healthcosts.net
Upper Endoscopy (EGD, with biopsy) at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$2,083.20
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.
?
What you pay up front if you don't use insurance.
$3,472.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$188.70 with AmeriHealth Caritas vs $3,485.00 with Aetna — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $188.70 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $202.37 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $216.42 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $253.21 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $368.11 | ↓ -82% |
| Capital Blue Cross | Medicare Advantage | $673.20 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $673.20 | ↓ -68% |
| UPMC Work Partners | Workers Comp | $719.53 | ↓ -65% |
| Prime Net | Managed Medicare | $814.57 | ↓ -61% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $913.04 | ↓ -56% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $926.78 | ↓ -56% |
| Humana | Medicare | $949.93 | ↓ -54% |
| Aetna | Medicare | $961.92 | ↓ -54% |
| Cigna | Medicare | $968.37 | ↓ -54% |
| United Healthcare | Medicare | $986.82 | ↓ -53% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $996.04 | ↓ -52% |
| InterGroup | PPO | $2,187.90 | ↑ +5% |
| Capital Blue Cross | CHIP | $2,200.80 | ↑ +6% |
| Capital Blue Cross | Commercial | $2,200.80 | ↑ +6% |
| Keystone Health Plan | Commercial | $2,200.80 | ↑ +6% |
| UPMC Health Plan | CHIP | $2,316.50 | ↑ +11% |
| Prime Net | FH-Medical Rental | $2,531.23 | ↑ +22% |
| Aetna | ACO | $2,684.00 | ↑ +29% |
| Wellspan Population Health | Commercial | $2,861.10 | ↑ +37% |
| Aetna | PEBTF ACO | $2,963.00 | ↑ +42% |
| Highmark BCBS of PA | CHIP | $3,012.49 | ↑ +45% |
| Highmark BCBS of PA | Commercial | $3,012.49 | ↑ +45% |
| Aetna | Commercial | $3,485.00 | ↑ +67% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | Tricare | not published by hospital | — |
Visitor-reported prices
Comments
Upper Endoscopy (EGD, with biopsy) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,214.00 | $163.44 – $3,136.50 |
| UPMC East | Monroeville | $3,055.20 | $163.44 – $4,073.60 |
| UPMC Hamot | Erie | $3,124.20 | $163.44 – $3,644.90 |
| UPMC Carlisle | Carlisle | $2,019.60 | $188.70 – $2,861.10 |
| UPMC Altoona | Altoona | $1,675.80 | $148.58 – $2,234.40 |
| UPMC Bedford | Everett | $1,656.60 | $156.01 – $2,484.90 |
| UPMC Cole | Coudersport | $637.20 | $156.01 – $1,041.88 |
| UPMC Hanover | Hanover | $2,019.60 | $188.70 – $2,928.42 |