Biopsy of nail unit 11755 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
not published by hospital
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.
?
What you pay up front if you don't use insurance.
not published by hospital
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.
?
The hospital's undiscounted list price — almost no one pays this.
$98.59 with United Healthcare Community Plan for Families vs $2,656.50 with Capital Blue Cross — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $98.59 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $101.60 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $102.50 | — |
| Geisinger | Medicaid/CHIP | $109.62 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $128.26 | — |
| UPMC Work Partners | Workers Comp | $230.63 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $685.19 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $695.50 | — |
| Humana | Medicare | $712.87 | — |
| Aetna | Medicare | $721.87 | — |
| Cigna | Medicare | $726.72 | — |
| United Healthcare | Medicare | $740.56 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $747.48 | — |
| Aetna | ACO | $1,633.00 | — |
| UPMC Health Plan | CHIP | $1,731.02 | — |
| Aetna | PEBTF ACO | $1,802.00 | — |
| Aetna | Commercial | $2,120.00 | — |
| Highmark BCBS of PA | CHIP | $2,249.82 | — |
| Highmark BCBS of PA | Commercial | $2,249.82 | — |
| Keystone Health Plan | Commercial | $2,656.50 | — |
| Capital Blue Cross | Commercial | $2,656.50 | — |
| Capital Blue Cross | CHIP | $2,656.50 | — |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of nail unit 11755 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $2,634.60 | $82.79 – $737.87 |
| UPMC St. Margaret | Pittsburgh | $2,493.60 | $82.79 – $550.23 |
| Uniontown Hospital | Uniontown | $814.00 | $82.79 – $1,425.57 |
| UPMC Memorial | York | not published | $95.58 – $1,079.47 |