Ghs clsd tx frac distal tibia w/manipulation at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
not published by hospital
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.
not published by hospital
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.
$736.75 with Highmark BCBS of PA vs $3,719.96 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | — |
| UPMC Health Plan | Commercial | $824.29 | — |
| UPMC Health Plan | Managed Medicare | $1,414.26 | — |
| UPMC Work Partners | Workers Comp | $1,421.13 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,542.02 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,565.17 | — |
| Aetna of PA | Medicare | $1,602.09 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,647.86 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $1,647.86 | — |
| AmeriHealth Caritas | Medicare | $1,647.86 | — |
| Aetna | Medicare | $1,678.38 | — |
| Highmark BCBS of PA | Managed Care | $2,065.14 | — |
| UPMC Health Plan | CHIP | $2,297.46 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,777.59 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $3,719.96 | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Ghs clsd tx frac distal tibia w/manipulation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,344.40 | $729.80 – $4,459.20 |
| UPMC Bedford | Everett | $5,239.20 | $550.51 – $7,858.80 |
| UPMC Carlisle | Carlisle | $2,319.00 | $529.50 – $3,285.25 |
| UPMC Community Osteopathic | Harrisburg | $2,319.00 | $773.00 – $3,285.25 |
| UPMC East | Monroeville | $3,055.20 | $736.75 – $4,073.60 |
| UPMC Hamot | Erie | $3,098.40 | $729.80 – $2,219.16 |
| UPMC Northwest | Seneca | $2,186.40 | $1,085.30 – $1,647.86 |
| UPMC Hanover | Hanover | $2,319.00 | $1,016.56 – $2,446.19 |