healthcosts.net
Appendix Removal (Laparoscopic) at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
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.
$892.40 with United Healthcare Community Plan for Families vs $7,509.19 with Occunet — 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 CHIP/PA Medicaid | $892.40 | — |
| UPMC Work Partners | Workers Comp | $1,067.82 | — |
| Cigna | Commercial | $1,339.68 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,660.22 | — |
| UPMC Health Plan | Commercial | $3,186.30 | — |
| UPMC Health Plan | CHIP | $5,169.42 | — |
| Aetna of PA | Medicare | $5,562.36 | — |
| Humana | Medicare | $5,562.36 | — |
| United Healthcare | Medicare | $5,562.36 | — |
| UPMC Health Plan | Managed Medicare | $5,797.09 | — |
| UPMC Health Plan | EPO Partners/Partners/Select | $5,808.22 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $6,006.79 | — |
| AmeriHealth Caritas | Medicare | $6,007.35 | — |
| Cigna | Medicare | $6,007.35 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,007.35 | — |
| United Healthcare | Commercial | $6,270.00 | — |
| Occunet | Commercial | $7,509.19 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Appendix Removal (Laparoscopic) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $805.20 | $372.00 – $1,677.17 |
| UPMC Community Osteopathic | Harrisburg | $1,580.40 | $1,016.56 – $11,519.55 |
| UPMC Somerset | Somerset | $1,580.40 | $570.59 – $5,562.36 |
| UPMC Passavant-McCandless | Pittsburgh | not published | $1,067.82 – $6,118.60 |
| UPMC East | Monroeville | not published | $1,067.82 – $6,118.60 |
| UPMC Hamot | Erie | not published | $1,067.82 – $8,090.06 |
| UPMC Carlisle | Carlisle | not published | $1,016.56 – $8,930.03 |
| UPMC Altoona | Altoona | not published | $1,067.82 – $6,007.35 |