Pr management transitional care moderate w/in 14 days of discharge at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$255.00
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.
$425.00
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.
$85.00 with Capital Blue Cross vs $716.08 with Highmark BCBS of PA — 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 | $85.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $85.00 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $96.57 | ↓ -62% |
| Prime Net | Managed Medicare | $102.85 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $125.50 | ↓ -51% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $127.39 | ↓ -50% |
| Humana | Medicare | $130.57 | ↓ -49% |
| Aetna | Medicare | $132.22 | ↓ -48% |
| Cigna | Medicare | $133.11 | ↓ -48% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $136.91 | ↓ -46% |
| Aetna | ACO | $208.68 | ↓ -18% |
| Aetna | PEBTF ACO | $221.43 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $233.75 | ↓ -8% |
| UPMC Work Partners | Workers Comp | $234.45 | ↓ -8% |
| Capital Blue Cross | CHIP | $234.90 | ↓ -8% |
| Capital Blue Cross | Commercial | $234.90 | ↓ -8% |
| Keystone Health Plan | Commercial | $246.63 | ↓ -3% |
| Aetna | Commercial | $260.52 | ↑ +2% |
| UPMC Health Plan | CHIP | $271.21 | ↑ +6% |
| InterGroup | PPO | $276.25 | ↑ +8% |
| Prime Net | FH-Medical Rental | $319.60 | ↑ +25% |
| Wellspan Population Health | Commercial | $361.25 | ↑ +42% |
| Highmark BCBS of PA | Commercial | $716.08 | ↑ +181% |
| Highmark BCBS of PA | CHIP | $716.08 | ↑ +181% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pr management transitional care moderate w/in 14 days of discharge at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $1,295.40 | $88.46 – $438.49 |
| UPMC Somerset | Somerset | $255.00 | $84.78 – $224.03 |
| UPMC Wellsboro | Wellsboro | $307.20 | $94.36 – $224.03 |
| UPMC Western Psychiatric | Pittsburgh | $1,295.40 | $132.39 – $135.15 |
| UPMC Williamsport | Williamsport | $93.00 | $94.36 – $247.47 |
| Uniontown Hospital | Uniontown | $153.00 | $103.97 – $268.02 |