Bx breast 1st lesion strtctc at WellSpan Waynesboro Hospital
501 E. Main St., Waynesboro, PA · Wellspan · · NPI 1821091059
$3,912.00
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.
$4,890.00
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.
$155.72 with UPMC_Medicare vs $6,630.03 with Highmark — 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_Medicare | UPMC_for_Life_Community_HealthChoices | $155.72 | ↓ -96% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $155.72 | ↓ -96% |
| UPMC_Medicaid | All_Plans | $156.46 | ↓ -96% |
| Health_Partners_Medicaid | All_Other_Plans | $176.36 | ↓ -95% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $185.38 | ↓ -95% |
| Geisinger_Medicaid | All_Plans | $185.38 | ↓ -95% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $185.38 | ↓ -95% |
| Amerihealth_Caritas_Medicaid | All_Plans | $210.59 | ↓ -95% |
| PA_Health_&_Wellness_Medicare | All_Plans | $1,724.26 | ↓ -56% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $1,727.47 | ↓ -56% |
| Highmark | All_Other_Plans | $1,727.47 | ↓ -56% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $1,727.47 | ↓ -56% |
| United_Medicaid | Community_Plan_For_Kids | $1,727.47 | ↓ -56% |
| Highmark_Medicare | All_Plans | $1,744.74 | ↓ -55% |
| Aetna_Advantra_Medicare | All_Plans | $1,779.29 | ↓ -55% |
| Aetna_Medicare | All_Plans | $1,779.29 | ↓ -55% |
| Devoted_Medicare | All_Plans | $1,813.84 | ↓ -54% |
| United_Medicare | ISNP_DSNP_Plans | $1,813.84 | ↓ -54% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $1,821.62 | ↓ -53% |
| Amerihealth_Medicare | All_Plans | $1,822.48 | ↓ -53% |
| Geisinger_Gold_Medicare | All_Plans | $2,159.34 | ↓ -45% |
| Highmark | Higmark_Healthy_Kids | $2,643.03 | ↓ -32% |
| Health_Partners_Medicaid | Kidz_Partners | $2,850.33 | ↓ -27% |
| UPMC | UPMC_For_Kids | $2,934.00 | ↓ -25% |
| Aetna | All_Plans | $3,286.08 | ↓ -16% |
| Cigna | All_Plans | $3,583.88 | ↓ -8% |
| Geisinger | All_Plans | $3,618.60 | ↓ -8% |
| Cigna | PPO_Plan | $3,762.86 | ↓ -4% |
| WellSpan_Capital_Blue_Cross | All_Plans | $4,401.00 | ↑ +13% |
| First_Health_Network | All_Plans | $4,645.50 | ↑ +19% |
| United_Healthcare | All_Plans | $4,665.06 | ↑ +19% |
| Highmark | My_Direct_Blue | $5,827.10 | ↑ +49% |
| Highmark | Shared_Cost_Blue_PPO | $5,827.10 | ↑ +49% |
| Aetna_Better_Health_Kids | All_Plans | $5,873.40 | ↑ +50% |
| Highmark | Blue_Cross_High_Performance_Network | $6,630.03 | ↑ +69% |
| Highmark | Choice_Blue_PPO | $6,630.03 | ↑ +69% |
| Highmark | Performance_Blue | $6,630.03 | ↑ +69% |
Visitor-reported prices
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Bx breast 1st lesion strtctc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,923.20 | $148.30 – $3,897.60 |
| UPMC Carlisle | Carlisle | $2,087.40 | $188.34 – $6,413.00 |
| UPMC Cole | Coudersport | $421.80 | $155.72 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,087.40 | $200.21 – $2,957.15 |
| UPMC Hamot | Erie | $7,023.60 | $163.13 – $900.48 |
| UPMC Northwest | Seneca | $5,112.00 | $163.13 – $1,621.93 |
| UPMC Hanover | Hanover | $2,087.40 | $188.34 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $4,273.80 | $155.72 – $919.85 |