Mnt subs tx for change dx at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$59.40
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.
$99.00
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.
$19.80 with Capital Blue Cross vs $84.15 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 |
|---|---|---|---|
| Capital Blue Cross | Medicare Advantage | $19.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $19.80 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $21.93 | ↓ -63% |
| Prime Net | Managed Medicare | $23.96 | ↓ -60% |
| Aetna | Medicare | $24.85 | ↓ -58% |
| UPMC Health Plan | CHIP | $37.97 | ↓ -36% |
| Aetna | ACO | $48.61 | ↓ -18% |
| Aetna | PEBTF ACO | $51.58 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $54.45 | ↓ -8% |
| Capital Blue Cross | Commercial | $54.72 | ↓ -8% |
| Capital Blue Cross | CHIP | $54.72 | ↓ -8% |
| Keystone Health Plan | Commercial | $57.45 | ↓ -3% |
| Aetna | Commercial | $60.69 | ↑ +2% |
| InterGroup | PPO | $64.35 | ↑ +8% |
| Prime Net | FH-Medical Rental | $74.45 | ↑ +25% |
| Highmark BCBS of PA | Commercial | $81.01 | ↑ +36% |
| Highmark BCBS of PA | CHIP | $81.01 | ↑ +36% |
| Wellspan Population Health | Commercial | $84.15 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Mnt subs tx for change dx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $19.80 | $12.96 – $37.97 |
| UPMC Carlisle | Carlisle | $59.40 | $13.56 – $115.00 |
| UPMC Hanover | Hanover | $59.40 | $21.93 – $115.00 |
| UPMC Lititz | Lititz | $59.40 | $21.93 – $115.00 |
| UPMC Magee | Pittsburgh | $24.60 | $13.08 – $37.97 |
| UPMC Memorial | York | $59.40 | $10.56 – $115.00 |
| UPMC Passavant-McCandless | Pittsburgh | $24.60 | $13.08 – $55.10 |
| UPMC Somerset | Somerset | $59.40 | $12.82 – $22.74 |