Lumizyme injection at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$1,487.20
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.
$1,859.00
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.
$130.44 with UPMC Health Plan vs $1,580.15 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 | $130.44 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $184.96 | ↓ -88% |
| United Healthcare | Compass Exchange | $201.64 | ↓ -86% |
| United Healthcare | All Business | $201.64 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $206.59 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $206.59 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $206.59 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $212.75 | ↓ -86% |
| Aetna | Medicare | $212.79 | ↓ -86% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $216.92 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison Kids | $216.92 | ↓ -85% |
| Aetna of PA | Medicare | $216.92 | ↓ -85% |
| United Healthcare | Medicare | $221.05 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $223.10 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $223.12 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $223.12 | ↓ -85% |
| Cigna | Medicare | $223.12 | ↓ -85% |
| UPMC Health Plan | CHIP | $228.92 | ↓ -85% |
| UPMC Health Plan | Commercial | $254.10 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $387.67 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $518.07 | ↓ -65% |
| Anthem Blue Cross Blue Shield | Traditional | $633.92 | ↓ -57% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $638.26 | ↓ -57% |
| Aetna | Neighborhood Network | $687.83 | ↓ -54% |
| Aetna | Home Depot Employer Group | $710.14 | ↓ -52% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $723.15 | ↓ -51% |
| Cigna | NBR ASO/FI | $725.01 | ↓ -51% |
| Aetna | NBR ASO/FI | $725.01 | ↓ -51% |
| Cigna | New Business ASO | $725.01 | ↓ -51% |
| Cigna | EBR | $743.60 | ↓ -50% |
| Aetna | EBR ASO | $743.60 | ↓ -50% |
| Cigna | Commercial | $743.60 | ↓ -50% |
| UPMC Work Partners | Workers Comp | $952.37 | ↓ -36% |
| Aetna | EBR FI | $1,115.40 | ↓ -25% |
| InterGroup | PPO | $1,208.35 | ↓ -19% |
| Coventry/First Health | Commercial | $1,226.94 | ↓ -18% |
| Health Coalition Partners | PPO | $1,301.30 | ↓ -13% |
| Private Health Care Systems | PPO | $1,487.20 | ↑ +0% |
| Prime Net | Commercial | $1,524.38 | ↑ +3% |
| Humana | Commercial | $1,580.15 | ↑ +6% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lumizyme injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $966.60 | $130.44 – $223.12 |
| UPMC Passavant-McCandless | Pittsburgh | $966.60 | $130.44 – $227.25 |
| UPMC Presbyterian | Pittsburgh | $4,834.80 | $130.44 – $227.25 |
| UPMC Western Psychiatric | Pittsburgh | $966.60 | $201.09 – $227.25 |
| WellSpan Waynesboro Hospital | Waynesboro | $2,781.60 | $31.59 – $3,527.48 |