Consultation/report referred material w/preparation of slides at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$60.60
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.
?
What you pay up front if you don't use insurance.
$101.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$10.95 with UPMC Health Plan vs $177.31 with UPMC Work Partners — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | Commercial | $10.95 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $26.78 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $32.99 | ↓ -46% |
| United Healthcare | Compass Exchange | $33.33 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $34.44 | ↓ -43% |
| Aetna | Neighborhood Network | $37.37 | ↓ -38% |
| Aetna | Home Depot Employer Group | $38.58 | ↓ -36% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $39.29 | ↓ -35% |
| UPMC Health Plan | CHIP | $39.31 | ↓ -35% |
| Cigna | New Business ASO | $39.39 | ↓ -35% |
| Cigna | NBR ASO/FI | $39.39 | ↓ -35% |
| United Healthcare | All Business | $39.39 | ↓ -35% |
| Aetna | NBR ASO/FI | $39.39 | ↓ -35% |
| Aetna | EBR ASO | $40.40 | ↓ -33% |
| Cigna | Commercial | $40.40 | ↓ -33% |
| Cigna | EBR | $40.40 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $45.61 | ↓ -25% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $52.46 | ↓ -13% |
| Aetna | Medicare | $52.47 | ↓ -13% |
| United Healthcare Community Plan for Families | Unison Kids | $53.49 | ↓ -12% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $53.49 | ↓ -12% |
| Aetna of PA | Medicare | $53.49 | ↓ -12% |
| United Healthcare | Medicare | $54.51 | ↓ -10% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.01 | ↓ -9% |
| AmeriHealth Caritas | Medicare | $55.02 | ↓ -9% |
| Cigna | Medicare | $55.02 | ↓ -9% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.02 | ↓ -9% |
| Aetna | EBR FI | $60.60 | ↑ +0% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $63.46 | ↑ +5% |
| InterGroup | PPO | $65.65 | ↑ +8% |
| Coventry/First Health | Commercial | $66.66 | ↑ +10% |
| UPMC Health Plan | Managed Medicaid | $69.81 | ↑ +15% |
| Aetna | Medicaid | $69.81 | ↑ +15% |
| Health Coalition Partners | PPO | $70.70 | ↑ +17% |
| Private Health Care Systems | PPO | $80.80 | ↑ +33% |
| Prime Net | Commercial | $82.82 | ↑ +37% |
| Humana | Commercial | $85.85 | ↑ +42% |
| Geisinger | Medicaid/CHIP | $88.20 | ↑ +46% |
| Highmark Wholecare (prev Gateway) | Medicaid | $94.11 | ↑ +55% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $95.59 | ↑ +58% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $99.07 | ↑ +63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $108.15 | ↑ +78% |
| UPMC Work Partners | Workers Comp | $177.31 | ↑ +193% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Consultation/report referred material w/preparation of slides at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $82.80 | $10.36 – $110.40 |
| UPMC Carlisle | Carlisle | $116.40 | $13.57 – $192.25 |
| UPMC Cole | Coudersport | $176.40 | $39.31 – $235.20 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $13.57 – $185.56 |
| UPMC Hamot | Erie | $102.00 | $16.56 – $176.58 |
| UPMC Hanover | Hanover | $116.40 | $13.57 – $185.56 |
| UPMC Lititz | Lititz | $116.40 | $13.57 – $192.25 |
| UPMC Magee | Pittsburgh | $1,295.40 | $11.44 – $176.58 |