Clsd tx of ankle fracture w/manip 28435 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$2,440.80
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.
$4,068.00
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.
$184.15 with AmeriHealth Caritas vs $3,485.00 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $184.15 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $197.49 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $211.21 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $247.11 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $806.83 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $813.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $813.60 | ↓ -67% |
| Prime Net | Managed Medicare | $984.46 | ↓ -60% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -58% |
| Capital Blue Cross | Commercial | $1,471.05 | ↓ -40% |
| Capital Blue Cross | CHIP | $1,471.05 | ↓ -40% |
| Keystone Health Plan | Commercial | $1,471.05 | ↓ -40% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,558.55 | ↓ -36% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,582.00 | ↓ -35% |
| Humana | Medicare | $1,621.52 | ↓ -34% |
| Aetna | Medicare | $1,641.98 | ↓ -33% |
| Cigna | Medicare | $1,653.00 | ↓ -32% |
| United Healthcare | Medicare | $1,684.49 | ↓ -31% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,700.23 | ↓ -30% |
| UPMC Health Plan | CHIP | $2,317.11 | ↓ -5% |
| InterGroup | PPO | $2,644.20 | ↑ +8% |
| Aetna | ACO | $2,684.00 | ↑ +10% |
| Aetna | PEBTF ACO | $2,963.00 | ↑ +21% |
| Highmark BCBS of PA | Commercial | $3,012.49 | ↑ +23% |
| Highmark BCBS of PA | CHIP | $3,012.49 | ↑ +23% |
| Prime Net | FH-Medical Rental | $3,059.14 | ↑ +25% |
| Wellspan Population Health | Commercial | $3,457.80 | ↑ +42% |
| Aetna | Commercial | $3,485.00 | ↑ +43% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx of ankle fracture w/manip 28435 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $145.00 – $4,246.40 |
| UPMC Carlisle | Carlisle | $2,440.80 | $184.15 – $3,457.80 |
| UPMC Cole | Coudersport | $477.60 | $152.25 – $1,041.88 |
| UPMC Hamot | Erie | $4,066.80 | $159.50 – $2,219.16 |
| UPMC Northwest | Seneca | $4,497.60 | $159.50 – $1,602.09 |
| UPMC Hanover | Hanover | $2,440.80 | $184.15 – $2,446.19 |
| UPMC Lititz | Lititz | $2,440.80 | $184.15 – $2,459.41 |
| UPMC McKeesport | Mckeesport | $3,861.60 | $159.50 – $1,678.38 |