Observation direct referral from physician office for admission at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$420.00
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.
$700.00
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.
$169.40 with Prime Net vs $8,017.80 with Capital Blue Cross — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $169.40 | ↓ -60% |
| InterGroup | PPO | $455.00 | ↑ +8% |
| Prime Net | FH-Medical Rental | $526.40 | ↑ +25% |
| Wellspan Population Health | Commercial | $595.00 | ↑ +42% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $597.06 | ↑ +42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $606.05 | ↑ +44% |
| Humana | Medicare | $621.18 | ↑ +48% |
| Aetna | Medicare | $629.02 | ↑ +50% |
| Cigna | Medicare | $633.24 | ↑ +51% |
| United Healthcare | Medicare | $645.31 | ↑ +54% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $651.34 | ↑ +55% |
| Keystone Health Plan | Medicare Advantage | $1,400.00 | ↑ +233% |
| Capital Blue Cross | Medicare Advantage | $1,400.00 | ↑ +233% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2,064.00 | ↑ +391% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,137.42 | ↑ +409% |
| Geisinger | Medicaid/CHIP | $2,207.16 | ↑ +426% |
| Aetna | ACO | $2,564.00 | ↑ +510% |
| Aetna | PEBTF ACO | $2,831.00 | ↑ +574% |
| UPMC Health Plan | CHIP | $3,000.00 | ↑ +614% |
| Aetna | Commercial | $3,329.00 | ↑ +693% |
| Keystone Health Plan | Commercial | $8,017.80 | ↑ +1809% |
| Capital Blue Cross | CHIP | $8,017.80 | ↑ +1809% |
| Capital Blue Cross | Commercial | $8,017.80 | ↑ +1809% |
| Tricare | Tricare | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $117.00 | $27.00 – $2,064.00 |
| UPMC Bedford | Everett | $166.20 | $31.88 – $2,207.16 |
| UPMC Carlisle | Carlisle | $420.00 | $95.90 – $2,064.00 |
| UPMC Cole | Coudersport | $84.00 | $38.81 – $112.00 |
| UPMC East | Monroeville | $130.20 | $31.88 – $2,207.16 |
| UPMC Hamot | Erie | $138.60 | $674.61 – $728.58 |
| UPMC Northwest | Seneca | $112.80 | $31.88 – $631.28 |
| UPMC Hanover | Hanover | $420.00 | $579.83 – $937.10 |