Biopsy of rectum wall anal approach 45100 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.
$203.18 with AmeriHealth Caritas vs $7,348.95 with Keystone Health Plan — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $203.18 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $204.98 | — |
| Geisinger | Medicaid/CHIP | $219.22 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $256.48 | — |
| UPMC Work Partners | Workers Comp | $625.14 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $758.49 | — |
| Aetna | ACO | $1,633.00 | — |
| UPMC Health Plan | CHIP | $1,731.07 | — |
| Aetna | PEBTF ACO | $1,802.00 | — |
| Aetna | Commercial | $2,120.00 | — |
| Highmark BCBS of PA | Commercial | $2,249.82 | — |
| Highmark BCBS of PA | CHIP | $2,249.82 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,670.65 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $2,710.85 | — |
| Humana | Medicare | $2,778.56 | — |
| Aetna | Medicare | $2,813.63 | — |
| Cigna | Medicare | $2,832.51 | — |
| United Healthcare | Medicare | $2,886.46 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,913.44 | — |
| Capital Blue Cross | Commercial | $7,348.95 | — |
| Capital Blue Cross | CHIP | $7,348.95 | — |
| Keystone Health Plan | Commercial | $7,348.95 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | Tricare | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of rectum wall anal approach 45100 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $339.60 | $68.19 – $771.51 |
| Uniontown Hospital | Uniontown | $3,190.50 | $165.55 – $5,587.82 |
| UPMC Altoona | Altoona | not published | $150.50 – $2,823.70 |
| UPMC East | Monroeville | not published | $165.55 – $2,875.99 |
| UPMC Hamot | Erie | not published | $165.55 – $3,802.67 |
| UPMC Mercy | Pittsburgh | not published | $165.55 – $2,875.99 |
| UPMC Presbyterian | Pittsburgh | not published | $165.55 – $2,875.99 |