Valvuloplasty mitral at UPMC Community Osteopathic
111 South Front Street, Harrisburg, PA · UPMC · · NPI 157809786
$23,686.20
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.
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What you pay up front if you don't use insurance.
$39,477.00
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.
$1,310.00 with United Healthcare Community Plan for Families vs $40,144.65 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 | $1,310.00 | ↓ -94% |
| UPMC Health Plan | CHIP | $2,468.82 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $2,898.89 | ↓ -88% |
| Highmark BCBS of PA | Commercial | $4,993.78 | ↓ -79% |
| Highmark BCBS of PA | CHIP | $4,993.78 | ↓ -79% |
| Aetna | ACO | $5,180.00 | ↓ -78% |
| Aetna | PEBTF ACO | $5,718.00 | ↓ -76% |
| Aetna | Commercial | $6,727.00 | ↓ -72% |
| Capital Blue Cross | Medicare Advantage | $7,895.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $7,895.40 | ↓ -67% |
| Prime Net | Managed Medicare | $9,553.43 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $11,043.94 | ↓ -53% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $11,210.15 | ↓ -53% |
| Humana | Medicare | $11,490.15 | ↓ -51% |
| Aetna | Medicare | $11,635.18 | ↓ -51% |
| Cigna | Medicare | $11,713.26 | ↓ -51% |
| United Healthcare | Medicare | $11,936.37 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12,047.93 | ↓ -49% |
| Geisinger | Medicaid/CHIP | $21,712.35 | ↓ -8% |
| InterGroup | PPO | $25,660.05 | ↑ +8% |
| Prime Net | FH-Medical Rental | $29,686.70 | ↑ +25% |
| Wellspan Population Health | Commercial | $33,555.45 | ↑ +42% |
| Capital Blue Cross | Commercial | $40,144.65 | ↑ +69% |
| Capital Blue Cross | CHIP | $40,144.65 | ↑ +69% |
| Keystone Health Plan | Commercial | $40,144.65 | ↑ +69% |
| Tricare | Tricare | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Valvuloplasty mitral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $23,686.20 | $1,310.00 – $33,555.45 |
| UPMC Hanover | Hanover | $23,686.20 | $1,310.00 – $17,333.84 |
| UPMC Lititz | Lititz | $23,686.20 | $1,310.00 – $17,427.46 |
| UPMC Memorial | York | $23,686.20 | $650.97 – $17,399.15 |
| UPMC Presbyterian | Pittsburgh | $17,108.40 | $806.29 – $11,893.06 |
| UPMC Somerset | Somerset | $23,686.20 | $790.61 – $11,675.74 |