Clsd tx/scapular fx without manip 23570 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$496.20
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.
$827.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$92.71 with AmeriHealth Caritas vs $2,249.82 with Highmark BCBS of PA — 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 | $92.71 | ↓ -81% |
| United Healthcare Community Plan for Families | PA Medicaid | $95.63 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $99.43 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $106.33 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $124.41 | ↓ -75% |
| Capital Blue Cross | Medicare Advantage | $165.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $165.40 | ↓ -67% |
| Prime Net | Managed Medicare | $200.13 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $233.61 | ↓ -53% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $237.13 | ↓ -52% |
| Humana | Medicare | $243.05 | ↓ -51% |
| Aetna | Medicare | $246.12 | ↓ -50% |
| Cigna | Medicare | $247.77 | ↓ -50% |
| United Healthcare | Medicare | $252.49 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $254.85 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $386.44 | ↓ -22% |
| InterGroup | PPO | $537.55 | ↑ +8% |
| Prime Net | FH-Medical Rental | $621.90 | ↑ +25% |
| Wellspan Population Health | Commercial | $702.95 | ↑ +42% |
| Keystone Health Plan | Commercial | $1,471.05 | ↑ +196% |
| Capital Blue Cross | CHIP | $1,471.05 | ↑ +196% |
| Capital Blue Cross | Commercial | $1,471.05 | ↑ +196% |
| Aetna | ACO | $1,633.00 | ↑ +229% |
| UPMC Health Plan | CHIP | $1,731.18 | ↑ +249% |
| Aetna | PEBTF ACO | $1,802.00 | ↑ +263% |
| Aetna | Commercial | $2,120.00 | ↑ +327% |
| Highmark BCBS of PA | Commercial | $2,249.82 | ↑ +353% |
| Highmark BCBS of PA | CHIP | $2,249.82 | ↑ +353% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx/scapular fx without manip 23570 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $496.20 | $92.71 – $702.95 |
| UPMC Cole | Coudersport | $1,266.00 | $57.93 – $771.51 |
| UPMC Hanover | Hanover | $496.20 | $92.71 – $386.44 |
| UPMC Lititz | Lititz | $496.20 | $92.71 – $381.92 |
| UPMC Memorial | York | $496.20 | $92.71 – $444.23 |
| UPMC Muncy | Muncy | $825.60 | $80.30 – $421.03 |
| UPMC Somerset | Somerset | $496.20 | $80.30 – $364.94 |
| UPMC Wellsboro | Wellsboro | $998.40 | $80.30 – $364.94 |