Drainage mouth roof lesion at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$3,349.80
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.
$5,583.00
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.
$22.00 with UPMC Health Plan vs $4,745.55 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $22.00 | ↓ -99% |
| Aetna | Medicaid | $22.00 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $27.80 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.66 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $30.16 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.22 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $34.08 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $184.74 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $198.21 | ↓ -94% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $227.99 | ↓ -93% |
| Aetna | Medicare | $228.03 | ↓ -93% |
| Aetna of PA | Medicare | $232.46 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison Kids | $232.46 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $232.46 | ↓ -93% |
| United Healthcare | Medicare | $236.89 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $239.08 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $239.10 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $239.10 | ↓ -93% |
| Cigna | Medicare | $239.10 | ↓ -93% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $415.44 | ↓ -88% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $699.00 | ↓ -79% |
| UPMC Health Plan | Commercial | $1,246.59 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,419.79 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,749.36 | ↓ -48% |
| United Healthcare | Compass Exchange | $1,842.39 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $1,903.80 | ↓ -43% |
| Aetna | Neighborhood Network | $2,065.71 | ↓ -38% |
| Aetna | Home Depot Employer Group | $2,132.71 | ↓ -36% |
| Cigna | NBR ASO/FI | $2,177.37 | ↓ -35% |
| United Healthcare | All Business | $2,177.37 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,177.37 | ↓ -35% |
| Cigna | New Business ASO | $2,177.37 | ↓ -35% |
| Aetna | EBR ASO | $2,233.20 | ↓ -33% |
| Cigna | Commercial | $2,233.20 | ↓ -33% |
| Cigna | EBR | $2,233.20 | ↓ -33% |
| UPMC Health Plan | CHIP | $2,298.02 | ↓ -31% |
| Aetna | EBR FI | $3,349.80 | ↑ +0% |
| InterGroup | PPO | $3,628.95 | ↑ +8% |
| Coventry/First Health | Commercial | $3,684.78 | ↑ +10% |
| Health Coalition Partners | PPO | $3,908.10 | ↑ +17% |
| Private Health Care Systems | PPO | $4,466.40 | ↑ +33% |
| Prime Net | Commercial | $4,578.06 | ↑ +37% |
| Humana | Commercial | $4,745.55 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Drainage mouth roof lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $837.00 | $25.40 – $1,185.75 |
| UPMC Cole | Coudersport | $154.80 | $21.00 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $837.00 | $25.40 – $2,298.02 |
| UPMC East | Monroeville | $2,565.00 | $22.00 – $3,420.00 |
| UPMC Hanover | Hanover | $837.00 | $25.40 – $1,016.56 |
| UPMC Jameson | New Castle | $808.20 | $22.00 – $892.40 |
| UPMC Lititz | Lititz | $837.00 | $25.40 – $1,016.56 |
| UPMC McKeesport | Mckeesport | $2,912.40 | $22.00 – $736.75 |