healthcosts.net
Knee X-ray at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$686.40
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.
$1,144.00
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.
$37.67 with UPMC Health Plan vs $972.40 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 | Commercial | $37.67 | ↓ -95% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $78.83 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $84.30 | ↓ -88% |
| UPMC Health Plan | Managed Medicare | $90.77 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $97.13 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $104.40 | ↓ -85% |
| Aetna | Medicare | $104.42 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison Kids | $106.45 | ↓ -84% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $106.45 | ↓ -84% |
| Aetna of PA | Medicare | $106.45 | ↓ -84% |
| United Healthcare | Medicare | $108.48 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -84% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -84% |
| Cigna | Medicare | $109.49 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -84% |
| UPMC Health Plan | CHIP | $135.24 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $190.24 | ↓ -72% |
| United Healthcare | Compass Exchange | $377.52 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $390.10 | ↓ -43% |
| Aetna | Neighborhood Network | $423.28 | ↓ -38% |
| Aetna | Home Depot Employer Group | $437.01 | ↓ -36% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $445.02 | ↓ -35% |
| Cigna | NBR ASO/FI | $446.16 | ↓ -35% |
| Aetna | NBR ASO/FI | $446.16 | ↓ -35% |
| Cigna | New Business ASO | $446.16 | ↓ -35% |
| United Healthcare | All Business | $446.16 | ↓ -35% |
| Cigna | EBR | $457.60 | ↓ -33% |
| Cigna | Commercial | $457.60 | ↓ -33% |
| Aetna | EBR ASO | $457.60 | ↓ -33% |
| Geisinger | Medicaid/CHIP | $629.20 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $629.20 | ↓ -8% |
| Aetna | EBR FI | $686.40 | ↑ +0% |
| InterGroup | PPO | $743.60 | ↑ +8% |
| Coventry/First Health | Commercial | $755.04 | ↑ +10% |
| Health Coalition Partners | PPO | $800.80 | ↑ +17% |
| Private Health Care Systems | PPO | $915.20 | ↑ +33% |
| Prime Net | Commercial | $938.08 | ↑ +37% |
| Humana | Commercial | $972.40 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Knee X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $37.20 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $37.53 – $594.15 |
| UPMC Hamot | Erie | $473.40 | $25.96 – $552.30 |
| UPMC Carlisle | Carlisle | $262.80 | $29.37 – $589.04 |
| UPMC Altoona | Altoona | $186.60 | $40.52 – $248.80 |
| UPMC Bedford | Everett | $133.20 | $36.58 – $199.80 |
| UPMC Cole | Coudersport | $215.40 | $42.48 – $287.20 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $29.37 – $372.30 |