Repair lip full thkns >one-half vert height/cmplx at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$2,046.00
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.
$3,410.00
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.
$467.69 with AmeriHealth Caritas vs $4,854.00 with Aetna — 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 | $467.69 | ↓ -77% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $501.57 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $536.41 | ↓ -74% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $627.59 | ↓ -69% |
| Capital Blue Cross | Medicare Advantage | $682.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $682.00 | ↓ -67% |
| Prime Net | Managed Medicare | $825.22 | ↓ -60% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -50% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,442.54 | ↓ -29% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,464.25 | ↓ -28% |
| Humana | Medicare | $1,500.82 | ↓ -27% |
| Aetna | Medicare | $1,519.77 | ↓ -26% |
| Cigna | Medicare | $1,529.97 | ↓ -25% |
| United Healthcare | Medicare | $1,559.11 | ↓ -24% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,573.68 | ↓ -23% |
| UPMC Work Partners | Workers Comp | $1,602.71 | ↓ -22% |
| InterGroup | PPO | $2,216.50 | ↑ +8% |
| Prime Net | FH-Medical Rental | $2,564.32 | ↑ +25% |
| UPMC Health Plan | CHIP | $2,655.02 | ↑ +30% |
| Wellspan Population Health | Commercial | $2,898.50 | ↑ +42% |
| Keystone Health Plan | Commercial | $3,135.30 | ↑ +53% |
| Capital Blue Cross | CHIP | $3,135.30 | ↑ +53% |
| Capital Blue Cross | Commercial | $3,135.30 | ↑ +53% |
| Highmark BCBS of PA | CHIP | $3,454.83 | ↑ +69% |
| Highmark BCBS of PA | Commercial | $3,454.83 | ↑ +69% |
| Aetna | ACO | $3,737.00 | ↑ +83% |
| Aetna | PEBTF ACO | $4,126.00 | ↑ +102% |
| Aetna | Commercial | $4,854.00 | ↑ +137% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Repair lip full thkns >one-half vert height/cmplx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,046.00 | $467.17 – $2,898.50 |
| UPMC Hamot | Erie | $4,856.40 | $405.09 – $2,053.97 |
| UPMC Hanover | Hanover | $2,046.00 | $467.69 – $2,264.11 |
| UPMC Jameson | New Castle | $3,645.60 | $405.09 – $1,906.50 |
| UPMC Lititz | Lititz | $2,046.00 | $467.69 – $2,276.34 |
| UPMC McKeesport | Mckeesport | $4,060.80 | $405.09 – $1,600.15 |
| UPMC Memorial | York | $2,046.00 | $467.69 – $2,272.64 |
| UPMC Mercy | Pittsburgh | $3,486.60 | $405.09 – $1,601.90 |