Exc tmr sft tiss shldr subq <3cm at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$849.60
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.
$1,416.00
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.
$72.90 with AmeriHealth Caritas vs $4,217.85 with Capital Blue Cross — 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 | $72.90 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $73.55 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $78.66 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $92.03 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $412.50 | ↓ -51% |
| United Healthcare Community Plan for Families | PA Medicaid | $893.42 | ↑ +5% |
| InterGroup | PPO | $1,203.60 | ↑ +42% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,577.86 | ↑ +86% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,601.61 | ↑ +89% |
| Humana | Medicare | $1,641.61 | ↑ +93% |
| Aetna | Medicare | $1,662.33 | ↑ +96% |
| Cigna | Medicare | $1,673.49 | ↑ +97% |
| United Healthcare | Medicare | $1,705.37 | ↑ +101% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,721.30 | ↑ +103% |
| UPMC Health Plan | CHIP | $2,299.58 | ↑ +171% |
| Aetna | ACO | $2,684.00 | ↑ +216% |
| Aetna | PEBTF ACO | $2,963.00 | ↑ +249% |
| Highmark BCBS of PA | CHIP | $3,012.49 | ↑ +255% |
| Highmark BCBS of PA | Commercial | $3,012.49 | ↑ +255% |
| Aetna | Commercial | $3,485.00 | ↑ +310% |
| Keystone Health Plan | Commercial | $4,217.85 | ↑ +396% |
| Capital Blue Cross | Commercial | $4,217.85 | ↑ +396% |
| Capital Blue Cross | CHIP | $4,217.85 | ↑ +396% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc tmr sft tiss shldr subq <3cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $450.00 | $56.70 – $1,041.88 |
| UPMC Presbyterian | Pittsburgh | $5,502.00 | $59.40 – $1,699.17 |
| UPMC Somerset | Somerset | $849.60 | $313.03 – $338.04 |
| Uniontown Hospital | Uniontown | $1,898.50 | $59.40 – $3,324.90 |
| UPMC Kane | Kane | not published | $59.40 – $2,161.06 |
| UPMC Wellsboro | Wellsboro | not published | $59.40 – $872.96 |