Repair recur ventrl hern reduce 49565 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$1,038.00
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.
$1,730.00
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.
$149.40 with Keystone Health Plan vs $634.95 with Wellspan Population Health — 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 | $149.40 | ↓ -86% |
| Capital Blue Cross | Medicare Advantage | $149.40 | ↓ -86% |
| Prime Net | Managed Medicare | $180.77 | ↓ -83% |
| Aetna | Medicare | $187.50 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $410.85 | ↓ -60% |
| Capital Blue Cross | Commercial | $412.87 | ↓ -60% |
| Capital Blue Cross | CHIP | $412.87 | ↓ -60% |
| Keystone Health Plan | Commercial | $433.48 | ↓ -58% |
| Aetna | PEBTF ACO | $457.91 | ↓ -56% |
| Aetna | Commercial | $457.91 | ↓ -56% |
| Aetna | ACO | $457.91 | ↓ -56% |
| InterGroup | PPO | $485.55 | ↓ -53% |
| Highmark BCBS of PA | Commercial | $493.02 | ↓ -53% |
| Highmark BCBS of PA | CHIP | $493.02 | ↓ -53% |
| UPMC Health Plan | CHIP | $522.90 | ↓ -50% |
| Prime Net | FH-Medical Rental | $561.74 | ↓ -46% |
| Wellspan Population Health | Commercial | $634.95 | ↓ -39% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Repair recur ventrl hern reduce 49565 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,360.80 | $628.69 – $1,814.40 |
| UPMC Somerset | Somerset | $1,038.00 | $4,228.00 – $4,228.00 |
| GROVE CITY HOSPITAL | GROVE CITY | not published | $2,015.72 – $2,015.72 |