Tx closed distal humerus fx at UPMC Horizon-Greenville
110 N Main St, Greenville, PA · UPMC · · NPI 1225048838
$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.
$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.
$26.85 with UPMC Health Plan vs $528.00 with Anthem Blue Cross Blue Shield — 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 | $26.85 | ↓ -89% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $36.16 | ↓ -86% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $44.56 | ↓ -83% |
| UPMC Health Plan | CHIP | $47.94 | ↓ -81% |
| United Healthcare | Compass Exchange | $140.58 | ↓ -45% |
| Anthem Blue Cross Blue Shield | Traditional | $145.27 | ↓ -43% |
| Aetna | Neighborhood Network | $157.62 | ↓ -38% |
| Aetna | Home Depot Employer Group | $162.73 | ↓ -36% |
| Cigna | NBR ASO/FI | $166.14 | ↓ -35% |
| Cigna | New Business ASO | $166.14 | ↓ -35% |
| Aetna | NBR ASO/FI | $166.14 | ↓ -35% |
| United Healthcare | All Business | $166.14 | ↓ -35% |
| Aetna | EBR ASO | $170.40 | ↓ -33% |
| Cigna | Commercial | $170.40 | ↓ -33% |
| Cigna | EBR | $170.40 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $204.76 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $234.30 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $234.30 | ↓ -8% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $235.52 | ↓ -8% |
| Aetna | Medicare | $235.56 | ↓ -8% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $240.13 | ↓ -6% |
| Aetna of PA | Medicare | $240.13 | ↓ -6% |
| United Healthcare Community Plan for Families | Unison Kids | $240.13 | ↓ -6% |
| United Healthcare | Medicare | $244.71 | ↓ -4% |
| Highmark Wholecare (prev Gateway) | Medicare | $246.97 | ↓ -3% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.00 | ↓ -3% |
| Cigna | Medicare | $247.00 | ↓ -3% |
| AmeriHealth Caritas | Medicare | $247.00 | ↓ -3% |
| Aetna | EBR FI | $255.60 | ↑ +0% |
| InterGroup | PPO | $276.90 | ↑ +8% |
| Coventry/First Health | Commercial | $281.16 | ↑ +10% |
| Health Coalition Partners | PPO | $298.20 | ↑ +17% |
| Private Health Care Systems | PPO | $340.80 | ↑ +33% |
| Prime Net | Commercial | $349.32 | ↑ +37% |
| Humana | Commercial | $362.10 | ↑ +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 | $429.16 | ↑ +68% |
| Anthem Blue Cross Blue Shield | Blue Access PPO/Blue Preferred HMO/HIC | $528.00 | ↑ +107% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Tx closed distal humerus fx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $121.20 | $18.59 – $247.00 |
| UPMC Bedford | Everett | $122.40 | $35.45 – $247.00 |
| UPMC Hamot | Erie | $104.40 | $18.59 – $332.62 |
| UPMC Northwest | Seneca | $134.40 | $34.54 – $247.00 |
| UPMC Mercy | Pittsburgh | $75.60 | $18.59 – $251.57 |
| UPMC Muncy | Muncy | $114.60 | $161.64 – $161.64 |
| UPMC Passavant-McCandless | Pittsburgh | $90.60 | $18.77 – $251.57 |
| UPMC Presbyterian | Pittsburgh | $337.20 | $18.77 – $251.57 |