Cystostomy cystotomy w/drainage 51040 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$3,276.00
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.
$5,460.00
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.
$334.35 with AmeriHealth Caritas vs $7,348.95 with Keystone Health Plan — 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 | $334.35 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $358.57 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $383.48 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $448.66 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -69% |
| Capital Blue Cross | Medicare Advantage | $1,092.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,092.00 | ↓ -67% |
| Prime Net | Managed Medicare | $1,321.32 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $1,471.24 | ↓ -55% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,994.93 | ↓ -39% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $2,024.95 | ↓ -38% |
| Humana | Medicare | $2,075.53 | ↓ -37% |
| Aetna | Medicare | $2,101.73 | ↓ -36% |
| Cigna | Medicare | $2,115.83 | ↓ -35% |
| United Healthcare | Medicare | $2,156.14 | ↓ -34% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,176.29 | ↓ -34% |
| UPMC Health Plan | CHIP | $3,269.06 | ↓ -0% |
| InterGroup | PPO | $3,549.00 | ↑ +8% |
| Prime Net | FH-Medical Rental | $4,105.92 | ↑ +25% |
| Highmark BCBS of PA | Commercial | $4,255.64 | ↑ +30% |
| Highmark BCBS of PA | CHIP | $4,255.64 | ↑ +30% |
| Aetna | ACO | $4,374.00 | ↑ +34% |
| Wellspan Population Health | Commercial | $4,641.00 | ↑ +42% |
| Aetna | PEBTF ACO | $4,829.00 | ↑ +47% |
| Aetna | Commercial | $5,681.00 | ↑ +73% |
| Capital Blue Cross | Commercial | $7,348.95 | ↑ +124% |
| Capital Blue Cross | CHIP | $7,348.95 | ↑ +124% |
| Keystone Health Plan | Commercial | $7,348.95 | ↑ +124% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Cystostomy cystotomy w/drainage 51040 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $3,276.00 | $334.35 – $4,641.00 |
| UPMC Cole | Coudersport | $489.00 | $225.92 – $1,470.59 |
| UPMC Hamot | Erie | $5,943.60 | $289.60 – $2,840.52 |
| UPMC Northwest | Seneca | $6,051.00 | $289.60 – $2,050.66 |
| UPMC Hanover | Hanover | $3,276.00 | $334.35 – $3,131.10 |
| UPMC Horizon-Greenville | Greenville | $5,115.00 | $289.60 – $2,109.25 |
| UPMC Lititz | Lititz | $3,276.00 | $334.35 – $3,148.02 |
| UPMC Magee | Pittsburgh | $6,178.80 | $289.60 – $2,109.25 |