Stent/tib/peroneal/unilat/initial 37230 at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$24,161.40
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.
$40,269.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $61,843.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -96% |
| Aetna | ACO | $4,374.00 | ↓ -82% |
| Aetna | PEBTF ACO | $4,829.00 | ↓ -80% |
| Aetna | Commercial | $5,681.00 | ↓ -76% |
| Keystone Health Plan | Medicare Advantage | $8,053.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $8,053.80 | ↓ -67% |
| Prime Net | Managed Medicare | $9,745.10 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $12,871.17 | ↓ -47% |
| Keystone Health Plan | Commercial | $15,803.55 | ↓ -35% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $17,487.03 | ↓ -28% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $17,750.22 | ↓ -27% |
| Humana | Medicare | $18,193.58 | ↓ -25% |
| Aetna | Medicare | $18,423.21 | ↓ -24% |
| Cigna | Medicare | $18,546.85 | ↓ -23% |
| United Healthcare | Medicare | $18,900.13 | ↓ -22% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $19,076.76 | ↓ -21% |
| Geisinger | Medicaid/CHIP | $22,147.95 | ↓ -8% |
| Capital Blue Cross | CHIP | $23,763.60 | ↓ -2% |
| Capital Blue Cross | Commercial | $23,763.60 | ↓ -2% |
| InterGroup | PPO | $26,174.85 | ↑ +8% |
| UPMC Health Plan | CHIP | $28,188.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $30,282.29 | ↑ +25% |
| Wellspan Population Health | Commercial | $34,228.65 | ↑ +42% |
| Highmark BCBS of PA | CHIP | $61,843.00 | ↑ +156% |
| Highmark BCBS of PA | Commercial | $61,843.00 | ↑ +156% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Stent/tib/peroneal/unilat/initial 37230 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $34,008.60 | $12,299.12 – $45,344.80 |
| UPMC Carlisle | Carlisle | $24,161.40 | $1,016.56 – $34,228.65 |
| UPMC East | Monroeville | $35,436.00 | $12,299.12 – $47,248.00 |
| UPMC Hamot | Erie | $31,604.40 | $644.90 – $24,899.21 |
| UPMC Hanover | Hanover | $24,161.40 | $1,016.56 – $27,446.48 |
| UPMC Lititz | Lititz | $24,161.40 | $1,016.56 – $27,594.74 |
| UPMC Memorial | York | $24,161.40 | $1,016.56 – $27,549.92 |
| UPMC Passavant-McCandless | Pittsburgh | $34,695.00 | $12,299.12 – $18,831.54 |