Exc tendon sheath or cap lesion 26160 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
not published by hospital
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.
not published by hospital
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.
$629.01 with UPMC Work Partners vs $4,854.00 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $629.01 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,015.25 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,558.55 | — |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,582.00 | — |
| Humana | Medicare | $1,621.52 | — |
| Aetna | Medicare | $1,641.98 | — |
| Cigna | Medicare | $1,653.00 | — |
| United Healthcare | Medicare | $1,684.49 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,700.23 | — |
| UPMC Health Plan | CHIP | $2,637.15 | — |
| Highmark BCBS of PA | Commercial | $3,454.83 | — |
| Highmark BCBS of PA | CHIP | $3,454.83 | — |
| Aetna | ACO | $3,737.00 | — |
| Aetna | PEBTF ACO | $4,126.00 | — |
| Capital Blue Cross | CHIP | $4,217.85 | — |
| Keystone Health Plan | Commercial | $4,217.85 | — |
| Capital Blue Cross | Commercial | $4,217.85 | — |
| Aetna | Commercial | $4,854.00 | — |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc tendon sheath or cap lesion 26160 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $840.00 | $388.08 – $1,192.92 |
| Uniontown Hospital | Uniontown | $1,848.00 | $205.80 – $3,237.13 |
| UPMC Altoona | Altoona | not published | $559.88 – $1,647.86 |
| UPMC Bedford | Everett | not published | $550.51 – $1,647.86 |
| UPMC Carlisle | Carlisle | not published | $585.92 – $2,637.15 |
| UPMC East | Monroeville | not published | $625.39 – $1,678.38 |
| UPMC Hamot | Erie | not published | $625.39 – $2,219.16 |
| UPMC Northwest | Seneca | not published | $601.05 – $1,647.86 |