Kit lead specify 5-6-5 at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$11,638.80
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.
?
What you pay up front if you don't use insurance.
$19,398.00
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.
$203.87 with Health Partners Plans (Jefferson Health Plan) vs $17,649.03 with UPMC Health Plan — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $203.87 | ↓ -98% |
| Aetna | Medicare | $268.25 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $321.90 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $354.09 | ↓ -97% |
| United Healthcare | Compass Exchange | $354.09 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $354.09 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $363.00 | ↓ -97% |
| Anthem Blue Cross Blue Shield | Traditional | $365.89 | ↓ -97% |
| Aetna | Neighborhood Network | $397.01 | ↓ -97% |
| Aetna | Home Depot Employer Group | $409.89 | ↓ -96% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $417.40 | ↓ -96% |
| Aetna | NBR ASO/FI | $418.47 | ↓ -96% |
| Cigna | NBR ASO/FI | $418.47 | ↓ -96% |
| Cigna | New Business ASO | $418.47 | ↓ -96% |
| United Healthcare | All Business | $418.47 | ↓ -96% |
| Cigna | EBR | $429.20 | ↓ -96% |
| Cigna | Commercial | $429.20 | ↓ -96% |
| Aetna | EBR ASO | $429.20 | ↓ -96% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $536.50 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicare | $536.50 | ↓ -95% |
| Aetna | EBR FI | $643.80 | ↓ -94% |
| InterGroup | PPO | $697.45 | ↓ -94% |
| Coventry/First Health | Commercial | $708.18 | ↓ -94% |
| Health Coalition Partners | PPO | $751.10 | ↓ -94% |
| Private Health Care Systems | PPO | $858.40 | ↓ -93% |
| Prime Net | Commercial | $879.86 | ↓ -92% |
| Humana | Commercial | $912.05 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $5,488.59 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $6,761.88 | ↓ -42% |
| UPMC Health Plan | CHIP | $13,170.92 | ↑ +13% |
| UPMC Health Plan | Commercial | $17,649.03 | ↑ +52% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $25,039.80 | $37.62 – $13,170.92 |
| UPMC Bedford | Everett | $7,272.00 | $38.00 – $13,170.92 |
| UPMC Cole | Coudersport | $18,036.00 | $5,711.40 – $24,048.00 |
| UPMC East | Monroeville | $21,221.40 | $133.00 – $13,170.92 |
| UPMC Hamot | Erie | $24,616.20 | $2,153.59 – $2,153.59 |
| UPMC Northwest | Seneca | $7,816.20 | $5,589.39 – $15,937.99 |
| UPMC Jameson | New Castle | $7,176.60 | $582.60 – $13,170.92 |
| UPMC Kane | Kane | $2,910.60 | $9,698.74 – $9,698.74 |