Exchange biliary drg cath at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$7,502.40
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.
$12,504.00
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.
$162.24 with AmeriHealth Caritas vs $10,628.40 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 | $162.24 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $163.69 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $175.05 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $204.81 | ↓ -97% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $1,091.86 | ↓ -85% |
| UPMC Health Plan | CHIP | $2,071.33 | ↓ -72% |
| Highmark BCBS of PA | Commercial | $2,248.59 | ↓ -70% |
| Highmark BCBS of PA | CHIP | $2,248.59 | ↓ -70% |
| Keystone Health Plan | Medicare Advantage | $2,500.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,500.80 | ↓ -67% |
| Aetna | ACO | $2,684.00 | ↓ -64% |
| Aetna | PEBTF ACO | $2,963.00 | ↓ -61% |
| Prime Net | Managed Medicare | $3,025.97 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,436.76 | ↓ -54% |
| Aetna | Commercial | $3,485.00 | ↓ -54% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $3,488.48 | ↓ -54% |
| Humana | Medicare | $3,575.61 | ↓ -52% |
| Aetna | Medicare | $3,620.74 | ↓ -52% |
| Cigna | Medicare | $3,645.04 | ↓ -51% |
| United Healthcare | Medicare | $3,714.47 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,749.19 | ↓ -50% |
| Capital Blue Cross | Commercial | $7,348.95 | ↓ -2% |
| Keystone Health Plan | Commercial | $7,348.95 | ↓ -2% |
| Capital Blue Cross | CHIP | $7,348.95 | ↓ -2% |
| InterGroup | PPO | $8,127.60 | ↑ +8% |
| Prime Net | FH-Medical Rental | $9,403.01 | ↑ +25% |
| Wellspan Population Health | Commercial | $10,628.40 | ↑ +42% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exchange biliary drg cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,273.40 | $120.18 – $3,031.20 |
| UPMC Carlisle | Carlisle | $7,502.40 | $152.63 – $10,628.40 |
| UPMC East | Monroeville | $3,058.80 | $132.20 – $4,078.40 |
| UPMC Hamot | Erie | $3,045.00 | $132.20 – $4,893.48 |
| UPMC Northwest | Seneca | $3,855.00 | $132.20 – $3,532.77 |
| UPMC Hanover | Hanover | $7,502.40 | $152.63 – $5,394.10 |
| UPMC Jameson | New Castle | $2,373.00 | $132.20 – $4,542.13 |
| UPMC Lititz | Lititz | $7,502.40 | $152.63 – $5,423.23 |