Ghs simple repair 7.6 - 12.5 cm - 12004 at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$749.40
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.
$1,249.00
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.
$53.35 with Aetna vs $1,061.65 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 | $53.35 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $53.35 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $67.41 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $71.93 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $73.14 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $75.71 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $82.65 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $169.61 | ↓ -77% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $195.09 | ↓ -74% |
| Aetna | Medicare | $195.12 | ↓ -74% |
| Aetna of PA | Medicare | $198.91 | ↓ -73% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $198.91 | ↓ -73% |
| United Healthcare Community Plan for Families | Unison Kids | $198.91 | ↓ -73% |
| United Healthcare | Medicare | $202.70 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.58 | ↓ -73% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | ↓ -73% |
| Cigna | Medicare | $204.60 | ↓ -73% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $327.02 | ↓ -56% |
| UPMC Health Plan | Commercial | $344.82 | ↓ -54% |
| 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 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $397.78 | ↓ -47% |
| United Healthcare | Compass Exchange | $412.17 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $425.91 | ↓ -43% |
| Aetna | Neighborhood Network | $462.13 | ↓ -38% |
| Aetna | Home Depot Employer Group | $477.12 | ↓ -36% |
| United Healthcare | All Business | $487.11 | ↓ -35% |
| Cigna | New Business ASO | $487.11 | ↓ -35% |
| Aetna | NBR ASO/FI | $487.11 | ↓ -35% |
| Cigna | NBR ASO/FI | $487.11 | ↓ -35% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $490.12 | ↓ -35% |
| Aetna | EBR ASO | $499.60 | ↓ -33% |
| Cigna | Commercial | $499.60 | ↓ -33% |
| Cigna | EBR | $499.60 | ↓ -33% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $528.00 | ↓ -30% |
| UPMC Health Plan | CHIP | $635.66 | ↓ -15% |
| Aetna | EBR FI | $749.40 | ↑ +0% |
| InterGroup | PPO | $811.85 | ↑ +8% |
| Coventry/First Health | Commercial | $824.34 | ↑ +10% |
| Health Coalition Partners | PPO | $874.30 | ↑ +17% |
| Private Health Care Systems | PPO | $999.20 | ↑ +33% |
| Prime Net | Commercial | $1,024.18 | ↑ +37% |
| Humana | Commercial | $1,061.65 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 7.6 - 12.5 cm - 12004 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $819.60 | $48.50 – $1,092.80 |
| UPMC Bedford | Everett | $454.20 | $50.92 – $681.30 |
| UPMC Carlisle | Carlisle | $808.20 | $61.59 – $1,144.95 |
| UPMC Cole | Coudersport | $554.40 | $50.92 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $808.20 | $61.59 – $1,144.95 |
| UPMC East | Monroeville | $856.80 | $53.35 – $1,142.40 |
| UPMC Hamot | Erie | $856.20 | $53.35 – $333.58 |
| UPMC Northwest | Seneca | $610.80 | $53.35 – $327.02 |