Whfo nontorsion joint prefab at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$106.20
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.
$177.00
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.
$58.41 with Geisinger vs $804.83 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 |
|---|---|---|---|
| Geisinger | Medicaid/CHIP | $58.41 | ↓ -45% |
| United Healthcare | Commercial | $61.77 | ↓ -42% |
| UPMC Health Plan | Commercial | $79.65 | ↓ -25% |
| Cigna | Commercial | $83.54 | ↓ -21% |
| Highmark Wholecare (prev Gateway) | Medicare | $88.50 | ↓ -17% |
| Aetna of PA | Medicare | $96.81 | ↓ -9% |
| PA Health & Wellness | PA Medicaid HMO | $97.35 | ↓ -8% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $132.37 | ↑ +25% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $132.75 | ↑ +25% |
| Humana | Commercial | $141.60 | ↑ +33% |
| National Provider Network | PPO | $155.76 | ↑ +47% |
| UPMC Work Partners | Workers Comp | $233.39 | ↑ +120% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $272.16 | ↑ +156% |
| UPMC Health Plan | CHIP | $804.83 | ↑ +658% |
| UPMC Health Plan | Managed Medicaid | not published by hospital | — |
| Aetna | Medicaid | not published by hospital | — |
Visitor-reported prices
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Whfo nontorsion joint prefab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $159.00 | $50.35 – $804.83 |
| UPMC Bedford | Everett | $585.60 | $180.12 – $853.20 |
| UPMC Cole | Coudersport | $670.80 | $212.42 – $894.40 |
| UPMC East | Monroeville | $201.60 | $16.72 – $804.83 |
| UPMC Hamot | Erie | $537.00 | $233.39 – $267.44 |
| UPMC Northwest | Seneca | $547.20 | $233.39 – $973.92 |
| UPMC Horizon-Greenville | Greenville | $339.60 | $233.39 – $804.83 |
| UPMC Magee | Pittsburgh | $165.60 | $106.49 – $804.83 |