Repair palate at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$3,255.60
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.
$5,426.00
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.
$52.25 with Aetna vs $10,583.22 with Highmark BCBS of PA — 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 | $52.25 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $52.25 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $66.02 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $70.44 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $71.63 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.15 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $80.95 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $589.38 | ↓ -82% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $699.00 | ↓ -79% |
| UPMC Health Plan | Commercial | $1,247.44 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,419.79 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,749.36 | ↓ -46% |
| United Healthcare | Compass Exchange | $1,790.58 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $1,850.27 | ↓ -43% |
| Aetna | Neighborhood Network | $2,007.62 | ↓ -38% |
| Aetna | Home Depot Employer Group | $2,072.73 | ↓ -36% |
| Cigna | NBR ASO/FI | $2,116.14 | ↓ -35% |
| United Healthcare | All Business | $2,116.14 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,116.14 | ↓ -35% |
| Cigna | New Business ASO | $2,116.14 | ↓ -35% |
| Aetna | EBR ASO | $2,170.40 | ↓ -33% |
| Cigna | EBR | $2,170.40 | ↓ -33% |
| Cigna | Commercial | $2,170.40 | ↓ -33% |
| UPMC Health Plan | CHIP | $2,299.58 | ↓ -29% |
| Aetna | EBR FI | $3,255.60 | ↑ +0% |
| InterGroup | PPO | $3,526.90 | ↑ +8% |
| Coventry/First Health | Commercial | $3,581.16 | ↑ +10% |
| Health Coalition Partners | PPO | $3,798.20 | ↑ +17% |
| Private Health Care Systems | PPO | $4,340.80 | ↑ +33% |
| Prime Net | Commercial | $4,449.32 | ↑ +37% |
| Humana | Commercial | $4,612.10 | ↑ +42% |
| UPMC Health Plan | Managed Medicare | $5,049.38 | ↑ +55% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $5,807.94 | ↑ +78% |
| Aetna | Medicare | $5,809.07 | ↑ +78% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $5,921.86 | ↑ +82% |
| Aetna of PA | Medicare | $5,921.86 | ↑ +82% |
| United Healthcare Community Plan for Families | Unison Kids | $5,921.86 | ↑ +82% |
| United Healthcare | Medicare | $6,034.66 | ↑ +85% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,090.50 | ↑ +87% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,091.06 | ↑ +87% |
| AmeriHealth Caritas | Medicare | $6,091.06 | ↑ +87% |
| Cigna | Medicare | $6,091.06 | ↑ +87% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $10,583.22 | ↑ +225% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Repair palate at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $4,104.60 | $52.25 – $8,202.79 |
| UPMC Magee | Pittsburgh | $3,572.40 | $52.25 – $6,091.06 |
| UPMC Passavant-McCandless | Pittsburgh | $4,334.40 | $52.25 – $6,203.86 |
| UPMC St. Margaret | Pittsburgh | $4,170.00 | $52.25 – $6,203.86 |
| Uniontown Hospital | Uniontown | $7,699.50 | $52.25 – $11,917.49 |
| UPMC Altoona | Altoona | not published | $47.50 – $6,091.06 |