Surgical pathology level 5 gross & microscopic examination at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$664.80
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.
$1,108.00
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.
$15.06 with United Healthcare Community Plan for Families vs $478.18 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $15.06 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $45.50 | ↓ -93% |
| Keystone Health Plan | Medicare Advantage | $47.20 | ↓ -93% |
| Capital Blue Cross | Medicare Advantage | $47.20 | ↓ -93% |
| Prime Net | Managed Medicare | $57.11 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $61.97 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $66.28 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $77.54 | ↓ -88% |
| UPMC Health Plan | CHIP | $130.59 | ↓ -80% |
| Aetna | ACO | $139.00 | ↓ -79% |
| Aetna | PEBTF ACO | $147.50 | ↓ -78% |
| InterGroup | PPO | $153.40 | ↓ -77% |
| Aetna | Commercial | $173.70 | ↓ -74% |
| Prime Net | FH-Medical Rental | $177.47 | ↓ -73% |
| Highmark BCBS of PA | Commercial | $196.10 | ↓ -71% |
| Highmark BCBS of PA | CHIP | $196.10 | ↓ -71% |
| Wellspan Population Health | Commercial | $200.60 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $288.58 | ↓ -57% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $350.31 | ↓ -47% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $355.58 | ↓ -47% |
| Humana | Medicare | $364.47 | ↓ -45% |
| Aetna | Medicare | $369.07 | ↓ -44% |
| Cigna | Medicare | $371.54 | ↓ -44% |
| United Healthcare | Medicare | $378.62 | ↓ -43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $382.16 | ↓ -43% |
| Capital Blue Cross | CHIP | $478.18 | ↓ -28% |
| Capital Blue Cross | Commercial | $478.18 | ↓ -28% |
| Keystone Health Plan | Commercial | $478.18 | ↓ -28% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $234.60 | $11.50 – $312.80 |
| UPMC Bedford | Everett | $189.60 | $36.42 – $284.40 |
| UPMC Carlisle | Carlisle | $664.80 | $15.06 – $941.80 |
| UPMC Cole | Coudersport | $572.40 | $47.77 – $763.20 |
| UPMC East | Monroeville | $379.20 | $35.92 – $505.60 |
| UPMC Hamot | Erie | $360.60 | $45.50 – $427.47 |
| UPMC Northwest | Seneca | $360.60 | $36.26 – $360.10 |
| UPMC Hanover | Hanover | $664.80 | $15.06 – $549.82 |