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Kit case 4.2mm spinejack at UPMC Muncy
215 East Water Street, Muncy, PA · UPMC · · NPI 1609816198
$7,686.60
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.
$12,811.00
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.
$1,743.00 with Highmark Wholecare (prev Gateway) vs $11,039.00 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicare | $1,743.00 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $1,743.00 | ↓ -77% |
| AmeriHealth Caritas | Medicare | $1,795.29 | ↓ -77% |
| Cigna | Medicare | $1,830.15 | ↓ -76% |
| United Healthcare | Medicare | $1,865.01 | ↓ -76% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,882.44 | ↓ -76% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2,324.00 | ↓ -70% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,834.60 | ↓ -50% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $4,557.36 | ↓ -41% |
| Aetna | PEBTF Custom Network | $4,711.91 | ↓ -39% |
| UPMC Health Plan | Commercial | $5,066.32 | ↓ -34% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5,367.28 | ↓ -30% |
| Aetna | Commercial | $5,542.74 | ↓ -28% |
| Coventry/First Health | Commercial | $5,821.62 | ↓ -24% |
| Wirerope Works | Commercial | $6,460.72 | ↓ -16% |
| Aetna | First Health | $7,669.20 | ↓ -0% |
| Geisinger | Commercial | $7,785.40 | ↑ +1% |
| Coventry/First Health | FH-Medical Rental | $7,820.26 | ↑ +2% |
| United Healthcare | Commercial | $7,948.08 | ↑ +3% |
| Cigna | Commercial | $7,959.70 | ↑ +4% |
| Multiplan | Auto | $9,063.60 | ↑ +18% |
| Multiplan | PPO (Includes PHCS as a Payer) | $9,063.60 | ↑ +18% |
| America's Choice | PPO | $9,296.00 | ↑ +21% |
| InterGroup | PPO | $9,296.00 | ↑ +21% |
| Three Rivers Provider Network | All | $10,458.00 | ↑ +36% |
| Multiplan | Worker's Compensation | $11,039.00 | ↑ +44% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Kit case 4.2mm spinejack at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $7,833.60 | $2,872.32 – $11,097.60 |
| UPMC Presbyterian | Pittsburgh | $12,441.00 | $2,488.20 – $17,624.75 |