Biliary endo perq dx w/speci at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$9,768.60
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.
$16,281.00
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.
$294.75 with United Healthcare Community Plan for Families vs $13,838.85 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 | $294.75 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $734.61 | ↓ -92% |
| UPMC Health Plan | CHIP | $2,299.08 | ↓ -76% |
| Aetna | ACO | $2,684.00 | ↓ -73% |
| Aetna | PEBTF ACO | $2,963.00 | ↓ -70% |
| Highmark BCBS of PA | CHIP | $3,012.49 | ↓ -69% |
| Highmark BCBS of PA | Commercial | $3,012.49 | ↓ -69% |
| Capital Blue Cross | Medicare Advantage | $3,256.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $3,256.20 | ↓ -67% |
| Aetna | Commercial | $3,485.00 | ↓ -64% |
| Prime Net | Managed Medicare | $3,940.00 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $6,076.54 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $6,168.00 | ↓ -37% |
| Humana | Medicare | $6,322.06 | ↓ -35% |
| Aetna | Medicare | $6,401.85 | ↓ -34% |
| Cigna | Medicare | $6,444.82 | ↓ -34% |
| United Healthcare | Medicare | $6,567.57 | ↓ -33% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,628.95 | ↓ -32% |
| Capital Blue Cross | CHIP | $7,348.95 | ↓ -25% |
| Keystone Health Plan | Commercial | $7,348.95 | ↓ -25% |
| Capital Blue Cross | Commercial | $7,348.95 | ↓ -25% |
| Geisinger | Medicaid/CHIP | $8,954.55 | ↓ -8% |
| InterGroup | PPO | $10,582.65 | ↑ +8% |
| Prime Net | FH-Medical Rental | $12,243.31 | ↑ +25% |
| Wellspan Population Health | Commercial | $13,838.85 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | Tricare | not published by hospital | — |
Visitor-reported prices
Comments
Biliary endo perq dx w/speci at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $9,768.60 | $294.75 – $13,838.85 |
| UPMC Hamot | Erie | $4,193.40 | $729.80 – $7,414.98 |
| UPMC Hanover | Hanover | $9,768.60 | $294.75 – $9,537.33 |
| UPMC Lititz | Lititz | $9,768.60 | $294.75 – $9,588.85 |
| UPMC Memorial | York | $9,768.60 | $294.75 – $9,573.28 |
| UPMC Mercy | Pittsburgh | $4,037.40 | $596.00 – $6,543.73 |
| UPMC Somerset | Somerset | $9,768.60 | $258.75 – $6,424.16 |