healthcosts.net
New Patient Office Visit (level 5) at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$814.80
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.
$1,358.00
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.
$149.28 with AmeriHealth Caritas vs $1,133.05 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 | $149.28 | ↓ -82% |
| United Healthcare Community Plan for Families | PA Medicaid | $153.98 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $160.09 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $171.21 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $200.31 | ↓ -75% |
| InterGroup | PPO | $238.85 | ↓ -71% |
| UPMC Work Partners | Workers Comp | $252.22 | ↓ -69% |
| Capital Blue Cross | Medicare Advantage | $266.60 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $266.60 | ↓ -67% |
| Prime Net | Managed Medicare | $322.59 | ↓ -60% |
| Aetna | Medicare | $334.58 | ↓ -59% |
| UPMC Health Plan | CHIP | $452.70 | ↓ -44% |
| Aetna | ACO | $654.50 | ↓ -20% |
| Aetna | PEBTF ACO | $694.49 | ↓ -15% |
| Capital Blue Cross | CHIP | $736.75 | ↓ -10% |
| Capital Blue Cross | Commercial | $736.75 | ↓ -10% |
| Keystone Health Plan | Commercial | $773.54 | ↓ -5% |
| Highmark BCBS of PA | CHIP | $799.53 | ↓ -2% |
| Highmark BCBS of PA | Commercial | $799.53 | ↓ -2% |
| Aetna | Commercial | $817.13 | ↑ +0% |
| Prime Net | FH-Medical Rental | $1,002.42 | ↑ +23% |
| Wellspan Population Health | Commercial | $1,133.05 | ↑ +39% |
Visitor-reported prices
Comments
New Patient Office Visit (level 5) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $663.60 | $129.29 – $940.10 |
| UPMC East | Monroeville | $516.00 | $36.08 – $688.00 |
| UPMC Hamot | Erie | $360.60 | $90.15 – $527.06 |
| UPMC Altoona | Altoona | $343.80 | $30.00 – $458.40 |
| UPMC Bedford | Everett | $355.80 | $36.08 – $533.70 |
| UPMC Cole | Coudersport | $526.20 | $65.78 – $385.60 |
| UPMC Horizon-Greenville | Greenville | $526.20 | $123.42 – $745.45 |
| UPMC Jameson | New Castle | $526.20 | $29.68 – $771.76 |