Av fistula revision at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$9,842.40
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.
$16,404.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $13,943.40 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 | $1,016.56 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $1,364.51 | ↓ -86% |
| Keystone Health Plan | Medicare Advantage | $3,280.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $3,280.80 | ↓ -67% |
| Prime Net | Managed Medicare | $3,969.77 | ↓ -60% |
| Aetna | ACO | $4,374.00 | ↓ -56% |
| Highmark BCBS of PA | CHIP | $4,577.82 | ↓ -53% |
| Highmark BCBS of PA | Commercial | $4,577.82 | ↓ -53% |
| Aetna | PEBTF ACO | $4,829.00 | ↓ -51% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $5,264.31 | ↓ -47% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $5,343.54 | ↓ -46% |
| Humana | Medicare | $5,477.00 | ↓ -44% |
| Aetna | Medicare | $5,546.13 | ↓ -44% |
| Cigna | Medicare | $5,583.35 | ↓ -43% |
| Aetna | Commercial | $5,681.00 | ↓ -42% |
| United Healthcare | Medicare | $5,689.70 | ↓ -42% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5,742.88 | ↓ -42% |
| UPMC Health Plan | CHIP | $6,773.76 | ↓ -31% |
| Geisinger | Medicaid/CHIP | $9,022.20 | ↓ -8% |
| InterGroup | PPO | $10,662.60 | ↑ +8% |
| Capital Blue Cross | CHIP | $11,127.90 | ↑ +13% |
| Keystone Health Plan | Commercial | $11,127.90 | ↑ +13% |
| Capital Blue Cross | Commercial | $11,127.90 | ↑ +13% |
| Prime Net | FH-Medical Rental | $12,335.81 | ↑ +25% |
| Wellspan Population Health | Commercial | $13,943.40 | ↑ +42% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Av fistula revision at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Somerset | Somerset | $9,842.40 | $892.40 – $5,565.47 |
| Uniontown Hospital | Uniontown | $4,841.50 | $205.80 – $11,202.11 |
| UPMC Altoona | Altoona | not published | $1,109.02 – $5,565.99 |
| UPMC East | Monroeville | not published | $1,119.58 – $5,669.06 |
| UPMC Hamot | Erie | not published | $1,109.02 – $7,495.67 |
| UPMC Hanover | Hanover | not published | $1,016.56 – $8,262.51 |
| UPMC Jameson | New Castle | not published | $892.40 – $6,957.48 |
| UPMC Lititz | Lititz | not published | $1,016.56 – $8,307.14 |