Closed tx sesamoid fx 28530 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$759.00
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.
$1,265.00
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.
$117.18 with United Healthcare Community Plan for Families vs $2,120.00 with Aetna — 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 | $117.18 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $200.75 | ↓ -74% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $233.61 | ↓ -69% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $237.13 | ↓ -69% |
| Humana | Medicare | $243.05 | ↓ -68% |
| Aetna | Medicare | $246.12 | ↓ -68% |
| Cigna | Medicare | $247.77 | ↓ -67% |
| United Healthcare | Medicare | $252.49 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $253.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $253.00 | ↓ -67% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $254.85 | ↓ -66% |
| Prime Net | Managed Medicare | $306.13 | ↓ -60% |
| UPMC Health Plan | CHIP | $635.71 | ↓ -16% |
| Geisinger | Medicaid/CHIP | $695.75 | ↓ -8% |
| InterGroup | PPO | $822.25 | ↑ +8% |
| Highmark BCBS of PA | CHIP | $844.01 | ↑ +11% |
| Highmark BCBS of PA | Commercial | $844.01 | ↑ +11% |
| Prime Net | FH-Medical Rental | $951.28 | ↑ +25% |
| Wellspan Population Health | Commercial | $1,075.25 | ↑ +42% |
| Capital Blue Cross | CHIP | $1,471.05 | ↑ +94% |
| Keystone Health Plan | Commercial | $1,471.05 | ↑ +94% |
| Capital Blue Cross | Commercial | $1,471.05 | ↑ +94% |
| Aetna | ACO | $1,633.00 | ↑ +115% |
| Aetna | PEBTF ACO | $1,802.00 | ↑ +137% |
| Aetna | Commercial | $2,120.00 | ↑ +179% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | Tricare | not published by hospital | — |
Visitor-reported prices
Comments
Closed tx sesamoid fx 28530 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $759.00 | $117.18 – $1,075.25 |
| UPMC Cole | Coudersport | $478.20 | $29.11 – $189.47 |
| UPMC Hanover | Hanover | $759.00 | $117.18 – $635.71 |
| UPMC Kane | Kane | $397.80 | $189.47 – $488.05 |
| UPMC Lititz | Lititz | $759.00 | $117.18 – $635.71 |
| UPMC Memorial | York | $759.00 | $117.18 – $635.71 |
| UPMC Somerset | Somerset | $759.00 | $102.87 – $246.97 |
| UPMC Williamsport | Williamsport | $1,258.80 | $114.50 – $247.00 |