Benign lesion paring 2-4 at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$271.20
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.
$452.00
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.
$32.65 with UPMC Health Plan vs $528.00 with Anthem Blue Cross Blue Shield — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $32.65 | ↓ -88% |
| Aetna | Medicaid | $32.65 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $41.25 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $44.02 | ↓ -84% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $44.76 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $46.33 | ↓ -83% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $50.58 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $59.32 | ↓ -78% |
| United Healthcare | Compass Exchange | $149.16 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $154.13 | ↓ -43% |
| Aetna | Neighborhood Network | $167.24 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $169.61 | ↓ -37% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $171.66 | ↓ -37% |
| Aetna | Home Depot Employer Group | $172.66 | ↓ -36% |
| Cigna | NBR ASO/FI | $176.28 | ↓ -35% |
| United Healthcare | All Business | $176.28 | ↓ -35% |
| Aetna | NBR ASO/FI | $176.28 | ↓ -35% |
| Cigna | New Business ASO | $176.28 | ↓ -35% |
| Cigna | Commercial | $180.80 | ↓ -33% |
| Aetna | EBR ASO | $180.80 | ↓ -33% |
| Cigna | EBR | $180.80 | ↓ -33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $195.09 | ↓ -28% |
| Aetna | Medicare | $195.12 | ↓ -28% |
| United Healthcare Community Plan for Families | Unison Kids | $198.91 | ↓ -27% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $198.91 | ↓ -27% |
| Aetna of PA | Medicare | $198.91 | ↓ -27% |
| United Healthcare | Medicare | $202.70 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.58 | ↓ -25% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | ↓ -25% |
| Cigna | Medicare | $204.60 | ↓ -25% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -25% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $211.51 | ↓ -22% |
| UPMC Health Plan | Commercial | $228.11 | ↓ -16% |
| Aetna | EBR FI | $271.20 | ↑ +0% |
| InterGroup | PPO | $293.80 | ↑ +8% |
| Coventry/First Health | Commercial | $298.32 | ↑ +10% |
| Health Coalition Partners | PPO | $316.40 | ↑ +17% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $355.48 | ↑ +31% |
| Private Health Care Systems | PPO | $361.60 | ↑ +33% |
| Prime Net | Commercial | $370.64 | ↑ +37% |
| Humana | Commercial | $384.20 | ↑ +42% |
| UPMC Health Plan | CHIP | $420.50 | ↑ +55% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $528.00 | ↑ +95% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Benign lesion paring 2-4 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $547.20 | $29.68 – $729.60 |
| UPMC Bedford | Everett | $552.60 | $31.16 – $828.90 |
| UPMC Carlisle | Carlisle | $364.20 | $37.69 – $1,016.56 |
| UPMC Cole | Coudersport | $183.60 | $9.98 – $2,094.25 |
| UPMC Community Osteopathic | Harrisburg | $364.20 | $37.69 – $1,016.56 |
| UPMC Hamot | Erie | $526.20 | $32.65 – $275.52 |
| UPMC Northwest | Seneca | $576.60 | $32.65 – $229.01 |
| UPMC Hanover | Hanover | $364.20 | $37.69 – $1,016.56 |