Surgical pathology level 5 gross & microscopic examination at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$338.40
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.
$564.00
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.
$36.37 with UPMC Health Plan vs $643.55 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $36.37 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $45.50 | ↓ -87% |
| Aetna | Medicaid | $50.05 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $50.05 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $63.24 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $67.48 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $71.03 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $77.54 | ↓ -77% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $79.32 | ↓ -77% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $97.72 | ↓ -71% |
| UPMC Health Plan | CHIP | $130.59 | ↓ -61% |
| United Healthcare | Compass Exchange | $186.12 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $192.32 | ↓ -43% |
| Aetna | Neighborhood Network | $208.68 | ↓ -38% |
| Aetna | Home Depot Employer Group | $215.45 | ↓ -36% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $219.40 | ↓ -35% |
| Aetna | NBR ASO/FI | $219.96 | ↓ -35% |
| Cigna | NBR ASO/FI | $219.96 | ↓ -35% |
| Cigna | New Business ASO | $219.96 | ↓ -35% |
| United Healthcare | All Business | $219.96 | ↓ -35% |
| Aetna | EBR ASO | $225.60 | ↓ -33% |
| Cigna | EBR | $225.60 | ↓ -33% |
| Cigna | Commercial | $225.60 | ↓ -33% |
| UPMC Work Partners | Workers Comp | $275.75 | ↓ -19% |
| UPMC Health Plan | Managed Medicare | $307.04 | ↓ -9% |
| Aetna | EBR FI | $338.40 | ↑ +0% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $353.17 | ↑ +4% |
| Aetna | Medicare | $353.24 | ↑ +4% |
| United Healthcare Community Plan for Families | Unison Kids | $360.10 | ↑ +6% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $360.10 | ↑ +6% |
| Aetna of PA | Medicare | $360.10 | ↑ +6% |
| InterGroup | PPO | $366.60 | ↑ +8% |
| United Healthcare | Medicare | $366.96 | ↑ +8% |
| Highmark Wholecare (prev Gateway) | Medicare | $370.35 | ↑ +9% |
| Cigna | Medicare | $370.39 | ↑ +9% |
| AmeriHealth Caritas | Medicare | $370.39 | ↑ +9% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $370.39 | ↑ +9% |
| Coventry/First Health | Commercial | $372.24 | ↑ +10% |
| Health Coalition Partners | PPO | $394.80 | ↑ +17% |
| Private Health Care Systems | PPO | $451.20 | ↑ +33% |
| Prime Net | Commercial | $462.48 | ↑ +37% |
| Humana | Commercial | $479.40 | ↑ +42% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $643.55 | ↑ +90% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Surgical pathology level 5 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $234.60 | $11.50 – $312.80 |
| UPMC Bedford | Everett | $189.60 | $36.42 – $284.40 |
| UPMC Carlisle | Carlisle | $664.80 | $15.06 – $941.80 |
| UPMC Cole | Coudersport | $572.40 | $47.77 – $763.20 |
| UPMC Community Osteopathic | Harrisburg | $664.80 | $15.06 – $378.62 |
| UPMC East | Monroeville | $379.20 | $35.92 – $505.60 |
| UPMC Hamot | Erie | $360.60 | $45.50 – $427.47 |
| UPMC Northwest | Seneca | $360.60 | $36.26 – $360.10 |