Incision of breast lesion at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$2,715.60
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.
$4,526.00
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.
$92.71 with AmeriHealth Caritas vs $5,805.45 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 | $92.71 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $99.43 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $106.33 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $124.41 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $521.86 | ↓ -81% |
| Capital Blue Cross | Medicare Advantage | $905.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $905.20 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,075.51 | ↓ -60% |
| Prime Net | Managed Medicare | $1,095.29 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,577.86 | ↓ -42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,601.61 | ↓ -41% |
| Humana | Medicare | $1,641.61 | ↓ -40% |
| Aetna | Medicare | $1,662.33 | ↓ -39% |
| Cigna | Medicare | $1,673.49 | ↓ -38% |
| United Healthcare | Medicare | $1,705.37 | ↓ -37% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,721.30 | ↓ -37% |
| UPMC Health Plan | CHIP | $2,298.80 | ↓ -15% |
| Aetna | ACO | $2,684.00 | ↓ -1% |
| InterGroup | PPO | $2,941.90 | ↑ +8% |
| Aetna | PEBTF ACO | $2,963.00 | ↑ +9% |
| Highmark BCBS of PA | Commercial | $3,012.49 | ↑ +11% |
| Highmark BCBS of PA | CHIP | $3,012.49 | ↑ +11% |
| Prime Net | FH-Medical Rental | $3,403.55 | ↑ +25% |
| Aetna | Commercial | $3,485.00 | ↑ +28% |
| Wellspan Population Health | Commercial | $3,847.10 | ↑ +42% |
| Capital Blue Cross | Commercial | $5,805.45 | ↑ +114% |
| Capital Blue Cross | CHIP | $5,805.45 | ↑ +114% |
| Keystone Health Plan | Commercial | $5,805.45 | ↑ +114% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Incision of breast lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,765.20 | $73.00 – $2,353.60 |
| UPMC Bedford | Everett | $4,534.80 | $76.65 – $6,802.20 |
| UPMC Carlisle | Carlisle | $2,715.60 | $92.71 – $3,847.10 |
| UPMC Cole | Coudersport | $1,693.20 | $76.65 – $1,041.88 |
| UPMC East | Monroeville | $3,824.40 | $80.30 – $5,099.20 |
| UPMC Hamot | Erie | $3,013.20 | $80.30 – $2,246.66 |
| UPMC Hanover | Hanover | $2,742.00 | $92.71 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $3,508.20 | $80.30 – $1,668.28 |