Ligation/biopsy of temporal artery 37609 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$4,489.80
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.
$7,483.00
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.
$157.48 with AmeriHealth Caritas vs $6,360.55 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 | $157.48 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $168.89 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $180.62 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $211.32 | ↓ -95% |
| United Healthcare Community Plan for Families | PA Medicaid | $534.48 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $561.26 | ↓ -87% |
| Capital Blue Cross | Medicare Advantage | $1,496.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,496.60 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,577.86 | ↓ -65% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,601.61 | ↓ -64% |
| Humana | Medicare | $1,641.61 | ↓ -63% |
| Aetna | Medicare | $1,662.33 | ↓ -63% |
| Cigna | Medicare | $1,673.49 | ↓ -63% |
| United Healthcare | Medicare | $1,705.37 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,721.30 | ↓ -62% |
| Prime Net | Managed Medicare | $1,810.89 | ↓ -60% |
| UPMC Health Plan | CHIP | $2,316.66 | ↓ -48% |
| Aetna | ACO | $2,684.00 | ↓ -40% |
| Aetna | PEBTF ACO | $2,963.00 | ↓ -34% |
| Highmark BCBS of PA | CHIP | $3,012.49 | ↓ -33% |
| Highmark BCBS of PA | Commercial | $3,012.49 | ↓ -33% |
| Aetna | Commercial | $3,485.00 | ↓ -22% |
| Capital Blue Cross | CHIP | $4,217.85 | ↓ -6% |
| Keystone Health Plan | Commercial | $4,217.85 | ↓ -6% |
| Capital Blue Cross | Commercial | $4,217.85 | ↓ -6% |
| InterGroup | PPO | $4,863.95 | ↑ +8% |
| Prime Net | FH-Medical Rental | $5,627.22 | ↑ +25% |
| Wellspan Population Health | Commercial | $6,360.55 | ↑ +42% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ligation/biopsy of temporal artery 37609 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,489.80 | $157.48 – $6,360.55 |
| UPMC Cole | Coudersport | $405.60 | $81.22 – $1,041.88 |
| UPMC Hanover | Hanover | $4,489.80 | $157.48 – $2,476.51 |
| UPMC Lititz | Lititz | $4,489.80 | $157.48 – $2,489.89 |
| UPMC Memorial | York | $4,489.80 | $157.48 – $2,485.84 |
| UPMC Somerset | Somerset | $4,489.80 | $136.40 – $1,544.70 |
| Uniontown Hospital | Uniontown | $943.50 | $1,600.82 – $3,729.91 |
| UPMC Altoona | Altoona | not published | $124.00 – $1,668.28 |