |
| UPMC Community Osteopathic | Harrisburg | $769.80 | $233.61 – $1,732.75 |
| UPMC Hanover | Hanover | $769.80 | $226.87 – $1,732.75 |
| UPMC Lititz | Lititz | $769.80 | $228.10 – $1,732.75 |
| UPMC Memorial | York | $769.80 | $239.91 – $1,732.75 |
| UPMC Muncy | Muncy | $825.60 | $511.98 – $993.28 |
| UPMC Somerset | Somerset | $769.80 | $226.41 – $892.40 |