healthcosts.net
Established Patient Office Visit (level 5) at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$678.00
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.
$1,130.00
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.
$99.12 with AmeriHealth Caritas vs $790.50 with Wellspan Population Health — 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 | $99.12 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $102.25 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $106.30 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $113.69 | ↓ -83% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $133.01 | ↓ -80% |
| InterGroup | PPO | $162.35 | ↓ -76% |
| Capital Blue Cross | Medicare Advantage | $186.00 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $186.00 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $197.87 | ↓ -71% |
| UPMC Health Plan | CHIP | $217.11 | ↓ -68% |
| Prime Net | Managed Medicare | $225.06 | ↓ -67% |
| Aetna | Medicare | $233.43 | ↓ -66% |
| Highmark BCBS of PA | CHIP | $393.95 | ↓ -42% |
| Highmark BCBS of PA | Commercial | $393.95 | ↓ -42% |
| Aetna | ACO | $456.63 | ↓ -33% |
| Aetna | PEBTF ACO | $484.53 | ↓ -29% |
| Capital Blue Cross | CHIP | $514.01 | ↓ -24% |
| Capital Blue Cross | Commercial | $514.01 | ↓ -24% |
| Keystone Health Plan | Commercial | $539.68 | ↓ -20% |
| Aetna | Commercial | $570.09 | ↓ -16% |
| Prime Net | FH-Medical Rental | $699.36 | ↑ +3% |
| Wellspan Population Health | Commercial | $790.50 | ↑ +17% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $573.00 | $74.33 – $811.75 |
| UPMC East | Monroeville | $253.80 | $36.08 – $338.40 |
| UPMC Altoona | Altoona | $343.80 | $20.00 – $458.40 |
| UPMC Bedford | Everett | $176.40 | $36.08 – $264.60 |
| UPMC Cole | Coudersport | $367.80 | $59.28 – $256.00 |
| UPMC Hamot | Erie | $205.80 | $51.45 – $333.55 |
| UPMC Horizon-Greenville | Greenville | $268.80 | $81.95 – $380.80 |
| UPMC Jameson | New Castle | $268.80 | $26.75 – $394.24 |