Ot re-evaluation patient/family at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$138.60
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.
$231.00
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.
$46.20 with Keystone Health Plan vs $307.65 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 |
|---|---|---|---|
| Keystone Health Plan | Medicare Advantage | $46.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $46.20 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $51.68 | ↓ -63% |
| United Healthcare Community Plan for Families | PA Medicaid | $53.30 | ↓ -62% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $55.42 | ↓ -60% |
| Prime Net | Managed Medicare | $55.90 | ↓ -60% |
| Aetna | Medicare | $57.98 | ↓ -58% |
| Geisinger | Medicaid/CHIP | $59.27 | ↓ -57% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $69.34 | ↓ -50% |
| UPMC Work Partners | Workers Comp | $70.04 | ↓ -49% |
| Highmark BCBS of PA | CHIP | $108.38 | ↓ -22% |
| Highmark BCBS of PA | Commercial | $108.38 | ↓ -22% |
| Aetna | ACO | $136.06 | ↓ -2% |
| Aetna | PEBTF ACO | $144.38 | ↑ +4% |
| InterGroup | PPO | $150.15 | ↑ +8% |
| Aetna | Commercial | $170.02 | ↑ +23% |
| Prime Net | FH-Medical Rental | $173.71 | ↑ +25% |
| Wellspan Population Health | Commercial | $196.35 | ↑ +42% |
| UPMC Health Plan | CHIP | $204.46 | ↑ +48% |
| Capital Blue Cross | Commercial | $307.65 | ↑ +122% |
| Keystone Health Plan | Commercial | $307.65 | ↑ +122% |
| Capital Blue Cross | CHIP | $307.65 | ↑ +122% |
Visitor-reported prices
Comments
Ot re-evaluation patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $113.40 | $32.98 – $151.20 |
| UPMC Bedford | Everett | $125.40 | $42.72 – $188.10 |
| UPMC Carlisle | Carlisle | $138.60 | $31.65 – $387.00 |
| UPMC Cole | Coudersport | $118.80 | $42.72 – $158.40 |
| UPMC East | Monroeville | $155.40 | $33.29 – $207.20 |
| UPMC Hamot | Erie | $147.60 | $32.98 – $121.18 |
| UPMC Northwest | Seneca | $105.00 | $44.76 – $85.58 |
| UPMC Hanover | Hanover | $138.60 | $51.68 – $193.00 |