healthcosts.net
Sm-153 lexidron ther at UPMC Muncy
215 East Water Street, Muncy, PA · UPMC · · NPI 1609816198
$12,410.40
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.
$20,684.00
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.
$2,208.32 with AmeriHealth Caritas vs $19,649.80 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 |
|---|---|---|---|
| AmeriHealth Caritas | Medicare | $2,208.32 | ↓ -82% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,315.52 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,102.60 | ↓ -75% |
| UPMC Health Plan | Managed Medicare | $3,102.60 | ↓ -75% |
| Cigna | Medicare | $3,257.73 | ↓ -74% |
| United Healthcare | Medicare | $3,319.78 | ↓ -73% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $8,112.26 | ↓ -35% |
| Aetna | PEBTF Custom Network | $8,387.36 | ↓ -32% |
| UPMC Health Plan | Commercial | $9,018.22 | ↓ -27% |
| Highmark BCBS of PA | Managed Care - Social Mission | $9,553.94 | ↓ -23% |
| Aetna | Commercial | $9,866.27 | ↓ -20% |
| Coventry/First Health | Commercial | $10,362.68 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $11,376.20 | ↓ -8% |
| Wirerope Works | Commercial | $11,500.30 | ↓ -7% |
| Aetna | First Health | $13,651.44 | ↑ +10% |
| Geisinger | Commercial | $13,858.28 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $13,920.33 | ↑ +12% |
| United Healthcare | Commercial | $14,147.86 | ↑ +14% |
| Cigna | Commercial | $14,168.54 | ↑ +14% |
| Multiplan | Auto | $16,133.52 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $16,133.52 | ↑ +30% |
| America's Choice | PPO | $16,547.20 | ↑ +33% |
| InterGroup | PPO | $16,547.20 | ↑ +33% |
| Three Rivers Provider Network | All | $18,615.60 | ↑ +50% |
| Multiplan | Worker's Compensation | $19,649.80 | ↑ +58% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Sm-153 lexidron ther at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $31,245.00 | $4,660.10 – $44,263.75 |
| UPMC Somerset | Somerset | $5,947.80 | $3,903.74 – $7,434.75 |
| UPMC Wellsboro | Wellsboro | $15,008.80 | $3,376.98 – $16,884.90 |
| UPMC Mercy | Pittsburgh | not published | $2,493.56 – $10,621.85 |
| UPMC Northwest | Seneca | not published | $3,575.00 – $7,596.88 |
| UPMC St. Margaret | Pittsburgh | not published | $2,252.25 – $10,723.00 |