healthcosts.net
Annual Physical, Established Patient (age 40-64) at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$148.20
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.
$247.00
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.
$26.20 with United Healthcare Community Plan for Families vs $209.95 with Wellspan Population Health — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $26.20 | ↓ -82% |
| Capital Blue Cross | Medicare Advantage | $49.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $49.40 | ↓ -67% |
| Prime Net | Managed Medicare | $59.77 | ↓ -60% |
| Aetna | Medicare | $62.00 | ↓ -58% |
| UPMC Health Plan | CHIP | $96.71 | ↓ -35% |
| Aetna | ACO | $121.28 | ↓ -18% |
| Aetna | PEBTF ACO | $128.69 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $135.85 | ↓ -8% |
| Capital Blue Cross | CHIP | $136.52 | ↓ -8% |
| Capital Blue Cross | Commercial | $136.52 | ↓ -8% |
| Keystone Health Plan | Commercial | $143.33 | ↓ -3% |
| Aetna | Commercial | $151.41 | ↑ +2% |
| Highmark BCBS of PA | CHIP | $156.84 | ↑ +6% |
| Highmark BCBS of PA | Commercial | $156.84 | ↑ +6% |
| InterGroup | PPO | $160.55 | ↑ +8% |
| Prime Net | FH-Medical Rental | $185.74 | ↑ +25% |
| Wellspan Population Health | Commercial | $209.95 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Annual Physical, Established Patient (age 40-64) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $154.80 | $29.31 – $206.40 |
| UPMC Magee | Pittsburgh | $590.40 | $29.59 – $905.28 |
| UPMC Somerset | Somerset | $148.20 | $23.00 – $185.25 |
| UPMC Wellsboro | Wellsboro | $170.40 | $25.60 – $255.60 |
| UPMC Williamsport | Williamsport | $96.60 | $25.60 – $144.90 |