Ghs simple repair 7.6 - 12.5 cm - 12015 at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$265.20
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.
$442.00
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.
$67.65 with UPMC Health Plan vs $636.94 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 | $67.65 | ↓ -74% |
| Aetna | Medicaid | $69.50 | ↓ -74% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $79.96 | ↓ -70% |
| Geisinger | Medicaid/CHIP | $85.48 | ↓ -68% |
| Cigna | Commercial | $91.23 | ↓ -66% |
| PA Health & Wellness | PA Medicaid HMO | $104.81 | ↓ -60% |
| United Healthcare | Medicare | $189.44 | ↓ -29% |
| Aetna of PA | Medicare | $189.44 | ↓ -29% |
| Humana | Medicare | $189.44 | ↓ -29% |
| UPMC Health Plan | Managed Medicare | $197.43 | ↓ -26% |
| UPMC Health Plan | EPO Partners/Partners/Select | $197.81 | ↓ -25% |
| UPMC Health Plan | Commercial | $198.90 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.58 | ↓ -23% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | ↓ -23% |
| Cigna | Medicare | $204.60 | ↓ -23% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -23% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $208.08 | ↓ -22% |
| Occunet | Commercial | $255.74 | ↓ -4% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $331.50 | ↑ +25% |
| Humana | Commercial | $353.60 | ↑ +33% |
| National Provider Network | PPO | $388.96 | ↑ +47% |
| UPMC Work Partners | Workers Comp | $419.77 | ↑ +58% |
| United Healthcare | Commercial | $581.00 | ↑ +119% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $631.35 | ↑ +138% |
| UPMC Health Plan | CHIP | $636.94 | ↑ +140% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 7.6 - 12.5 cm - 12015 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $819.60 | $61.50 – $1,092.80 |
| UPMC Bedford | Everett | $454.20 | $64.58 – $681.30 |
| UPMC Carlisle | Carlisle | $808.20 | $78.11 – $1,144.95 |
| UPMC Cole | Coudersport | $765.00 | $64.58 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $808.20 | $78.11 – $1,144.95 |
| UPMC East | Monroeville | $856.80 | $67.65 – $1,142.40 |
| UPMC Hamot | Erie | $857.40 | $67.65 – $446.19 |
| UPMC Northwest | Seneca | $610.80 | $67.65 – $419.77 |