Proctosigmoidoscopy dx 45300 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$1,420.20
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.
$2,367.00
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.
$32.90 with AmeriHealth Caritas vs $2,656.50 with Keystone Health Plan — 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 | $32.90 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $33.19 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $35.50 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $41.53 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $126.05 | ↓ -91% |
| Capital Blue Cross | Medicare Advantage | $473.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $473.40 | ↓ -67% |
| Prime Net | Managed Medicare | $572.81 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $887.86 | ↓ -37% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $901.22 | ↓ -37% |
| Humana | Medicare | $923.73 | ↓ -35% |
| Aetna | Medicare | $935.39 | ↓ -34% |
| Cigna | Medicare | $941.67 | ↓ -34% |
| United Healthcare | Medicare | $959.61 | ↓ -32% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $968.58 | ↓ -32% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -28% |
| UPMC Health Plan | CHIP | $1,064.56 | ↓ -25% |
| Highmark BCBS of PA | CHIP | $1,381.10 | ↓ -3% |
| Highmark BCBS of PA | Commercial | $1,381.10 | ↓ -3% |
| InterGroup | PPO | $1,538.55 | ↑ +8% |
| Aetna | ACO | $1,633.00 | ↑ +15% |
| Prime Net | FH-Medical Rental | $1,779.98 | ↑ +25% |
| Aetna | PEBTF ACO | $1,802.00 | ↑ +27% |
| Wellspan Population Health | Commercial | $2,011.95 | ↑ +42% |
| Aetna | Commercial | $2,120.00 | ↑ +49% |
| Capital Blue Cross | Commercial | $2,656.50 | ↑ +87% |
| Capital Blue Cross | CHIP | $2,656.50 | ↑ +87% |
| Keystone Health Plan | Commercial | $2,656.50 | ↑ +87% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Proctosigmoidoscopy dx 45300 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $817.20 | $24.37 – $1,089.60 |
| UPMC Cole | Coudersport | $780.60 | $25.59 – $2,325.85 |
| UPMC Magee | Pittsburgh | $2,279.40 | $26.81 – $938.75 |
| UPMC Memorial | York | $1,420.20 | $30.95 – $1,398.78 |
| UPMC Passavant-McCandless | Pittsburgh | $1,189.80 | $26.81 – $956.13 |
| UPMC Presbyterian | Pittsburgh | $1,857.60 | $26.81 – $956.13 |
| UPMC Somerset | Somerset | $1,420.20 | $26.81 – $892.40 |
| UPMC St. Margaret | Pittsburgh | $1,663.20 | $26.81 – $956.13 |