Clsd tx shoulder dislc/fx 23665 at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$1,264.80
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.
$2,108.00
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.
$172.70 with UPMC Health Plan vs $2,298.74 with UPMC Health Plan — 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 | $172.70 | ↓ -86% |
| Aetna | Medicaid | $177.41 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $204.12 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $218.21 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $267.56 | ↓ -79% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $742.68 | ↓ -41% |
| UPMC Work Partners | Workers Comp | $750.58 | ↓ -41% |
| United Healthcare | Commercial | $882.00 | ↓ -30% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $892.40 | ↓ -29% |
| UPMC Health Plan | Commercial | $948.60 | ↓ -25% |
| Cigna | Commercial | $953.25 | ↓ -25% |
| United Healthcare | Medicare | $1,525.80 | ↑ +21% |
| Humana | Medicare | $1,525.80 | ↑ +21% |
| Aetna of PA | Medicare | $1,525.80 | ↑ +21% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,581.00 | ↑ +25% |
| UPMC Health Plan | Managed Medicare | $1,590.19 | ↑ +26% |
| UPMC Health Plan | EPO Partners/Partners/Select | $1,593.24 | ↑ +26% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,647.71 | ↑ +30% |
| Cigna | Medicare | $1,647.86 | ↑ +30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,647.86 | ↑ +30% |
| AmeriHealth Caritas | Medicare | $1,647.86 | ↑ +30% |
| Humana | Commercial | $1,686.40 | ↑ +33% |
| National Provider Network | PPO | $1,855.04 | ↑ +47% |
| Occunet | Commercial | $2,059.83 | ↑ +63% |
| UPMC Health Plan | CHIP | $2,298.74 | ↑ +82% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Clsd tx shoulder dislc/fx 23665 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $157.00 – $4,246.40 |
| UPMC Bedford | Everett | $4,739.40 | $164.85 – $7,109.10 |
| UPMC Carlisle | Carlisle | $2,055.00 | $199.39 – $2,911.25 |
| UPMC Cole | Coudersport | $1,693.20 | $164.85 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $199.39 – $2,911.25 |
| UPMC East | Monroeville | $3,055.20 | $172.70 – $4,073.60 |
| UPMC Hamot | Erie | $3,099.00 | $172.70 – $2,219.16 |
| UPMC Northwest | Seneca | $2,186.40 | $172.70 – $1,602.09 |