Aco annual medicare visit (awv), subsq g0439aco at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$290.40
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.
$484.00
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.
$96.80 with Keystone Health Plan vs $1,045.68 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 |
|---|---|---|---|
| Keystone Health Plan | Medicare Advantage | $96.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $96.80 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $103.99 | ↓ -64% |
| Prime Net | Managed Medicare | $117.13 | ↓ -60% |
| Aetna | Medicare | $121.48 | ↓ -58% |
| Aetna | ACO | $237.64 | ↓ -18% |
| Aetna | PEBTF ACO | $252.16 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $266.20 | ↓ -8% |
| Capital Blue Cross | Commercial | $267.51 | ↓ -8% |
| Capital Blue Cross | CHIP | $267.51 | ↓ -8% |
| Keystone Health Plan | Commercial | $280.87 | ↓ -3% |
| Aetna | Commercial | $296.69 | ↑ +2% |
| InterGroup | PPO | $314.60 | ↑ +8% |
| UPMC Health Plan | CHIP | $338.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $363.97 | ↑ +25% |
| Wellspan Population Health | Commercial | $411.40 | ↑ +42% |
| Highmark BCBS of PA | CHIP | $1,045.68 | ↑ +260% |
| Highmark BCBS of PA | Commercial | $1,045.68 | ↑ +260% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), subsq g0439aco at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Somerset | Somerset | $290.40 | $91.29 – $193.46 |
| UPMC Wellsboro | Wellsboro | $141.00 | $101.61 – $101.61 |
| Uniontown Hospital | Uniontown | $113.50 | $94.96 – $273.54 |