Biopsy abdominal mass at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$2,304.60
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.
$3,841.00
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.
$89.07 with Aetna vs $3,264.85 with Humana — 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 | Medicaid | $89.07 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $89.07 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $112.54 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.08 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $122.10 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.40 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $137.99 | ↓ -94% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $528.00 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $637.10 | ↓ -72% |
| UPMC Health Plan | Commercial | $930.05 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,060.34 | ↓ -54% |
| United Healthcare | Compass Exchange | $1,267.53 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,306.47 | ↓ -43% |
| Anthem Blue Cross Blue Shield | Traditional | $1,309.78 | ↓ -43% |
| UPMC Health Plan | Managed Medicare | $1,382.97 | ↓ -40% |
| Aetna | Neighborhood Network | $1,421.17 | ↓ -38% |
| Aetna | Home Depot Employer Group | $1,467.26 | ↓ -36% |
| Cigna | NBR ASO/FI | $1,497.99 | ↓ -35% |
| United Healthcare | All Business | $1,497.99 | ↓ -35% |
| Aetna | NBR ASO/FI | $1,497.99 | ↓ -35% |
| Cigna | New Business ASO | $1,497.99 | ↓ -35% |
| Cigna | EBR | $1,536.40 | ↓ -33% |
| Aetna | EBR ASO | $1,536.40 | ↓ -33% |
| Cigna | Commercial | $1,536.40 | ↓ -33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,590.73 | ↓ -31% |
| Aetna | Medicare | $1,591.04 | ↓ -31% |
| Aetna of PA | Medicare | $1,621.93 | ↓ -30% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $1,621.93 | ↓ -30% |
| United Healthcare Community Plan for Families | Unison Kids | $1,621.93 | ↓ -30% |
| United Healthcare | Medicare | $1,652.83 | ↓ -28% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.12 | ↓ -28% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↓ -28% |
| AmeriHealth Caritas | Medicare | $1,668.28 | ↓ -28% |
| Cigna | Medicare | $1,668.28 | ↓ -28% |
| UPMC Health Plan | CHIP | $1,714.50 | ↓ -26% |
| Aetna | EBR FI | $2,304.60 | ↑ +0% |
| InterGroup | PPO | $2,496.65 | ↑ +8% |
| Coventry/First Health | Commercial | $2,535.06 | ↑ +10% |
| Health Coalition Partners | PPO | $2,688.70 | ↑ +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 | $2,898.63 | ↑ +26% |
| Private Health Care Systems | PPO | $3,072.80 | ↑ +33% |
| Prime Net | Commercial | $3,149.62 | ↑ +37% |
| Humana | Commercial | $3,264.85 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Biopsy abdominal mass at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,224.60 | $80.97 – $1,632.80 |
| UPMC Carlisle | Carlisle | $2,461.20 | $102.83 – $3,486.70 |
| UPMC Community Osteopathic | Harrisburg | $2,461.20 | $102.83 – $3,486.70 |
| UPMC East | Monroeville | $1,689.60 | $89.07 – $2,252.80 |
| UPMC Hamot | Erie | $2,312.40 | $89.07 – $2,246.66 |
| UPMC Northwest | Seneca | $2,419.20 | $89.07 – $1,621.93 |
| UPMC Hanover | Hanover | $2,461.20 | $102.83 – $2,476.51 |
| UPMC Jameson | New Castle | $2,304.60 | $89.07 – $2,085.34 |