healthcosts.net
Drainage absc/cyst/hmtma/vestibule mouth smpl at UPMC Muncy
215 East Water Street, Muncy, PA · UPMC · · NPI 1609816198
$1,440.00
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.
$2,400.00
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.
$29.15 with UPMC Health Plan vs $2,280.00 with Multiplan — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $29.15 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $29.15 | ↓ -98% |
| UPMC Health Plan | CHIP | $29.15 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.55 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $29.88 | ↓ -98% |
| AmeriHealth Caritas | Medicaid | $29.88 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $45.16 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $185.74 | ↓ -87% |
| Three Rivers Provider Network | All | $198.70 | ↓ -86% |
| UPMC Health Plan | Managed Medicare | $360.00 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $360.00 | ↓ -75% |
| AmeriHealth Caritas | Medicare | $370.80 | ↓ -74% |
| Cigna | Medicare | $378.00 | ↓ -74% |
| United Healthcare | Medicare | $385.20 | ↓ -73% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $388.80 | ↓ -73% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $941.28 | ↓ -35% |
| Aetna | PEBTF Custom Network | $973.20 | ↓ -32% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -31% |
| UPMC Health Plan | Commercial | $1,046.40 | ↓ -27% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,108.56 | ↓ -23% |
| Aetna | Commercial | $1,144.80 | ↓ -21% |
| Coventry/First Health | Commercial | $1,202.40 | ↓ -17% |
| Wirerope Works | Commercial | $1,334.40 | ↓ -7% |
| Aetna | First Health | $1,584.00 | ↑ +10% |
| Geisinger | Commercial | $1,608.00 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $1,615.20 | ↑ +12% |
| United Healthcare | Commercial | $1,641.60 | ↑ +14% |
| Cigna | Commercial | $1,644.00 | ↑ +14% |
| Multiplan | Auto | $1,872.00 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,872.00 | ↑ +30% |
| America's Choice | PPO | $1,920.00 | ↑ +33% |
| InterGroup | PPO | $1,920.00 | ↑ +33% |
| Multiplan | Worker's Compensation | $2,280.00 | ↑ +58% |
Visitor-reported prices
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Drainage absc/cyst/hmtma/vestibule mouth smpl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $647.40 | $29.15 – $917.15 |
| UPMC Mercy | Pittsburgh | $942.60 | $29.15 – $1,413.90 |
| UPMC Northwest | Seneca | $824.40 | $29.15 – $1,167.90 |
| UPMC Presbyterian | Pittsburgh | $630.00 | $29.15 – $931.20 |
| UPMC Somerset | Somerset | $924.60 | $29.15 – $892.40 |
| UPMC St. Margaret | Pittsburgh | $846.60 | $29.15 – $1,199.35 |
| UPMC Wellsboro | Wellsboro | $1,741.60 | $29.15 – $1,959.30 |
| UPMC Williamsport | Williamsport | $1,440.00 | $29.15 – $1,920.00 |