Correct rectal prolapse 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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$892.40 with United Healthcare Community Plan for Families vs $4,493.00 with United Healthcare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,438.79 | — |
| UPMC Work Partners | Workers Comp | $2,086.57 | — |
| Humana | Medicare | $2,614.54 | — |
| United Healthcare | Medicare | $2,614.54 | — |
| Aetna of PA | Medicare | $2,614.54 | — |
| UPMC Health Plan | Managed Medicare | $2,724.87 | — |
| UPMC Health Plan | EPO Partners/Partners/Select | $2,730.10 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $2,823.44 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,823.70 | — |
| AmeriHealth Caritas | Medicare | $2,823.70 | — |
| Cigna | Medicare | $2,823.70 | — |
| UPMC Health Plan | CHIP | $3,102.62 | — |
| Occunet | Commercial | $3,529.63 | — |
| United Healthcare | Commercial | $4,493.00 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Correct rectal prolapse at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $9,169.80 | $1,413.84 – $12,226.40 |
| UPMC East | Monroeville | $8,036.40 | $1,427.30 – $10,715.20 |
| UPMC Mercy | Pittsburgh | $8,616.60 | $1,413.84 – $2,875.99 |
| UPMC Presbyterian | Pittsburgh | $10,834.80 | $931.20 – $2,875.99 |
| UPMC St. Margaret | Pittsburgh | $7,807.80 | $1,392.47 – $2,875.99 |
| UPMC Williamsport | Williamsport | $8,777.40 | $993.28 – $2,823.70 |
| Uniontown Hospital | Uniontown | $3,817.00 | $715.70 – $2,793.92 |